斜视患儿视网膜神经纤维层厚度不同分区变化特点

Characteristic of retinal nerve fiber layer thickness at different partitions for pediatric strabismus

目的探讨斜视患儿视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度不同分区变化特点。方法选择2010年6月至2014年6月在我院眼科就诊的斜视患儿80例(80眼)作为观察组,选择同期在我院进行健康体检的儿童80例(80眼)作为对照组,两组都进行屈光度与眼轴长度的测定,同时进行各分区RNFL厚度的测定与视盘面积分析。结果观察组与对照组的等效球镜度数绝对值、眼轴长度、视盘面积、盘沿面积、校正视盘面积、校正盘沿面积等数据差异均无统计学意义(均为P>0.05)。观察组的上方、鼻侧、下方、颞侧及全周RNFL厚度分别为(146.82±15.02)μm、(85.92±12.00)μm、(148.26±16.90)μm、(94.20±13.45)μm、(119.37±10.62)μm,均高于对照组的(132.97±10.82)μm、(75.46±11.89)μm、(136.92±14.20)μm、(81.40±14.02)μm、(105.35±11.38)μm,差异均有统计学意义(均为P<0.05)。轻度、中度、重度斜视患儿各分区及全周的RNFL厚度均明显高于对照组(均为P<0.05),但不同程度斜视患儿间RNFL厚度差异均无统计学意义(均为P>0.05)。相关性分析结果显示等效球镜度数绝对值和眼轴长度可影响RNFL厚度的变化(均为P<0.05)。结论斜视儿童RNFL各分区及全周厚度均较正常眼明显增加,与疾病程度无明显相关性。

Objective To investigate the characteristic of retinal nerve fiber layer thickness at different partition for pediatric strabismus. Methods A total of 80 pediatric strabismus from June2010 to August June 2014 in our hospital of ophthalmology were selected as the observation group,and 80 healthy children were selected as the control group at the same period in our hospital,the diopter and axial length of both groups were measured,and disc partition retinal thickness and disc area were measured simultaneously. Results There was no statistical difference in spherical equivalent absolute axial length,optic disc area,rim area,calibration disc area,rim area,such as calibration data between observation group and control group（ all P〉0. 05）. The anterior,nasal,inferior,temporal side and entire circumference of retinal nerve fiber layer thickness in the observation group were（ 146. 82 ± 15. 02） μm,（ 85. 92 ± 12. 00） μm,（ 148. 26 ± 16.90） μm,（ 94. 20 ± 13. 45） μm,（ 119. 37 ± 10. 62） μm,respectively,were higher than those of（ 132. 97 ± 10. 82） μm,（ 75. 46 ± 11. 89） μm,（ 136. 92 ± 14. 20） μm,（ 81. 40 ± 14. 02） μm,（ 105. 35 ± 11. 38） μm in the control group,the differences were statistically significant（ all P〈0. 05）. The retinal nerve fiber layer thickness in children with mild,moderate and severe strabismus were higher than those in the control group（ P〈0. 05）,but there was no statistical difference among the different degrees of strabismus（ all P〉0. 05）. Correlation analysis showed that the absolute value of spherical equivalent and axial length could affect the retinal nerve fiber layer thickness changes（ all P〈0. 05）. Conclusion The retinal nerve fiber layer thickness at different partitions and entire circumference in the pediatric strabismus is higher than those of the normal eye,it has no significant correlation with the extent of the disease.