无ROP早产儿视盘周围视网膜神经纤维层及黄斑区视网膜和脉络膜厚度分析

Analysis of optic nerve fiber layer,macular foveal layer and choroidal thickness in prematurity children without ROP

目的应用光学相干断层扫描(optical coherence tomography,OCT)测量早产儿视盘周围视网膜神经纤维层(retinal nerve fiber layer,RNFL)、黄斑中心凹处视网膜及黄斑中心凹下脉络膜的厚度,了解早产儿视网膜及脉络膜的结构特点。方法 2006年9月至2008年9月在南方医科大学珠江医院出生的31例(62眼)无早产儿视网膜病变(retinopathy of prematurity,ROP)的早产儿为早产儿组,同期出生的35例(70眼)足月儿为足月儿组。应用频域OCT行视盘环形扫描,测量不同象限和不同钟点范围的RNFL厚度并计算全周平均RNFL厚度;应用传统扫描方式和深度扫描图像增强技术对被检者眼黄斑中心凹水平和垂直方位进行扫描,测量黄斑中心凹处视网膜及中心凹下脉络膜厚度。结果早产儿各象限及全周平均RNFL厚度均较足月儿薄,其中下方、鼻侧及全周平均RNFL厚度与对照组比较差异均有统计学意义(均为P<0.01)。早产儿黄斑中心凹处视网膜厚度比足月儿厚,差异有统计学意义(P<0.001)。早产儿黄斑中心凹下脉络膜厚度与足月儿相比差异无统计学意义(P>0.05)。结论早产儿RNFL厚度较足月儿薄,黄斑中心凹处视网膜厚度比足月儿厚,黄斑中心凹下脉络膜厚度无明显差异。

Objective To comprehend structural features of retina and choroid in prematurity by measuring retinal nerve fiber layer（RNFL）,macular foveal thickness and choroidal thickness by spectral-domain optical coherence tomography（SD-OCT）.Methods Thirtyone prematurity（62 eyes）,who were born during September 2006 and September 2008 in Zhujiang Hospital Affiliated to Southern Medical University,were set as research group,and35 full-term children（70 eyes） who were born at same and place were set as control group.SD-OCT was used to measure RNFL thickness with circle scan around optic nerve,and the horizontal and vertical SD-OCT crosshair scans were performed through the foveal with or without an enhanced depth technique in all subjects.RNFL,retinal layer and choroidal thicknesses were measured.Results The mean RNFL thickness of each quadrant in prematurity group was significantly thinner than that of control group,and there were statistical differences in the mean and inferior,nasal of RNFL（all P〈0.01）.The macular foveal thickness in prematurity group was significantly thicker than that in control group（P〈0.001）.There was no statistical difference in choroidal thickness under macular fovea between two groups（P〉0.05）.Conclusion RNFL thickness in prematurity is thinner than that in full-term children,macular foveal retinal thickness is thicker,but no statistical difference is found in macular foveal thickness.