高度近视性弱视儿童视网膜厚度及其影响因素分析

目的：研究高度近视性弱视儿童视网膜厚度变化，并探讨中心凹下视网膜厚度与眼轴、年龄的关系。
　　方法：儿童39例65眼，平均年龄9．913．41岁，所有受检眼排除眼底的疾病和眼前节的病变。根据阿托品扩瞳验光的结果，分成高度近视性弱视组（24眼）、高度近视组（19眼）、正视眼组（22眼），运用海德堡OCT对中心凹下视网膜厚度及距中心凹0．5，1．0，1．5，2．0，2．5，3．0mm处上方（ S，12∶00位）、颞侧（ T，9∶00位）、下方（ I，6∶00位）、鼻侧（ N，3∶00位）的视网膜厚度进行测量，并通过A超测量出所有受检者眼轴长度。对各组间同一位点的视网膜厚度进行比较，分析中心凹下视网膜厚度与眼轴、年龄的关系。
　　结果：高度近视性弱视组中心凹下视网膜厚度薄于高度近视组，厚于正视眼组，但均无统计学差异（ P＞0．05）。其中距中心凹0．5 mm处颞侧及下方视网膜厚度、距中心凹1．0 mm处颞侧及上方视网膜厚度，高度近视性弱视组与正视眼组相比均变薄，并有统计学差异（P＜0．05），距中心凹1．5，2．0，2．5，3．0mm处鼻、上、颞、下视网膜厚度，高度近视性弱视组与高度近视组、正视眼组相比均变薄，有统计学差异（P＜0．05）。高度近视性弱视组中心凹下视网膜厚度与眼轴、年龄之间无明显相关性。
　　结论：高度近视性弱视儿童黄斑区视网膜结构存在异常。

Analysis on retinal thickness and its relevant factors in high myopia amblyopic children

AIM:To investigate the retinal thickness change of high myopia amblyopic children, so as to discuss the relationships between the retinal thickness of central fovea of macula and the factors of axis oculi and age.

METHODS:Thirty-nine children(65 eyes)with the average age of(9.91±3.41)years were recruited. All eyes were ruled out the pathological changes of fundus diseases and front section. After atropine optometry, they were divided into three groups: high myopia amblyopic group(24 eyes), high myopia group(19 eyes)and normal group(22 eyes). Retinal scans were obtained for all eyes using Heidelberg optical coherence tomography(OCT). Subfoveal macular thickness, retinal thickness at 0.5mm, 1.0mm, 1.5mm, 2.0mm, 2.5mm, 3.0mm superior(S, 12:00 position), temporal(T, 9:00 position), inferior(I, 6:00 position)and nasal(N, 3:00 position)from the fovea were measured and axial length was also surveyed by A-ultrasound. Statistical analyses were performed to evaluate retinal thickness at each location and to correlate subfoveal macular thickness with axial length and age.

RESULTS:The average subfoveal macular thinkness of the high myopia amblyopic group was thinner than high myopia group but thicker than normal group. There was no statistical difference between three groups(P>0.05). Retinal thickness inferior to the fovea at 0.5mm temporal and superior to the fovea in the high myopia amblyopic group at 1.0mm temporal were both thinner than normal group which had statistically significant(P<0.05). Retinal thickness on nasal, superior, temporal, and inferior at 1.5mm, 2.0mm, 2.5mm, 3.0mm from the fovea were measured, high myopia amblyopic group were the thinnest in the three groups, and there was statistically significant between three groups(P<0.05). There was no correlation between the average subfoveal macular thickness and axial length, age in high myopia amblyopic group.

CONCLUSION:There are significant abnormalities of macula retinal structure in high myopia amblyopic children.