近视眼神经纤维层厚度光学相干断层扫描分析

目的研究人视网膜神经纤维层(RNFL)厚度随近视眼屈光度加深而变化的特点及临床意义。方法将近视眼108例(197眼)和正常对照者42例(60眼)分为低度近视组、中度近视组、高度近视组和正常对照组,应用光学相干断层扫描仪(OCT)进行以视乳头为中心,直径3．46mm圆周的RNFL厚度测量,计算各组平均RNFL厚度及鼻、颞、上、下四个象限的RNFL厚度,各近视组分别与正常组对比,并进行统计学分析。结果低度、中度近视眼平均神经纤维层厚度变薄但与正常对照无显著性差异(P＞0．05),高度近视眼平均神经纤维层厚度明显变薄,与正常对照相比具有显著性差异(P＜0．01)。近视眼各象限RNFL最早变薄的是鼻象限,低度近视即与正常人有显著性差异(P＜0．01)。高度近视跟鼻、下、上象限RNFL均明显变薄(P＜0．01),而颞象限RNFL反而增厚,与正常人相比有显著性差异(P＜0．01)。结论近视眼平均RNFL厚度呈变薄的改变,随着近视度数的加深,近视跟RNFL厚度变薄越来越明显。分区分析上、下、鼻象限变化与平均相一致,而颞象限增厚,这可能是近视眼RNFL的特点。这些特点对临床疾病的诊断具指导意义。

Analysis on thickness of retinal nerve fiber layer in myopia by using optical conhenrence tomography

Objective To study the characteristics and clinical significance of retinal nerve fiber layer (RNFL)thickness along with an increase of myopia degree.Methods According to the myopic degree,150 subjects were divided into 4 groups:normal,slight,medium and high myopic groups.Optical conhenrence tomography(OCT)was used to measure the RNFL thickness.Each subject had circular scans aroud the optic nerve with a circle size of 3.46mm.The mean and different quadrants RNFL thickness in different groups were analyzed.Results Compared with normal groups,the mean RNFL thickness in myopic groups were thinner,but only high myopic groups were significantly thinner.The change occurred first in nasal quadrant.RNFL thickness in high myopic groups were significantly thinner in nasal,inferior and superior quadrant.However,temporal quadrant was significantly thicker.ConcIusion The mean RNFL thickness in myopic groups are thinner and thinner along with an increase of myopia degree.Different from others, temporal quadrant is thicker,which maybe characteristics of RNFL thickness in myopic groups.Above- mentioned features have the clinical significance for diagnosing disease.