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目的研究人视网膜神经纤维层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进行以视盘为中心,直径3.46mm圆周的视网膜神经纤维层(retinal nerve fiberlayer,RNFL)厚度测量,计算各组平均RNFL厚度及鼻、颞、上、下4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、中度近视患者平均RNFL分别为(119.33±37.23)μm、(117.84±36.57)μm,已变薄但与正常人(123.74±35.68)μm无显著差异(P>0.05);高度近视平均神经纤维层厚度为(112.89±37.09)μm明显变薄,与正常人相比有显著性(P<0.01)。近视眼各象限RNFL最早变薄的是鼻侧,低度近视即与正常人有显著性差异(P<0.01)。高度近视眼鼻、下、上方RNFL均明显变薄(P<0.01),而颞侧RNFL反而增厚,与正常人相比差异具有显著性(P<0.01)。结论近视眼中平均RNFL厚度变薄,随着近视度数的加深,近视眼RNFL厚度变薄越来越明显。分区分析上、下、鼻侧变化与平均相一致,而颞侧增厚,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。
Objective To study the characteristics and clinical significance of the thickness of human retinal nerve fiber layer changing with the refraction of myopia. Methods 108 cases (197 eyes) of myopia and 42 cases (60 eyes) of normal control were divided into low myopia group, moderate myopia group, high myopia group and normal control group. Optical coherence tomography RNFL thickness measured at the circumference of 3.46mm in diameter, RNFL thickness and RNFL thickness in four groups at the nose, the temporal, the upper and the lower were calculated, and the myopia group was compared with the normal group , And statistical analysis. Results The average RNFL of patients with low and moderate myopia were (119.33 ± 37.23) μm and (117.84 ± 36.57) μm, respectively, but they were thinner but not significantly different from those of normal subjects (123.74 ± 35.68 μm) (P> 0.05) The average nerve fiber layer thickness (112.89 ± 37.09) μm significantly thinner, compared with normal people (P <0.01). The RNFL thinning in each quadrant of myopia was nasal, and low myopia was significantly different from normal (P <0.01). The RNFL in the high, middle and high myopia were significantly thinner (P <0.01), while temporal RNFL thicker, but the difference was significant compared with the normal (P <0.01). Conclusions The average thickness of RNFL in myopia is thinner. With the deepening of myopia, the thickness of RNFL becomes more and more obvious. Zoning analysis, the next, nasal changes consistent with the average, while the temporal thickening, which may be characterized by myopia RNFL. These characteristics of the clinical diagnosis of disease is instructive.