屈光参差性弱视者对侧眼神经纤维层及黄斑的厚度分析

目的比较分析正常眼与屈光参差造成的单眼弱视者对侧眼视网膜神经纤维层和黄斑的厚度及其与眼轴长度(AL)或等效球镜度(SE)的关联性。方法通过光学生物测量仪(IOLMaster)和光学相干断层扫描仪(OCT)分别获得56例(56眼)屈光参差性弱视者的对侧眼(单眼弱视组)及85例(170眼)年龄相匹配的正常者双眼(对照组)的AL和环视乳头神经纤维层厚度(RNFLT)及黄斑厚度(MT)。结果单眼弱视组的对侧眼与正常对照组相比,平均RNFLT(RNFLT-fc)、颞侧RNFLT(RNFLT-t)和下方RNFLT(RNFLT-i)更厚(P均<0.05),鼻侧RNFLT(RNFLT-n)更薄(P<0.05),MT和上方RNFLT(RNFLT-s)的差异没有统计学意义。控制年龄、性别及AL或者SE的影响后,进一步比较发现对侧眼组只有RNFLT-t比正常对照组厚(P<0.05)。两组各厚度值与AL/SE的相关性及回归系数也有不同。遮盖组与未遮盖组各量间经比较未发现差异有统计学意义。结论尽管屈光参差性单眼弱视者对侧眼的视力与正常者相比没有差异,但是其视网膜的结构与正常者相比仍然存在异常。遮盖对对侧眼视网膜的结构未造成改变。AL或SE会对RNFLT的测量产生一定的影响。

Retinal nerve fiber layer and macular thickness in the fellow eyes of patients with anisometropic amblyopia

Objective To measure the retinal structure of the fellow eyes of patients with anisometropic amblyopes with retinal nerve fiber layer thickness(RNFLT),macular thickness(MT),and their correlations with axial length(AL) and spherical equivalent(SE).Methods AL was measured by IOLMaster.RNFLT and MT were obtained through optical coherence tomography(OCT).The data of the 56 unilateral amblyopes(56 fellow eyes) were compared with those of 170 normal eyes from 85 age-matched people.Results The fellow eyes had thicker RNFLT(RNFLT-fc),temporal RNFLT(RNFLTt) and inferior(RNFLT-i);and thinner nasal RNFLT(RNFLT-n) than the normal eyes.But no statistically significant differences in superior RNFLT(RNFLT-s) and MT were found between the fellow eyes and normal eyes.After adjustments for age,gender and AL or SE,only the change of RNFLT-t remained significant(P<0.05).Partial correlation analysis between the thickness values and AL/SE adjusted for age and gender showed different trends between the fellow eyes and normal eyes.Multiple linear regression adjusted for age and gender also obtained different coefficients between the fellow eyes and normal eyes. Independent sample t test found no difference in thickness parameters between occlusion and non-occlusion eyes in patients with anisometropic amblyopes.Conclusion Fellow eyes of patients with anisometropic amblyopes have subnormal retinal structure despite a normal corrected visual acuity.Occlusion does not affect the retinal structure.AL or SE can affect the measurements of RNFLT.