上海6～17岁学生正常眼视盘旁视网膜神经纤维层厚度值研究

Retinal nerve fiber layer thickness in normal students aged 6 to 17 years in Shanghai

目的测量6到17岁国人正常眼视盘旁视网膜神经纤维层（retinal nerve fiber layer，RNFL）厚度值，探讨相关因素，为青光眼的诊断和手术预后判断提供资料。方法2011年10月至11月期间随机选取2006名（3915只眼）年龄在6到17岁，平均（13．24±2．94）岁的身体健康眼部正常青少年，采用光学相干断层扫描技术（Optical Coherence Tomography，OCT）行眼部检查，分析不同性别、眼别、年龄等对RNFL厚度的影响。结果正常青少年平均RNFL厚度在视盘全周为（105．78±12．13）μm，上方象限为（130．78±19．41）μm，鼻侧象限为（78．45±17．10）μm，下方象限为（128．45±20．67）μm，颞侧象限为（85．30±12．38）μm。不同眼别之间的RNFL厚度存在差异统计学意义（P〈0．05）。在下方象限、颞侧象限以及全周RNFL厚度值上，女性比男性厚（P〈0．05）。12岁以上青少年的年龄、等效球镜度数和眼轴长度都与RNFL厚度之间存在负相关关系（P〈0．05）。结论临床评价青少年的RNFL厚度值时需要考虑性别、眼别、年龄、屈光状态和眼轴长度的影响。

Objective To obtain retinal nerve fiber layer （RNFL） thickness measurements in nor- mal Chinese students aged 6 to 17 years, and to investigate the relationship between RNFL thick- ness and gender, eyes, age, axial length and refractive error. Methods A total of 3,915 eyes from 2, 006 normal Chinese students aged 6 to 17 years, randomly selected, were recruited for study. RNFL thickness was measured by optical coherence tomography （OCT）. The effects of gender, left or right eye, age and refractive error on RNFL thickness were also assessed. Results The average age of subjects was 13.24±2.94 years. The global average RNFL thickness （is） was 105.78±12.13μm. The thickest RNFL measurements were found at the superior （130.78±19.41μm） and inferior （128.45±20.67 μm） quadrants of the retina, followed by the temporal （85.30±12.38μm） and nasal （78.45±17.10μm） quadrants. Both gender and eye side had statistically significant differences in RNFL thicknesses （P 〈 0.05）. The average RNFL thickness was positively correlated with the axial length, age and refrac- tive error （P 〈0.05）. Conclusions For clinical assessments of RNFL thickness, the influence of gen- der, eye side, age, refractive error and axial length should be recognized.