远视性弱视儿童视网膜神经纤维层厚度分析

目的研究远视性弱视儿童视盘周围视网膜神经纤维层（RNFL）厚度和黄斑中心凹厚度的变化,并与单眼弱视儿童对侧正常眼的检查结果进行比较。方法对32例（41只眼）远视性弱视儿童和18例（18只眼）单眼弱视儿童对侧正常眼进行光学相干断层扫描（OCT）检查,记录视盘周围RNFL的平均厚度和黄斑中心凹的视网膜厚度。结果远视性弱视组和对照组视盘周围RNFL的平均厚度分别为118.77±11.43μm和109.12±11.09μm,两者相比,差异有统计学意义;远视性弱视组和对照组黄斑中心凹处视网膜厚度分别为155.98±29.30μm和147.28±13.11μm,两组之间无明显差异（P=0.121）。将弱视分组发现,轻度弱视组和中度弱视组的视盘周围RNFL的平均厚度分别为118.42±10.95μm和119.12±12.19μm,,黄斑中心凹处视网膜厚度分别为154.29±34.23μm和157.75±23.81μm。两者分别与对照组比较,视盘周围RNFL厚度差异有统计学意义;黄斑中心凹视网膜厚度差异无统计学意义（P=0.777,0.629）。结论远视性弱视儿童视盘周围RNFL变厚,而黄斑视网膜厚度无明显变化。

Analysis of retinal nerve fiber layer thickness in patients with hypermetropic amblyopia

Objective This study was designed to assess and compare the thickness of the peripapillary region retinal nerve fiber layer（RNFL） and the fovea in normal children and children with hypermetropic amblyopia.Mehtods OCT was performed on 32 children（41 amblyopic eyes） with hypermetropic amblyopia and 18 children（18 normal eyes,as control eyes） with unilateral amblyopia.The RNFL thickness were taken from the fovea and the peripapillary region.Results The mean peripapillary region RNFL thickness was 118.77±11.43 μm and109.12±11.09μm,and that of fovea was 155.98±29.30μm and 147.28±13.11μm respectively in the hypermetropic amblyopic eyes and the control eyes.OCT assessment of peripapillary region RNFL thickness revealed a significantly thicker RNFL in hypermetropic amblyopia（P=0.004）,but no statistically significant difference was found in retinal thickness of fovea（P=0.121）.For the children with mild and moderate hypermetropic amblyopia,the peripapillary RNFL thickness was 118.42±10.95μm and 119.12±12.19μm respectively and the mean retinal thickness of fovea was 154.29±34.23μm and 157.75±23.81μm respectively.OCT assessment of peripapillary RNFL thickness revealed a significantly thicker RNFL in mild and moderate hypermetropic amblyopia（P=0.037,0.035 respectively）,but no statistically significant difference was found in retinal thickness of fovea（P=0.777,0.629 respectively）.Conclusions The hypermetropic amblyopia may involve thicker peripapillary RNFL,but not the macula.