单眼屈光参差性弱视黄斑区及视盘周围神经纤维层厚度的Meta分析

目的：评估应用光学相干断层成像术(OCT)评价单眼屈光参差性弱视青少年儿童双眼黄斑区及视盘周围神经纤维层厚度(RNFL)的差异，为探讨弱视的发病机制及指导弱视的诊疗提供依据。

方法：检索维普、万方、PubMed、EMBASE等中英文数据库，对1995-01-01/2019-12-08采用OCT检查单眼屈光参差性弱视青少年儿童患者双眼黄斑区及RNFL的相关临床研究进行筛选、评估和数据提取，将单眼屈光参差性弱视患者双眼黄斑中心小凹、黄斑中心凹1mm直径中央区、1～3mm内环区、3～6mm外环区及RNFL厚度纳入研究，采用RevMan 5.3软件进行Meta分析。

结果：采用时域OCT(TD-OCT)的研究结果显示，弱视眼黄斑中心小凹、黄斑中心凹1mm直径中央区厚度均大于对侧非弱视眼(P<0.05)，弱视眼RNFL平均厚度大于对侧非弱视眼(P>0.05)。采用频域OCT(SD-OCT)的研究结果显示，弱视眼黄斑中心小凹及各分区厚度均大于对侧非弱视眼，除黄斑中心凹1mm直径中央区、3～6mm的外环区下方外，余比较均有差异(P<0.05)； 弱视眼RNFL平均厚度及鼻侧各分区厚度均大于对侧非弱视眼(P<0.05)。

结论：单眼屈光参差性弱视患者弱视眼黄斑区及RNFL厚度高于对侧非弱视眼，且弱视主要引起黄斑中心凹1mm直径区域内厚度增厚。

Thickness of macular area and peripapillary retinal nerve fiber layer in monocular anisometropic amblyopia measured by optical coherence tomography: a Meta-analysis

AIM: To evaluate the application of optical coherence tomography(OCT)in evaluation of the differences in macular area and peripheral nerve fiber layer thickness(RNFL)of the binocular anisometropic amblyopia of adolescents and children with monocular anisometropic amblyopia, so as to provide a basis for exploring the pathogenesis of amblyopia and guiding the diagnosis and treatment of amblyopia.

METHODS: Retrieved Chinese and English databases such as Weipu, WanFang, PubMed, EMBASE etc, and carried out relevant clinical research on the use of OCT to examine macular area and RNFL of adolescents and children with monocular anisometropic amblyopia from 1995-01-01/2019-12-08 screening, evaluation and data extraction, including the thickness of central fovea, central area of macular fovea with diameter 1mm, the inner ring area with 1-3mm, the thickness of the outer ring area with 3-6mm, and the RNFL of monocular anisometropia amblyopia patients into studies, then do Meta-analysis with the RevMan 5.3 software.

RESULTS: Results of the time-domain OCT(TD-OCT)study showed that the thickness of macular fovea in the amblyopic eyes and the thickness of the central area of the macular fovea with diameter 1mm were greater than those of the contralateral non-amblyopic eyes(P<0.05), and the average thickness of RNFL in amblyopic eyes was thicker in the contralateral eye(P>0.05). Results of the study using frequency domain OCT(SD-OCT)showed that the thickness of macular fovea and the thickness of each zone in amblyopic eyes were greater than those of the contralateral non-amblyopic eyes, except for the central area of the macular fovea with diameter 1mm and the outer ring area below 3-6mm. In addition, the rest of the comparisons were different(P<0.05); the average thickness of RNFL and the thickness of each zone of the nose in amblyopic eyes were larger than those of the contralateral non-amblyopic eyes(P<0.05).

CONCLUSION: Thickness of the macular area and RNFL of the amblyopic eye of monocular anisometropic amblyopia is higher than that of the contralateral non-amblyopic eye, and amblyopia mainly causes the thickness of the macular fovea to increase within 1mm diameter.