六岁儿童黄斑厚度测量及其相关因素分析

Macular thickness measurement of six-year-old children and analysis of its relevant factors

目的 观察正常6岁儿童黄斑厚度特征,分析其与眼轴、性别、屈光状态和种族的关系.方法 随机抽取悉尼市区34所小学中平均年龄为6岁的1543名儿童.采用光相干断层扫描（OCT）测定其黄斑中心环（CM）、内环（IM）、外环（OM）厚度,对比分析不同性别、种族儿童间黄斑厚度的差异.所有儿童均采用光学生物测量仪测定眼轴长度,自动屈光仪RK-F1测量屈光状态,分析CM、IM、OM厚度与眼轴、屈光状态的关系.结果 儿童CM、IM和OM厚度均呈正态分布,分别为193.6、264.3、236.7μm,各环之间差异有统计学意义（t=0.40,0.08,0.20;P值均＜0.05）.男性CM、IM、OM厚度分别为194.2、264.9、229.0 μm,女性CM、IM、OM厚度分别为189.3、262.5、231.5μm.两者比较,男性CM和IM厚度较女性厚,差异有统计学意义（t=0.15,0.11;P值均＜0.05）.白种人CM、IM、OM厚度分别为196.0、265.2、237.5μm,东亚人CM、IM、OM厚度分别为186.0、262.3、236.5μm,中东人CM、IM、OM厚度分别为193.4、263.7、233.8μm.白种人、中东人CM和IM厚度较东亚人厚,差异有统计学意义（t=0.12,0.15;P值均＜0.05）,3者间OM厚度差异无统计学意义（t=0.16,P=0.6）.IM和OM厚度随眼轴增长而明显变薄（P＜0.05）,CM、IM和OM厚度随远视度数增加而变厚（P＜0.05）.结论 正常6岁儿童的黄斑厚度呈正态分布,性别、种族,眼轴和屈光度明显影响黄斑的厚度.

Objective To observe the distribution of macular thickness and its relationship with axial length, gender, refraction status and race in six-year-old children. Methods 1543 six-year-old children from 34 schools in Sydney were randomly selected. The thickness of center macula（CM）, inner macula（IM）and outer macula （OM）were measured by optical coherence tomography （OCT）, the differences of macular thickness between different genders and races were comparatively analyzed. The axial length and refraction status of all children were measured by IOL Master and autorefractor RK-F1 respectively. Results The CM, IM and OM thickness of all those six-year-old children were normally distributed,on average they were 193.6, 264.3 and 236.9 μm respectively, the differences were statistically significant （t = 0.40,0. 08,0.20;P〈0. 05）. The CM,IM and OM average thickness was 194.2,264.9,229.0 μm for boys and 189.3,262.5,231.5 μm for girls respectively. CM and IM thickness of boys were thicker than those in girls（t=0. 15,0. 11;P〈0. 05）. The CM, IM and OM average thickness was 196.0,265.2,237.5 μm for White kids,186.0,262.3,236.5 μm for East Asia kids and 193.4,263.7,233.8 μm for Central East kids respectively.The CM and IM thickness of White and Central East children were significantly thicker than East Asia children （t=0. 12,0.15; P〈0.05）. There was no difference between these three races in OM thickness（t=0. 16,P=0.6）. The IM and OM were thinner with longer axial length （P〈0. 05）. The CM,IM and OM thickness was thicker with higher hyperopic degrees （P 〈0. 05）. Conclusions Macular thickness was normally distributed in six-year-old children and was significantly affected by gender, race, axial length and refraction status.