OCT对弱视儿童黄斑区视网膜参数测量分析

Measurement and analysis of macular parameters in children with amblyopia by OCT

目的应用相干光断层扫描(OCT)对弱视儿童黄斑区视网膜参数进行测量,探讨弱视发病机制。方法选取2014年11月至2017年1月在我院收治5~14岁单眼屈光参差性弱视患者38例(38只眼)为观察组,其中近视性弱视17例(17只眼),远视性弱视21例(21只眼),38例患者对侧非弱视眼为对照组(38只眼)。行SD-OCT快速扫描黄斑各区视网膜厚度。结果近视组患者视盘周围平均视网膜神经纤维层(RNFL)厚度薄于对照组患者,远视组患者视盘周围平均RNFL厚度厚于对照组和近视组患者(P<0.05)。观察组患者黄斑A1、A2、A3区视网膜厚度均厚于对照组患者,视网膜容积均大于对照组患者(P<0.05)。两组患者黄斑A4、A5、A6、A7、A8、A9区视网膜厚度和视网膜容积比较,差异无统计学意义(P>0.05)。远视组患者黄斑A4、A6、A7、A8区视网膜厚度均厚于近视组患者,差异有统计学意义(P<0.05)。两组患者黄斑A1、A2、A3、A5、A9区视网膜厚度比较,差异无统计学意义(P>0.05)。结论 OCT可以准确测量弱视儿童黄斑各区视网膜结构和厚度,并且安全可靠,可客观评估弱视预后情况。

Objective To analyze the macular parameters of OCT(optical coherence tomography)in amblyopic children and to explore the mechanism of amblyopia.Methods From November 2014 to January 2017 in our hospital from 5 to 14 years old of monocular anisometropic amblyopia and 38 cases(38 eyes)as the observation group,17 cases(17 eyes)of myopic amblyopia,Hyperopia Amblyopia in 21 cases(21 eyes),38 cases of patients with contralateral non amblyopic eyes in control group(38 eyes).Line SD-OCT quickly scans macular retinal thickness.Results The average thickness of RNFL in patients with myopia was thinner than that in the control group.The average RNFL thickness of the optic disc in the hyperopia group was thicker than that in the control group and the myopia group(P<0.05).The retinal thickness of macular A1,A2 and A3 in the observation group was thicker than that in the control group,and the retinal volume was greater than that of the control group(P<0.05).Macular A4,A5,A6,A7,A8,A9,retinal thickness and retinal volume in the two groups were not statistically significant(P>0.05).The macular thickness of macular A4,A6,A7,A8 in patients with hyperopia was thicker than that in myopic group,the difference was statistically significant(P<0.05).Two groups of patients with macular A1,A2,A3,A5,A9 area of retinal thickness,the difference was not statistically significant(P>0.05).Conclusions OCT is a safe and reliable method for the accurate measurement of retinal structure and thickness in children with amblyopia.