摘要：
Objective To observe the changes of circumpapillary retinal nerve fiber layer (cpRNFL) thickness and the correlation with visual field defect (VFD) in patients with ocular contusion.Methods Twenty-four eyes of 24 patients with ocular contusion were collected in this study.Nineteen patients were male and 5 were female.The age ranged from 18 to 45 years old with a mean of (31.13 ±9.02) years.The thickness of cpRNFL of all patients were examined by optical coherence tomography (OCT) 10 days,1,3,6 and 9 months after ocular trauma.The examinations of mean visual field defect (MVFD) were performed in traumatic eyes.Data of best corrected visual acuity (BCVA) and the correlation between thickness of cpRNFL and VFD were recorded.The mean follow-up time was (1.22 ± 0.43) years with a range from 10 months to 2 years.Results There was an increased trend in BCVA 1 month after trauma (F =5.473,P =0.000),and then the BCVA kept stable (F =0.026,P =0.994).The mean thickness of cpRNFL of the non-trauma eye was (100.58 ± 12.62) μm.The mean thickness of cpRNFL was (88.96 ± 11.11)μm 10 days after trauma.The thickness of cpRNFL had a decreased trend 3 months after trauma with a significant regression 1 month after the trauma (F =25.977,P =0.000).The MVFD were (-3.58±2.30) dB and (-5.63 ±2.18) dB 10 days and 1 month after respectively.There was a regressive trend in VFD after ocular trauma with a stable level 3 months after the trauma (F =14.965,P =0.000).There was a positive correlation between the decrease of cpRNFL thickness and VFD after ocular blunt trauma (r =0.646,P =0.000).Conclusion The thickness of cpRNFL decreases after ocular blunt trauma,and is stable 3 months after the trauma.There is a correlation between cpRNFL thickness and VFD,and the more the decrease of cpRNFL thickness is,the more the defect of the visual field will be.%目的 观察眼球挫伤后视盘周围视网膜神经纤维层(cpRNFL)厚度的变化,及其与视野缺损的关系.方法 眼球挫伤24例(24只眼).其中男19例,女5例.年龄18-45岁,平均(31.13±9.02)岁.所有患者于伤后10 d,1、3、6及9个月对双眼进行相干光断层扫描(OCT)及伤眼Humphrey自动视野计检查.记录患者最佳矫正视力(BCVA).分析cpRNFL厚度与视野缺损的相关性.随访10个月～2年,平均(1.22±0.43)年.结果 经治疗视力在伤后1个月内呈逐渐上升趋势(F =5.473,P=0.000),1个月后视力趋于稳定(F =0.026,P=0.994).健眼cpRNFL平均厚度为(100.58±12.62) μm.伤眼伤后10d cpRNFL平均厚度为(88.96±11.11) μm.在伤后3个月内cpRNFL平均厚度逐渐减少(F=25.977,P=0.000),1个月时减少最为明显,3个月时趋于稳定(F=0.042,P=0.959).伤后10 d视野缺损为(-3.58 ±2.30)dB,1个月为(-5.63±2.18)dB,视野缺损呈进行性加重(F=14.965,P=0.000),3个月时趋于稳定.cpRNFL厚度减少与视野损害呈正相关(r =0.646,P=0.000).结论 眼球挫伤后cpRNFL厚度减少,3个月时趋于稳定.视野缺损与cpRNFL厚度减少有关,厚度减少越多,视野损害越大.
