学龄前儿童脉络膜厚度的研究

摘要

Objective To estimate the choroidal thickness (CT) in healthy children aged 2-6 years old and its relation to axial length,age and gender.Methods Cross-sectional study.CT was assessed using spectral domain optical coherence tomography (OCT) in 126 children aged 2 to 6 years.CT was measured at nine locations,including the subfovea and 1 mm and 3 mm nasal,temporal,superior and inferior to the fovea.Results Mean subfoveal choroidal thickness (SFCT) was 331.56±62.03 μm.The choroid was thickest at the subfoveal and 1 mm temporal area,and thinner nasally compared to temporally,superiorly and inferiorly.No statistical significance of SFCT between male and female was noted.Stepwise multiple regression analysis revealed that axial length and age were associated significantly with SFCT (P=0.00),while there was no detectable effect of sex on SFCT (P=0.94).Conclusions Choroidal thickness was negatively correlated to axial length and positively correlated to age in preschool children.The development of the choroid in early childhood offset the effect of the expansion of eyes.Gender played a minor role in the choroidal development in early childhood.%目的 探讨健康学龄前儿童脉络膜厚度的特点及其与眼轴、年龄和性别的关系.方法 横断面研究.选取2016年10月至2017年5月于厦门市儿童医院眼科就诊的3～ 6(4.1±0.95)岁健康儿童126名,其中男性58名,女性68名.采用频域相干光层析成像术(OCT)测量黄斑中心凹下及黄斑的上方、下方、鼻侧和颞侧各1和3 mm的脉络膜厚度,并分析其与眼轴、年龄和性别的关系.采用逐步多元回归方法分析脉络膜厚度和眼轴长度、年龄及性别的关系.不同测量点间脉络膜厚度的差异采用单因素方差分析.不同性别脉络膜厚度的比较采用独立样本t检验.结果 126名受检儿童黄斑中心凹下脉络膜厚度(SFCT)为(331.56±62.03) μm,黄斑中心凹下及颞侧1 mm的脉络膜最厚,鼻侧脉络膜厚度较颞侧及黄斑上、下方薄,9个测量点的脉络膜厚度差异具有统计学意义(F=158.53,P＜0.001).男性与女性SFCT之间的差异无统计学意义(t=1.804,P=0.072).逐步多元回归分析显示,SFCT和眼轴长度、年龄具有相关性,眼轴每增长1 mm则SFCT减少31.94 μm(95％可信区间为24.40～39.48 μm,r=0.22,P＜0.001,);年龄每增长1岁则SFCT增加11.46μm(95％可信区间为3.97～18.96 μm,r2=0.22,P=0.003).性别对SFCT无影响(P=0.94).结论 学龄前儿童脉络膜厚度与眼轴呈负相关关系,与年龄呈正相关关系.性别对儿童早期脉络膜发育无影响.