框架眼镜与角膜塑形镜矫正的近视儿童脉络膜厚度差异比较研究

目的 应用光学相干断层扫描(optical coherence tomography,OCT)在水平方向上进行近视儿童脉络膜厚度区域性厚度分析,比较首诊发现近视的儿童与OK镜戴镜1 a以上儿童脉络膜厚度差异.方法 回顾性分析就诊于我院的低至中度近视(-1.00～-6.00 D)近视儿童,对其中进行OCT脉络膜图像采集的68位儿童进行研究,其中首诊发现近视并以框架眼镜矫正的34人,持续配戴用OK镜1 a以上的34人,仅分析右眼数据.以自行编制的软件以500 μm为间隔分析以黄斑中心凹为中心共3.5 mm范围内的脉络膜图像,分为7区进行统计.单因素方差分析比较每组各区域间的脉络膜厚度差异,以配对t检验比较两组间脉络膜厚度差异.结果 OK镜组年龄为(12.3±1.8)岁,框架镜组年龄(11.8±1.4)岁,两组间差异无统计学意义.OK镜组各区域脉络膜厚度分别为:颞侧3区(296.7±61.8) μm,颞侧2区(290.7±58.9) μm,颞侧1区(285.7±57.4) μm,黄斑中心凹区(278.5±57.7) μm,鼻侧1区:(262.2±57.9) μm,鼻侧2区(239.8±59.7) μm,鼻侧3区(214.7±59.0) μm;框架镜组分别为:颞侧3区(294.2±45.4) μm,颞侧2区(292.0±44.0)μm,颞侧1区(283.6±45.5) μm,黄斑中心凹区(272.0±51.6) μm,鼻侧1区(255.2±56.3) μm,鼻侧2区(236.5±58.1)μm,鼻侧3区(212.8±57.7)μm.两组都是颞侧脉络膜比鼻侧更厚,差异均有统计学意义(均为P＜0.05).而两组间在各个区域上的脉络膜厚度差异均无统计学意义(均为P＞0.05).结论 近视儿童的脉络膜厚度呈区域性差异分布,在水平方向上颞侧脉络膜最厚,鼻侧最薄.干预时间超过1 a的OK镜组儿童与近视屈光度匹配的初次戴框架镜儿童之间脉络膜厚度无明显差异.

Comparison of choroid thickness difference between myopia children corrected by spectacles and orthokeratology

Objective To investigate choroid thickness at horizontal meridian with optical coherence tomography (OCT) and compare the choroid thickness difference between first visit myopia children with those children who wear orthokeratology lens for more than 1 year.Methods This retrospective study enrolled 68 myopia children with low to moderate myopia (-1.00--6.00 D) who visited our hospital and took choroid images by OCT.The total subjects were divided into 2 groups.The subjects of 34 children in group 1 visited for myopia initially and wear spectacles.The other one group wear orthokeratology lens more than 1 year.Only the data of right eye were analyzed.Scans through the fovea at horizontal meridian were acquired with OCT.Choroid images were detected by custom software with 500 μm intervals up to 3.5 mm around fovea.Choroid thickness (CT) was calc~ated based on the average of the 7 zones.Statistical analysis was performed to evaluate choroid thickness at each zone.ANOVA was used to compare choroid thickness differences between various zones in each group.Paired t test was used to compare choroid thickness difference at the same zone between two groups.Results The mean age of OK lens group was (12.3 ± 1.8) years old,and the spectacles group was (11.8 ± 1.4) years old,there was no statistical difference.From temple to nasal choroid,the mean CT of the orthokeratology lens group were (296.7 ± 61.8) μm (T3),(290.7 ± 58.9) μm (T2),(285.7 ± 57.4) μm (T1),(278.5 ±57.7) μm (M),(262.2 ±57.9) μm (N1),(239.8 ±59.7) μm (N2),(214.7 ±59.0) μm (N3);And the mean CT of the spectacles group were (294.2 ± 45.4) μm (T3),(292.0±44.0) μm (T2),(283.6 ±45.5) μm (T1),(272.0 ±51.6) μm (M),(255.2 ± 56.3) μm (N1),(236.5 ±58.1)μm (N2),(212.8 ±57.7) μm (N3),respectively.The thicknesses were significantly thicker in temple zones than that in nasal zones in each group (all P ＜ 0.05),but the CT was not significantly different between the two groups in each zone (all P ＞ 0.05).Conclusion The choroid thickness has regional deference in myopia children,the thickest is in the temple and the thinnest in the nasal region.There is no significant difference between the children who initially corrected by spectacles and those who wear OK lens more than 1 year.