摘要
目的：通过测量6．18岁正视和近视儿童青少年盘周神经纤维层（RNFL）厚度，分析盘周平均RNFL厚度及相关的影响因素，研究不同屈光状态下盘周RNFL厚度分布地形图特点。方法：横断面研究。采用频域光学相干断层扫描仪测量6～18岁正视和近视儿童青少年盘周RNFL厚度，测量眼部及全身生物学指标（包括身高、体质量、体质量指数、头围、胸围、腰围、血压等）。根据等效球镜度（SE）分为不同的屈光组（包括正视组、低度近视组、中度近视组和高度近视组），分析不同屈光状态下盘周不同区域RNFL厚度和地形图及厚度变化的影响因素。盘周RNFL厚度与各测量指标之间的相关性采用一元和多元逐步回归，各个组之间的差异采用单因素方差分析。结果：1056名正视和近视儿童青少年盘周各区域平均RNFL厚度为（104±10）μm，正视组为（107±9）μm，低度近视组为（105±9）μm，中度近视组为（101±10）μm，高度近视组为（95±8）μm。不同屈光组之间RNFL厚度差异均具有统计学意义（P〈0．01）。多元逐步回归显示RNFL平均厚度与SE（r=0．25，P〈0．001）、眼轴长度（AL）（r=0．18，P〈0．001）和晶状体厚度（LT）（r=0．10，P=-0．033）有相关性，与SE和LT呈正相关，与AL呈负相关；与性别、年龄等其他因素无相关性。不同屈光组，盘周RNFL厚度分布地形图不同。所有参与者的颞下象限最厚，为（162±23）μm，鼻侧象限最薄，为（61±10）gm。正视组和不同程度近视组中RNFL厚度均为颞下象限最厚，鼻侧象限最薄，其他区域的厚度地形图在不同的屈光组是不同的。颞侧盘周RNFL厚度随近视程度增加而增加，低度近视组为（87±14）gm，高度近视组为（98±21）gm；而其他区域的RNFL厚度则随着近视度数的增加而降低，尤其是鼻下象限。结论：盘周RNFL平均厚度与sE和LT呈正相关，与AL呈负相关；近视程度不同，盘周各区域RNFL厚度分布不同；颞侧RNFL随近视程度增加而逐渐变厚，其余象限则变薄。
Objective： To establish a database of the peripapillary retinal nerve fiber layer （RNFL） thickness in myopic and emmetropic children; to analyze the thickness and distribution of the peripapillary RNFL topographical map in children and adolescents with different degrees of myopia; and to measure regional differences in the thickness of the peripapillary RNFL and the factors that influence it in myopic and emmetropic children. Methods： This was a population-based, cross-sectional study. The average thickness of the peripapillary RNFL in children 6-18 years old was measured by spectral domain-optical coherence tomography. Ophthalmic parameters and systemic parameters, including height, weight, body mass index, head circumference, chest circumference, waist circumference, and blood pressure were measured. The children were divided into different refractive groups based on spherical equivalent （SE）. The thickness of the peripapillary RNFL in different quadrants under different refractive conditions and relevant influencing factors were analyzed. The correlation between the average RNFL thickness and all parameters was analyzed by a simple linear regression and multiple stepwise regression. Differences between the groups were analyzed by one-way analysis of variance. Results： The average thickness of the peripapillary RNFL in 1 056 myopic and emmetropic children was 104±10μm. It was 107±9μm for emmetropes, and 105＋9 pm for mild myopes, 101±10μm for moderate myopes, and 95±8μm for high myopes. The RNFL in emmetropes was thicker than in mild myopes （P=0.007） and moderate and high myopes （P〈0.001 each）. The RNFL thickness was positively correlated with SE （r=0.25, P〈0.001） and lens thickness （r=0.10, P=0.033）. It was negatively correlated with axial length （r=-0.18, P〈0.001）, but not correlated with age, sex, or other parameters. In all subjects, the inferior temporal quadrant was thickest, 162±23μm, and the nasal quadrant thinnest, 61±10μm. The topographical distribution for each group was different. The infratemporal sector was the thickest, and the nasal sector was the thinnest. The thickness of the temporal peripapillary RNFL increased with an increase in the degree of myopia. In mild myopes it was 87±14μm, and in high myopes it was 98±21μm.. The thickness in other quadrants changed in the opposite direction, especially the infranasal sector. Conclusions： The average thickness of the peripapillary RNFL was positively correlated with SE and lens thickness, and negatively correlated with axial length. The topographical distribution was different in each myopia group. The thickness of the temporal quadrant gradually increased with increased degree of myopia, while that of the other quadrants decreased.
出处
《中华眼视光学与视觉科学杂志》
CAS
CSCD
2017年第8期454-461,共8页
Chinese Journal Of Optometry Ophthalmology And Visual Science
基金
临沂市科技发展计划项目（201616018）
山东省医药卫生科技发展计划项目（2015WS0368）
