难治性弱视眼的视网膜厚度分析

The analysis of the retinal thickness in refractory amblyopia eyes

目的检测难治性弱视眼的视网膜厚度，探讨难治性弱视是否存在视网膜形态学改变。方法对2010年5月至2011年4月在威海市立二院眼科从门诊患儿中选择难治性弱视眼27例30只眼作为实验组；另选非难治性弱视眼22例30只眼为非难治组；屈光度〈±1．00D的同龄正常儿19名30只眼为对照组。利用光学相干断层扫描技术（OCT）对被检眼的黄斑区进行快速扫描，测量黄斑中心凹、中心区（1mm直径范围）及旁中心区（直径为3mm环形区域内）上方、下方、鼻侧、颞侧的平均视网膜厚度，比较不同区域视网膜厚度之间的差别。三组数据，两两比较，分别采用t检验。结果难治性弱视眼、非难治性弱视眼与正常对照眼的黄斑中心凹厚度和黄斑中心区平均厚度，三组两两比较，差异均有统计学意义（f值分别为-2．27、-2．19、-5．10、-3．73、-2．96、-2．05，P均〈0．05）。而黄斑旁中心区上方、下方、鼻侧及颞侧视网膜厚度，四象限区域视网膜厚度在三组之间，差异均无明显统计学意义（P〉0．05）。结论难治性弱视眼黄斑中心凹、中心区视网膜厚度增加，这种改变可能与难治性弱视眼的发病机制有关。

Objective To detect the retinal thickness in refractory amblyopia eyes, and to investi- gate the morphologic changes of retina. Methods All cases were collected from Out-patient Depart- ment. Twenty-seven cases （30 eyes） of refractory amblyopia eyes were selected as the experimental group. In addition, 22 cases （30 eyes） of recovered amblyopia eyes and 19 eases （30 eyes） of nor- mal eyes with the same age （diopter 〈± 1.00D） were selected as the normal control group. These eyes were fast-scanned by using Optical Coherence Tomography （OCT） in the macula. The average thickness of the foveola, the fovea （1-mm diameter range） and the superior, inferior, nasal, temporal parafovea （the ring of 3-mm diameter） were then assessed by macular retinal tomography map mea- surement. Finally, the results were analyzed statistically and the retinal thickness was compared in different areas. Results There was significant difference in the foveola and fovea thickness between refractory amblyopia eyes and the other eyes （P 〈0.05）. There was no significant difference in the thickness of superior, inferior, nasal, temporal parafovea between them （P 〉0.05）. Conclusions The retinal thicknesses of foveola and fovea in refractory amblyopia eyes are thicker than the others. The changes may be related to the pathogenesis of refractory amblyopia.