神经纤维层厚度与屈光不正和年龄的关系研究

目的 运用偏相关分析评估通过光学相干断层扫描（OCT）测量健康人神经纤维层厚度（RNFL）与屈光不正和年龄的相关性.方法 对106例健康受试者的右眼的各个钟点、各象限和整个RNFL平均厚度进行横断面分析,其中高度近视33例（SE〈-6.0 D）,中度近视60例（-6.0 D≤SE〈-3.0 D）,低度近视和正视眼13例（-3.0 D≤SE〈0.5 D）,用偏相关分析来评估RNFL和等效球径（SE）和年龄的相关性.结果 高度近视眼中平均RNFL厚度（95.74±13.46）μm比中度近视眼（101.43±11.53）μm以及低度近视和正视眼（108.06±8.42）μm的RNFL厚度要薄（P〈0.05）.1、5、6和12钟点处以及上下方象限的RNFL厚度和平均RNFL厚度与SE呈正相关（r=0.36,0.33,0.43,0.29,0.28,0.39,P〈0.01,r=0.22,P〈0.05）,而8、9和10点处以及颢侧象限的RNFL厚度随着近视的发展与SE呈负相关（r=-0.21,P〈0.05,r=-0.36,P〈0.01;r=-0.24,P〈0.05;r=-0.30,P〈0.01）.2、3、4、6钟点处以及鼻侧和下方RNFL厚度的变化同年龄具有相关性（r=-0.20,-0.20,-0.20,P〈0.05,r=0.31,P〈0.01）.结论 RNFL厚度随着屈光不正和年龄的变化而变化,运用RNFL厚度评估青光眼要考虑屈光状态和年龄,同时要了解RNFL厚度变化所在的位置.

Correlation between retinal nerve fiber layer measurements and refractive error and age

Objective To evaluate the relationship between retinal nerve fiber layer (RNFL)thickness measured by optical coherence tomography (OCT) and the refractive error and age using partial correlation analysis. Methods A total of 106 right eyes of healthy subjects, comprising 33 eyes with high myopia ( spherical equivalent [SE] < - 6. 0 D) , 60 eyes with moderate myopia ( - 6. 0 D ≤ SE < - 3.0 D) and 13 eyes with low myopia and emmetropia ( -3.0 D≤SE <0. 5 D) were analyzed in this cross-sectional study. Mean clock hour, quadrant and total average RNFL thicknesses were measured by OCT and compared among the three groups respectively. Associations among RNFL measurements and spherical equivalent and age were evaluated by partial correlation analysis. Results The mean RNFL thickness measurement in high myopia(95.74 ± 13.46) μm was significantly lower than that in moderate myopia group ( 101.43 ± 11.53 ) μm, low myopia group and emmetropia group ( 108. 06 ± 8.42) μm ( P < 0. 05 ). Positive correlations were found between RNFL measurements at 1, 5, 6 and 12 o'clock, superior and inferior quadrant, and total average RNFL and SE ( r = 0. 36,0. 33,0. 43,0. 29,0. 28,0. 39, P < 0. 01, r = 0. 22,P <0. 05), while negative correlations were found between RNFL measurements at 8, 9 and 10 o'clock and temporal quadrant and SE ( r = -0.21, P <0.05, r = -0.36, P <0.01; r = -0.24, P <0.05; r = -0. 30, P <0. 01 ). RNFL measurements at 2, 3, 4 and 6 o'clock and nasal and inferior quadrant varied with age ( r = -0.20,-0.20,-0.20,P <0.05,r =0.31,P <0.01). Conclusions RNFL measurements varied with the refractive error and age. Analysis of RNFL thickness in the evaluation of glaucoma should always be interpreted with reference to the refractive status and age. In the same time, the location of the RNFL should be noted.