高度近视眼黄斑部不同区域神经上皮厚度的定量测定及其意义

Measurement of macular neurosensory retinal thickness in eyes with high myopia by optical coherence tomography

目的研究高度近视眼黄斑部不同区域的神经上皮层厚度的变化,并分析其与屈光度之间的相关性。方法选取高度近视眼患者78例,按屈光度不同分为A(-6.0^-9.0 D)、B(-9.1^-15.0 D)、C(>-15.0 D)三组。采用Huphery-3000光学相干断层扫描(optical coherence tomogra-phy,OCT)测量黄斑部9个不同分区的视网膜神经上皮层厚度,比较它们之间的差别,并分析各区域神经上皮层厚度与屈光度之间的相关性。结果C组A2~A6区视网膜神经上皮厚度分别为(244.31±24.46)mm、(224.73±27.45)mm、(236.08±27.71)mm、(236.15±34.10)mm与(219.88±20.42)mm,与A、B组比较差别有显著性(P<0.001),其余各区组间差别不明显;A2~A6区视网膜神经上皮厚度与近视屈光度明显相关,r分别为0.387、0.462、0.315、0.403、0.326,经统计学检验发现,差异有显著性(P<0.05)。结论高度近视眼黄斑部神经上皮损害随近视屈光度不断增高而呈区域选择性萎缩变薄,OCT将为追踪观察此种损害提供理想方法。

Objective To investigate changes of aenresensory retinal thickness in different region of maoxlar in eyes with high myopia by optical coherence tomograpby （OCT）. Its clinical meanings were also analyzed. Methods According to spherical equivalent （SE）, 78 eyes were divided into three, groups： group A with SE from - 6.0 D to - 9.0 D （14 eyes）, group B ： from - 9.1 D to - 15.0 D（ 38 eyes ）, and group C： over - 15.0 D （26 eyes）. Neurosensory retinal thickness in different rngions of macular was measured and recorded by OCT （Huphery-3000）. And the correlations between retinal thickness of various macular regions and SE were analyzed. Results The macular neurosensory retinal thickness in every regions in group C was thinner than those in groups A and B Among the group C, there was a descent trend of macolar neurosensory retinal thickness from A2 to A6 whose thickness were. （244.31 ± 24.46）μm, （224.73 ± 27.45）μm, （236.08 ± 27.71）μm, （236.15 ± 34.10）μm and （219.88 ± 20.42）μm respectively. There were significant difference among various groups（ P 〈 0. 001 ）, and there were significant correla6om between between neurosensory retinal thickness of each macular regions from A2 to A6 and SE（r=0.387,0.462,0.315,0.403 and 0.326 respectively）.Conclusion With increases of myopic diopters the neurosensory retinal thickness of macular in regions from A2 to A6 were decreased that indicates regional selectivity.OCT would offer an ideal metbod for this exmination.