Cirrus HD OCT检测近视眼视网膜神经纤维层厚度的研究

目的：应用Cirrus HD OCT检测近视眼视网膜神纤维层厚度,探讨近视眼神经纤维层厚度分布特点及其与屈光度的关系。 方法：将近视眼106例196眼分为低、中、高度近视组和正常对照组38例60眼,应用Cirrus HD OCT进行以视盘为中心,直径3.46 mm圆周的RNFL厚度测量,计算各组平均、各象限及各钟点RNFL厚度,各近视组分别与正常对照组对比,研究近视眼RNFL厚度与屈光度的关系。 结果：各近视组平均、上方象限及下方象限RNFL厚度较正常对照组变薄,其中中度、高度近视与正常对照组相比有统计学差异（ P〈0.05）,鼻侧象限RNFL厚度变薄,无统计学显著性差异（ P〉0.05）,颞侧象限RNFL厚度增加,有统计学差异（ P〈0.05）；各近视组2：00,6：00,12：00位RNFL厚度较正常对照组变薄,有统计学差异（ P〈0.05）,8：00,9：00,10：00位RNFL厚度较正常对照组增加,有统计学差异（ P〈0.05）,中、高度近视1：00,5：00位厚度较正常对照组变薄,有统计学差异（P〈0.05）。 结论：近视眼平均、上方及下方象限、2：00,6：00,12：00位RNFL厚度较正常对照组变薄,颞侧象限、8：00,9：00,10：00位RNFL厚度较正常对照组相比明显增加,这是近视眼RNFL厚度的特点,当临床出现RNFL厚度异常时,应考虑屈光度的影响,综合评价其临床意义；近视眼7：00,8：00,10：00,11：00位RNFL厚度与正常对照组相比均未变薄,出现异常变薄时,应考虑青光眼可能。

Study on retinal nerve fibre layer thickness in myopia measured by Cirrus HD OCT

AIM:To investigate the characteristics of the retinal nerve fibre layer(RNFL)thickness in myopia measured by Cirrus HD optical coherence tomography(OCT), and the relationship between RNFL thickness and refractive diopter/axial length.

METHODS: Totally 106 cases(196 eyes)were divided into low, moderate and high myopia group and 38 cases(60 eyes)as normal group were included in the study. Cirrus HD OCT was used to measure the RNFL thickness. Each eye was performed circular scans around the optic nerve with a circle size of 3.46mm. The average RNFL thickness, the mean RNFL thickness in each quadrant and clock hour in each group were recorded. The difference between each myopia group and normal group and the relationship between RNFL thickness and refractive diopter was researched.

RESULTS: Compared to normal group, the average RNFL thickness, the mean RNFL thickness of superior and inferior were thinner in myopia groups, the difference between moderate, high myopia group and normal group were significant(P<0.05), the nasal quadrant RNFL thickness was also thinner, but the difference was not significant(P>0.05), the temporal quadrant RNFL thickness was thicker and the difference was significant(P<0.05); Compared to normal group, at 2:00, 6:00, 12:00 position, the RNFL thickness decreased significantly in each myopia group(P<0.05); at 8:00, 9:00, 10:00 position, the RNFL thickness increased significantly(P<0.05); at 1:00, 5:00 position in moderate, high myopia group, the RNFL thickness decreased significantly(P<0.05).

CONCLUSION: The average RNFL thickness and the RNFL thickness at superior quadrant, inferior quadrant, 2:00, 6:00, 12:00 position in myopia groups are thinner than normal group; the RNFL thickness at temporal quadrant, 8:00, 9:00 and 10:00 position are thicker. The result shows the characteristics of the RNFL thickness in myopia, which is of instructive significance to guide the diagnosis of disease. Effect of refractive diopter on RNFL should be concerned for a clinical diagnosis; The RNFL thickness at 7:00, 8:00, 10:00 and 11:00 position in myopia group are not thinner than normal group. If they become thinner, glaucoma should be considered.