学龄期儿童远视性弱视脉络膜及视网膜厚度的研究

Study on choroidal and retinal thickness in school-age children with hyperopic amblyopia

目的研究不同严重程度弱视儿童的脉络膜厚度及视网膜厚度分布情况及变化规律。方法回顾性病例对照研究。选取2021年12月至2022年12月我院就诊的学龄期远视性弱视儿童共48例(96只眼),根据弱视严重程度分为轻度(34只眼)、中度(34只眼)、重度(28只眼)三个亚组;选取同期视力正常儿童17例(34只眼)为正视组。利用相干光层析成像增强技术(EDI‐OCT)行黄斑中心凹下脉络膜厚度(SFCT)以及距中心凹1.0 mm、3.0 mm鼻侧(N1、N3)和颞侧(T1、T3)脉络膜厚度(CT)及黄斑中心凹视网膜厚度(FRT)检测,记录年龄、性别、视力、眼轴长度(AL)、等效球镜(SE),分析脉络膜厚度与视网膜厚度、眼轴、等效球镜、年龄的相关性以及视网膜厚度与眼轴、年龄的相关性。结果各组五个位置CT随着弱视程度加重而增厚,各组间差异均有统计学意义(均P<0.05)。中度远视性弱视组与正视组比较在各位置中CT均增厚、与轻度弱视组相比仅SFCT及N3处CT增厚;重度远视性弱视组CT与其余三组相比在各位置中均明显更厚,差异均有统计学意义(均P<0.05)。远视性弱视组中SFCT较其余四个部位更厚;T1、T3分别厚于N1、N3;T1、N1分别厚于T3、N3,差异均有统计学意义(均P<0.05)。四组中FRT有随着弱视程度的加重而变厚的趋势,但差异无统计学意义(P>0.05)。远视性弱视组中SFCT与AL负相关、与FRT、SE均呈正相关(均P<0.05);FRT与AL负相关(P<0.05);SFCT、FRT与年龄均无相关性(均P>0.05)。结论远视性弱视儿童中弱视眼可影响黄斑区的脉络膜组织结构。

Objective To study the distribution and changes of choroidal thickness and retinal thickness in children with different degrees of amblyopia.Methods A prospective case-control study.A total of 48 children(96 eyes)with hyperopic amblyopia were divided into the mild(34 eyes),moderate(34 eyes)and severe(28 eyes)groups according to the severity of amblyopia,and 17 children(34 eyes)with normal vision in the same period were selected as the emmetropia group.Enhanced depth imaging optical coherence tomography(EDI-OCT)subfoveal choroidal thickness(SFCT),1.0mm from fovea,nasal(N1,N3)and temporal(T1,T3)choroidal thickness(CT)and macular foveal retinal thickness(FRT)were measured.Age,sex,visual acuity,axis length(AL)and spherical equivalent(SE)were recorded.The correlations between CT and RT,AL,SE and age,as well as between RT and AL and age were analyzed.Results The CT of five positions in each group thickened with the aggravation of amblyopia,and there were significant differences among the three groups(P<0.05).The CT of the moderate hyperopic amblyopia group was thicker than that of the emmetropia group,and only SFCT and N3 CT of the moderate hyperopic amblyopia group were thicker than those of the mild amblyopia group.The CT of the severe hyperopic amblyopia group was significantly thicker than that of the other three groups(P<0.05).In hyperopic amblyopia group,SFCT was thicker than the other four positions,and T1 and T3 were thicker than N1 and N3,respectively,and N1 was thicker than T3 and N3,respectively(P<0.05).FRT in the four groups tended to thicken with the aggravation of amblyopia,but there was no significant difference among the four groups(P>0.05).In the hyperopic amblyopia group,SFCT was negatively correlated with AL,positively correlated with FRT and SE(P<0.05),FRT was negatively correlated with AL(P<0.05),and SFCT,FRT had no correlation with age(P>0.05).Conclusions Amblyopia in children with hyperopic amblyopia can affect the choroidal tissue structure of the macular area.