应用光学相干断层成像术检测中国儿童青少年正常眼视网膜神经纤维层厚度

Retinal nerve fiber layer thickness measured by optical coherence tomography in Chinese children and teenagers

目的建立应用光学相干断层成像术(optical coherence tomography,OCT)检测的中国儿童及青少年正常眼视盘周围视网膜神经纤维层厚度(retinal nerve fiber layerthickness,RNFLT)参考值,并研究RNFLT各参数值与性别、眼别、屈光度和年龄的关系。方法选取5～18岁的正常中国儿童青少年199例(398眼),应用OCT测量全周平均以及不同象限和不同钟点位的RNFLT,7个和RNFLT相关的参数由RNFL厚度平均分析仪分析得出,分析年龄、性别、眼别、屈光度等多个因素对RNFLT的影响。结果全周平均RNFLT为(112.36±9.21)μm,上方、鼻侧、下方和颞侧的RNFLT分别为(148.73±17.06)μm、(74.84±15.03)μm、(142.08±16.03)μm、(83.82±13.53)μm,其中上方最厚,其次是下方、颞侧和鼻侧。不同性别RNFLT的3个参数间差异有统计学意义(均为P<0.05),分别是右眼上方厚度最大值/下方厚度最大值、左眼9点钟位和左眼颞侧RNFLT,其他各参数性别间差异无统计学意义(均为P>0.05)。眼别对RNFLT有影响,年龄和屈光度与全周平均RNFLT呈正相关。结论本研究建立了正常中国儿童及青少年RNFLT和相关参数的正常参考值,有助于为涉及RNFL改变的疾病诊断和随诊提供标准。

Objective To establish a reference range of retinal nerve fiber layer （RNFL） thickness （RNFLT） by optical coherence tomography （OCT） in Chinese chil- dren and teenagers, and investigate its relationship with gender, age, eye side, and re- fractive error. Methodu A total of 398 eyes from 199 normal Chinese aged from 5 years old to 18 years old were recruited for this study. Their RNFLT at different quad- rant were measured by OCT, and seven parameters associated with RNFLT were ana- lyzed by the RNFLT average analysis program. The influences of several factors （ such as gender, age, eye side, and refractive error）on RNFLT were also analyzed. Results The global average RNFLT was （ 112.36± 9.21 ） μm in the present cohort. The RNFLT at the superior, inferior, nasal and temporal quadrant were （ 148. 73 ± 17. 06 ） μm, （ 142.08 ± 15.03 ） μm, （74.84± 15.03 ）μm and （ 83.82± 13.53 ） μm, respectively, the su- perior was thickest, followed by the inferior, nasal and temporal. There was no signifi- cant difference in three indexes （ superior thickest/ inferior thickest in right eye, nine o＇ clock in left eye and temporal thickness in left eye） of RNFLT between boys and girls （ all P 〈 0.05 ）, and there was no statistical difference in other indexes （ all P 〉 0.05 ）. The eye side had effect on RNFLT, the average RNFLT was positively correlated with the age and refractive error. Conclusion This study has established a normal stand- ard reference of RNFLT and its related indexes by OCT in Chinese children and teenag- ers,which is helpful for providing the standard for diagnosis and follow-up of diseases involving in RNFL changes.