青少年近视患者视网膜厚度与屈光度的关系研究

Relationship between retinal thickness and refractive error in juvenile myopia patients

目的:探讨青少年近视患者视盘周围视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度与等效球镜数(spherical equivalent,SE)以及眼轴长度(axial length,AL)的关系。方法:本研究纳入对象为2015-12/2017-12于我院诊断的100例200眼青少年近视患者,按SE<-3.00D、-3.00D≤SE≤-6.00D、SE>-6.00D设为低、中、高度近视组,分别为34例68眼、36例72眼、30例60眼,选择30例60眼正常视力青少年设为对照组。光学相干断层成像术(optical coherence tomography,OCT)测量所有待检者上、下、鼻、颞4个象限RNFL厚度以及视盘全周平均RNFL厚度,采用A超测量AL,并通过Pearson相关分析法对视盘全周平均RNFL厚度与SE绝对值、AL的相关性进行分析。结果:低度组、中度组、高度组的上、下、鼻、颞4个象限RNFL厚度以及视盘全周平均RNFL厚度均显著低于对照组,差异有统计学意义(P<0.05),低度组、中度组、高度组RNFL厚度逐渐降低,组间比较差异有统计学意义(P<0.05);低度组、中度组、高度组SE逐渐降升高,组间比较差异有统计学意义(P<0.05),均显著高于对照组,差异有统计学意义(P<0.05);对照组、低度组、中度组、高度组AL逐渐升高,组间比较差异有统计学意义(P<0.05);视盘全周平均RNFL厚度与SE绝对值呈负相关(r=-0.564,P<0.001),与AL呈负相关(r=-0.423,P<0.001)。结论:RNFL厚度与SE和AL呈负相关关系,提示RNFL厚度越薄青少年近视患者近视越严重。

AIM： To investigate the relationship between retinal nerve fiber layer（RNFL）thickness and spherical equivalent（SE）refraction and axial length（AL）in juvenile myopic patients. METHODS： Totally 100 cases（200 eyes）of juvenile myopia diagnosed in our hospital from December 2015 to December 2017 were selected. Patients were divided referring to the SE, in which 34 cases（68 eyes）with SE 〈-3.00D were divided into low myopia group, 36 cases（72 eyes）with -3.00D≤SE≤-6.00D were divided into moderate myopia group, 30 cases（60 eyes）with SE〉-6.00D were divided into high myopia group. And 30 patients（60 eyes）with normal visual acuity were selected as the control group. The average RNFL of the whole visual field and the RNFL of upper visual field, inferior visual field, nasal visual field, and temporal visual field were measured by optical coherence tomography（OCT）. AL was measured by A-scan. Pearson correlation analysis was used to analyze the correlation between the average RNFL thickness of whole visual field and the absolute value of SE and AL. RESULTS： The average RNFL of the whole visual field and the RNFL of upper visual field, inferior visual field, nasal visual field, and temporal visual field in three myopia groups were significantly lower than those of the control group, the difference was statistically significant（P〈0.05）. The RNFL of four visual fields in three myopia groups decreased in turn（P〈0.05）. The SE of the three myopia groups increased in turn（P〈0.05）. And the SE of three myopia groups were significantly higher than those of control group, the difference was statistically significant（P〈0.05）. The AL of control group, low myopia group, moderate myopia group, and high myopia group increased in turn with significant differences（P〈0.05）. The average RNFL of the whole visual field was negatively correlated with the absolute value of SE（r=-0.564,P〈0.001）and AL（r=-0.423, P〈0.001）. CONCLUSION： RNFL thickness was negatively correlated with SE but positively correlated with AL, suggesting that juvenile with thinner RNFL thickness has more severe myopia.