高度近视眼视网膜神经纤维层和脉络膜厚度及相关因素分析

摘要

目的：探讨成年高度近视患者视网膜神经纤维层（ retinal nerve fiber layer，RNFL）及脉络膜厚度与正常对照组的差异及其与眼轴长度、屈光度、年龄的关系。方法2013年3月至2015年3月在爱尔集团成都康桥眼科医院就诊的高度近视患者85例（150眼）为高度近视组，同期健康志愿者80例（160眼）为正常对照组。采用频域光学相干断层扫描（ spectral-do-main optical coherence tomography，SD-OCT）加强深度扫描（ enhanced depth imaging，EDI）模式，3.46 mm扫描视盘周围RNFL厚度及盘周脉络膜厚度，以6 mm的扫描线对黄斑部进行0 o扫描，测量黄斑中心凹下的脉络膜厚度。比较组间RNFL厚度和脉络膜厚度的差异，并分析其与眼轴长度、屈光度和年龄的关系。结果高度近视眼和正视眼RNFL厚度分别为（85.35±12.31）μm和（108.42±9.42）μm，中心凹下脉络膜厚度分别为（167.23±45.26）μm和（342.25±58.39）μm，盘周脉络膜厚度分别为（141.38±48.93）μm和（198.85±63.23）μm。与正常对照组比较，高度近视组RNFL厚度和脉络膜厚度明显变薄（P＜0.01）。高度近视RNFL和脉络膜厚度与眼轴长度、屈光度、年龄均呈负相关（P＜0.05）。结论高度近视眼患者RNFL和脉络膜厚度较正常人明显变薄，且与眼轴长度、屈光度、年龄密切相关。%Objective To investigate the difference in retinal nerve fiber layer( RNFL) and choroidal thickness between highly myopic eyes and normal eyes,and the correlation of RNFL and choroidal thickness with axial length,spherical equivalent( SE) and age. Methods Eighty-five patients with high myopia(150 eyes) were enrolled from March,2013 to March,2015 in Kangqiao Eye Hospital of Aier Eye Hospital Group.Eighty age-and gender-matched healthy volunteers(160 eyes)were included as control group.Spectral-do-main optical coherence tomography(SD-OCT)with enhanced depth imaging(EDI)model were used to measure the RNFL thickness, peripapillary choroidal thickness and subfoveal choroidal thickness.The difference of RNFL and choroidal thickness were compared be-tween the two groups,and the correlation of RNFL and choroidal thickness with axial length,SE and age were analyzed.Results The RNFL thickness,subfoveal choroidal thickness and mean peripapillary choroidal thickness in the high myopia group were ( 85.35 ± 12.31)μm,(167.23±45.26)μm and (141.38±48.93)μm,respectively,while they were (108.42 ±9.42)μm,(342.25±58.39)μm and (198.85±63.23)μm in the control group,respectively.The thickness of RNFL and choroidal were thinner in the high myopia group than that in the control group( P<0.01) .A negative correlation was found between the RNFL and choroidal thickness and axial, SE and age(P<0.05).Conclusion RNFL and choroidal thickness are decreased in highly myopic eyes when compared with normal eyes.They are closely correlated with axial length,SE and age.