近视眼患者近视程度对视网膜神经纤维层厚度的影响

The relationship between myopia and retinal nerve fiber layer thickness

目的探讨近视眼患者近视程度对视网膜神经纤维层(RNFL)厚度的影响。方法 2012年7月至2015年2月选择在我院就诊的近视患者120例作为近视组,同期选择在我院健康体检的正常视力受试者120例作为正常组,都进行了眼部常规指标的检测与RNFL厚度检测,并进行了相关性分析。结果近视组120例中判定低度近视74例,中度近视26例,高度近视20例,平均屈光度分别为(-2.08±0.66)D、(-4.73±0.82)D、(-6.85±0.57)D,而正常组为(-10.06±2.318)D。近视组的上方120°范围RNFL厚度的平均值(SA值)明显低于正常组(P<0.05),而环形区域的神经纤维指数(NFI值)明显高于正常组(P<0.05),同时SA在高度近视组较低、中度近视组均显著减少(P<0.05),NFI在高度近视组较低、中度近视组均显著增加(P<0.05)。进行多元线性逐步回归分析显示在近视眼患者中,SA与眼轴长度呈负相关,相关系数r=-0.298(P<0.05),与近视屈光度和眼压呈正相关,相关系数分别为r=0.323(P<0.05),r=0.184(P<0.05);NFI与眼轴长度呈正相关,相关系数r=O.424(P<0.05),与近视屈光度呈负相关,相关系数r=-0.461(P<0.05)。结论近视眼患者都伴随有RNFL厚度变薄,而随着近视程度的增加,SA值与NFI值都有明显波动,主要的影响因素包括眼轴长度、近视屈光度、眼压等,相干光断层扫描能取得比较好的检测效果。

Objective To investigate the effect of the degree of myopia myopic retinal nerve fiber layer thickness.Methods Authors enrolled 120 myopia patients who visited our hospital between July 2012 and February 2015 as subjects. Another 120 normal subjects（ normal visual acuity） served as control group. All subjects received routine eye examinations and retinal nerve fiber layer thickness measurement. Results Among 120 myopia patients,74 were low degree myopia,26 were moderate myopia and 20 were high myopia. Average refraction error were- 2. 08 ± 0. 66 D,- 4. 73 ± 0. 82 D,and- 6. 85 ± 0. 57 D,respectively. In normal group average refraction was- 10. 06 ± 2. 318 D. SA value in the myopia group was significantly lower than in normal group（ P〈0. 05）,while the NFI values was significantly higher（ P〈0. 05）. High myopia patients showed lower SA values（ P〈0. 05） and higher NFI（ P〈0. 05）. Multiple linear regression analysis showed that in patients with myopia,SA was negatively correlated with axial length r =- 0. 298（ P〈0. 05）,and positively correlated with myopia degrees（ r = 0. 323,P〈0. 05）,intraocular pressure（ r = 0. 184,P〈0. 05）. NFI was positively correlated with axial length（ r = 0. 424,P〈0. 05） and negatively correlated with myopia degrees（ r =- 0. 461,P〈0. 05）. Conclusion Myopia is accompanied by thinning of the retinal nerve fiber layer. With the increasing degrees of myopia,SA values and NFI has significant fluctuations in value. Other factors include axial length myopia and intraocular pressure. Optical coherence tomography can be used to detect these changes.