高度近视眼后极部视网膜厚度的光学相干断层成像测量

目的 应用光学相干断层成像(OCT)技术探讨高度近视眼黄斑区及视盘周围视网膜神经纤维层(RNFL)的厚度变化 方法 前瞻性病例对照研究随机选取2011年3月至2011年8月在金华市中心医院眼科就诊并行OCT检查的高度近视患者33例(33眼)和正常对照者35例(35眼),分别测量其黄斑中心凹和距中心凹750μm处的四q个方向上的RNFL厚度,并测量视盘周围12个钟点方向上的RNFL厚度,比较两组之间有无显著性差异.两组间的比较采用独立样本t检验 结果 高度近视眼组黄斑区各方向RNFL.厚度均明显小于正常对照组(t=3.08,P＜0.01),而视盘周围RNFL厚度较正常对照组有变薄趋势,但差异无统计学意义 结论 高度近视眼黄斑区RNFL厚度明显低于正常眼视盘周围的RNFL厚度有变薄的趋势,因此在对合并高度近视的青光眼眼患者进行视盘周围RNFL厚度评价时,需持谨慎的态度,0CT能够精确量化RNFL厚度,可重复性好.

Peripapillary and macular retinal nerve fiber layer thickness in the high myopia as measured by optical coherence tomography

Objective To evaluate the changes in the distribution of peripapillary and macular retinal nerve fiber layer （RNFL） thickness distribution in a group of subjects with high myopia. Methods It was a prospective case control study. Thirty-three eyes of 33 patients with high myopia （33 eyes） and 35 eyes of 35 control subjects （35 eyes） were recruited in jinhua Municipal Central Hospital from March 2011 to August 2011. Maeular RNFL thickness was measured in the macular fovea and 750 p.m away from the center of the fovea in the superior, inferior, temporal and nasal directions using optical coherence tomograhy （OCT）. Peripapillary RNFL thickness was measured using the OCT Fast RNFL 3.4 mm scan protocol. An independent samples t test was used to compare the difference between the two groups. Results The thickness of macular RNFL was significantly thinner in patients with high myopia than that in the control subjects. Although there was no significant difference in peripapillary RNFL thickness between the patients and the controls, tthere was a trend to be thinner in the patients with high myopia in each the 12 o＇clock hour direction. Conclusion It is significant that the thickness of the macular RNFL is thinner in patients with high myopia than that in control subjects. Particular caution is needed to prevent false positive errors when the RNFL appears to be below the normal limit in glaucoma patients complicated by high myopia. OCT offers a good method to evaluate the thickness of RNFL and to be used in follow-ups.