健康学龄儿童视网膜血管发育的临床研究

Retinal vessel development in healthy children

目的探讨健康学龄儿童视网膜血管发育的情况。方法横断面研究。收集2019年1月至2019年7月于成都爱尔眼科医院体检的健康学龄儿童和成年人共50例(50只眼)的临床资料。其中,儿童25例(25只眼),男性10例(10只眼),女性15例(15只眼),年龄4~11岁,平均年龄(6.68±2.22)岁;成年人25例(25只眼),男性9例(9只眼),女性16例(16只眼),年龄25~40岁,平均年龄(32.45±5.10)岁。根据年龄分为儿童组和成人组。检查并收集全部受检者的视力、眼压、血压、眼轴长度、视盘周围视网膜血流密度(VD)及视网膜神经纤维层(RNFL)厚度,采用均数±标准差描述。上述指标,儿童组与成人组组间比较采用独立样本t检验,组内比较采用配对t检验;此外,收集并记录受检者的性别资料,以例数和百分比进行描述,组间比较采用卡方检验。VD与各个因素的相关性,使用Person相关系数进行评价。结果儿童组受检者视盘周围上方、下方、鼻侧及颞侧区域四个象限的VD分别为(19.48±0.46)mm^-1、(19.78±0.37)mm^-1、(18.70±0.69)mm^-1及(20.05±0.74)mm^-1;成人组分别为(19.25±0.53)mm^-1、(19.67±0.51)mm^-1、(18.53±0.81)mm^-1及(19.43±1.37)mm^-1。经配对t检验,两组VD均一致表现为下方象限大于上方,差异有统计学意义(t=-2.890,-3.535;P<0.05);颞侧大于鼻侧,差异有统计学意义(t=-3.429,-7.619;P<0.05);独立样本t检验分析儿童组与成人组组间各象限VD差异均无统计学意义(t=-1.660,-0.925,-0.802,-2.201;P>0.05)。儿童组视盘周围上方、下方、鼻侧及颞侧的RNFL厚度分别为(132.92±14.16)μm、(135.63±14.82)μm、(70.50±12.43)μm及(80.71±13.50)μm;成人组分别为(132.40±19.33)μm、(138.16±16.71)μm、(74.08±13.59)μm及(81.12±11.95)μm。Person相关系数分别评价儿童组和成人组各象限VD与RNFL厚度呈正相关,且具有一致的象限性,差异有统计学意义(r=0.403,0.418;P<0.05)。结论健康学龄儿童视盘周围视网膜血管已发育至成人水平,且与RNFL厚度具有一致的象限性分布。

Objective The aim of this study was to investigate the development of retinal vessel in healthy children.Methods Cross-sectional study.The clinical data of 50 healthy children and adults(50 eyes)who were examined in Aier Eye Hospital(Chengdu)from January 2019 to July 2019 were collected.The children group recruited 25 children(25 eyes),including 10 males(10 eyes)and 15 females(15 eyes).They were 4 to 11 years-old with an average age(6.68±2.22)years-old.The adults group recruited 25 adults(25 eyes),including 9 males(9 eyes)and 16 females(16 eyes),with an average age(32.45±5.10)years-old ranging from 25 to 40 years-old.Visual acuity,intraocular pressure,blood pressure,axial length,peripapillary vessel density(VD)and retinal nerve fiber layer(RNFL)thickness were collected and described by mean±SD.The independent sample t-test was used for the comparison between two groups;the paired t-test was used for the comparison within the group and the correlation between VD and various factors was evaluated by Person correlation coefficient.Results The VD of the four quadrants of superior,inferior,nasal and temporal around the optic disc was(19.48±0.46)mm^-1,(19.78±0.37)mm^-1,(18.70±0.69)mm^-1 and(20.05±0.74)mm^-1 in the children group,and(19.25±0.53)mm-1,(19.67±0.51)mm^-1,(18.53±0.81)mm^-1 and(19.43±1.37)mm^-1 in the adults.According to paired t test,VD in the inferior was significantly greater than that in the superior in both groups(t=-2.890,-3.535;P<0.05),while that in the temporal was significantly greater than that in the nasal(t=-3.429,-7.619;P<0.05).There was no statistical significance in VD in each quadrant between two groups(t=-1.660,-0.925,-0.802,-2.201;P>0.05).RNFL in children of four quadrants of superior,inferior,nasal and temporal around the optic disc was(132.92±14.16)μm,(135.63±14.82)μm,(70.50±12.43)μm and(80.71±13.50)μm;while that in adults was(132.40±19.33)μm,(138.16±16.71)μm,(74.08±13.59)μm and(81.12±11.95)μm,respectively.There was a positive correlation between VD and RNFL in each quadrant of both groups(r=0.403,0.418;P<0.05).Conclusions The development level of the peripapillary vessel in healthy school-age children had the same with adults,and the thickness of the peripapillary vessel had the same the quadrant distribution with RNFL.