首页> 中文期刊> 《中华实验眼科杂志》 >上海市宝山区7~15岁健康儿童人群角膜厚度的分布

上海市宝山区7~15岁健康儿童人群角膜厚度的分布

摘要

Background Measurement of corneal thickness is important for the early diagnosis and treatment of some eye disorders,including corneal diseases and refractive errors.However,the corneal parameters from schoolage population are rarely reported.Objective The aim of this survey was to characterize the central corneal thickness (CCT),minimum corneal thickness (MCT) and paracentral corneal thickness in healthy Chinese schoolage population.Methods A cross-sectional study was designed in this study.Children aged 7 to 15 years with the diopter of-3.00 D to +3.00 D were recruited from two primary schools in Baoshan district in Shanghai based on random cluster sampling under the approval of Shanghai First People's Hospital and informed consent of child custodian.Routine examinations were firstly performed to determine the healthy participants.CCT (within 2 mm range away the corneal vertex),MCT and paracentral corneal thicknesses (2 to 5 mm zone away the cornea vertex in superior,inferior,nasal and temporal quadrants) were then measured by RTVue Fourier optical coherence tomography (OCT) for the comparison between both eyes and different gender.The subjects were grouped into the 7-9,10-12 and 13-15 years groups,and the correlations between age and CCT,MCT and paracental corneal thicknesses were analyzed.The coordinate position of the thinnest cornea was determined.Results A total of 147 children were enrolled in the study.The mean CCT value of the right eyes was (537.77±29.33) μm,and that of the left eyes was (539.22±29.16) μm,showing a significant difference between them (t =-3.21,P =0.00).The paracentral corneal thicknesses of the right and left eyes were (565.52±30.11) μm and (568.42±31.07) pm in the superior quadrant,and those in the temporal quadrant were (549.01 ±30.46) μm and (547.24±30.23) μm,with significant differences between them (t =-2.47,P =0.01 ; t =2.12,P =0.04).No significant difference was found in the CCT,MCT,paracentral corneal thicknesses from various quadrants (all at P>0.05).In addition,no considerably correlation was seen between age and CCT,MCT and paracentral corneal thickness (all at P>0.05).The thinnest cornea area was located in the inferotemporal region in 40.82% right eyes and 57.82% left eyes.The distance of thinnest cornea area away corneal vertex was (0.62±0.33)mm in the right eyes and (0.91±0.63)mm in the left eyes,with a significant difference between them (t =-5.17,P =0.00).Conclusions The central,superior and temporal corneal thicknesses are significantly different between the right and the left eyes among healthy Chinese school-age children,but corneal thickness change is not associated with age or gender.The thinnest corneal area does not locate at the vertex.%背景 了解角膜厚度的正常范围及分布对多种相关儿童眼病,如角膜病和屈光不正等的诊断和治疗具有重要意义,目前中国尚缺少相关的研究资料. 目的 探讨中国健康儿童中央角膜厚度(CCT)、最小角膜厚度(MCT)和周边角膜厚度值的分布特征,为相关研究提供参考依据.方法 采用横断面调查研究方法和整群随机抽样设计,选择上海市宝山区2所中小学的7 ~ 15岁学生作为调查对象,受检者屈光度为-3.00 ~ +3.00 D.通过眼部常规检查明确纳入研究对象,采用傅里叶光学相干断层扫描仪(OCT)测量受检者CCT、距角膜顶点2 mm区域内的角膜平均厚度)、周边角膜厚度(上方、下方、鼻侧和颞侧象限距角膜顶点2~5 mm区域内的角膜平均厚度)、MCT值.将受检者按年龄分为7~9岁组、10 ~ 12岁组和13 ~ 15岁组,分析不同年龄组上述各项指标与年龄间的相关性.确定角膜最薄点的坐标,角膜最薄点测量时以角膜中央顶点为坐标原点,计算公式为√(x2+y2). 结果 147名受检儿童的右眼CCT为(537.77±29.33) μm,左眼为(539.22±29.16) μm,双眼间CCT差异有统计学意义(t=-3.21,P=0.00);右眼和左眼上方周边角膜厚度值分别为(565.52±30.11)μm和(568.42±31.07) μm,颞侧周边角膜厚度为(549.01 ±30.46) μm和(547.24±30.23) μm,双眼间上方和颞侧周边角膜厚度值的差异均有统计学意义(t=-2.47,P=0.01;t=2.12,P=0.04);不同性别间左眼及右眼CCT、MCT和各象限的周边角膜厚度值差异均无统计学意义(P>0.05);受检儿童年龄与CCT、周边角膜厚度和MCT间均无明显相关性(P>0.05).右眼角膜最薄点40.82%位于颞下方,左眼角膜最薄点57.82%位于颞下方.右眼角膜最薄点至角膜中央顶点的距离为(0.62±0.33) mm,左眼为(0.91±0.63)mm,双眼间差异有统计学意义(t=-5.17,P=0.00). 结论 中国7~15岁健康儿童不同眼别间CCT、上方和颞侧的周边角膜厚度值存在差异,但双眼角膜厚度值的改变与性别和年龄无关.角膜中央顶点并不是角膜最薄点.

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