光学相干断层成像术在近视眼视网膜神经纤维层厚度测量中的临床应用

目的:研究光学相干断层成像术(OCT)在近视眼视网膜神经纤维层(RNFL)厚度测量中的应用价值。方法:选择2016年1月到2016年5月在医院就诊的近视患者73例(138眼)纳入此次研究,根据近视情况将患者分为低度近视组(-0.30D~-3.00D)共26例(48眼)、中度近视组(-3.01~-6.00D)共24例(47眼)及高度近视组(-6.00D)共23例(43眼)。另选同期在医院体检(视力正常)的健康志愿者25例(45眼)作为对照组,对比各组不同象限的RNFL厚度,屈光度及眼轴长度,分析近视眼各象限的RNFL厚度与患者屈光度和眼轴长度的相关性。结果:高度近视组的上方象限、下方象限以及鼻侧象限的RNFL厚度均明显低于对照组及中度近视组,中度近视组的下方象限及鼻侧象限的RNFL厚度均明显低于对照组,低度近视组鼻侧象限的RNFL厚度明显低于对照组,差异均有统计学意义(均P0.05)。近视组的屈光度及眼轴长度均明显大于对照组,且高度近视组均明显大于中度近视组与低度近视组,中度近视组均明显大于低度近视组,差异均有统计学意义(均P0.05)。根据Pearson法分析相关性可知,近视眼患者上象限、下象限、鼻侧象限的RNFL厚度与其屈光度及眼轴长度均呈负相关。结论:利用OCT技术检测近视眼RNFL厚度时,应考虑屈光度及眼轴长度可能造成的影响,综合进行分析判断,以获得最佳检测数值。

Clinical Application of Optical Coherence Tomography in the Measurement of Retinal Nerve Fiber Layer Thickness in Myopia

ABSTRACT Objective: To study the clinical application value of optical coherence tomography(OCT)in the measurement of retinal nerve fiber layer(RNFL)thickness in myopia. Methods: 73 patients(138 eyes)with myopia who were treated in the hospital from January 2016 to May 2016 were included in this study,according to the condition of myopia, the patients were divided into low myopia group(-0.30~-3.00D)of 26 cases(48 eyes), moderate myopia group(-3.01~-6.00D)of 24 cases(47 eyes)high myopia group(>-6.00D)of 23 cases(43 eyes), selected 25 cases of healthy volunteers with normal eyes(45 eyes)as control group over the same period in hospital, RNFL thick- ness, refraction and axial length of different quadrant of each group were compared, analyzed the correlation between the RNFL thick- ness of each quadrant of myopia and the refractive index and the axial length of the eyes. Results: RNFL thickness of in the upper quad- rant, lower quadrant and the nasal quadrant of the high myopia group were significantly lower than those of the control group and the moderate myopia group, which in lower quadrant and nasal quadrant of the moderate myopia group were significantly lower than that of the control group, and that in nasal quadrant of the low myopia group was significantly lower than that of the control group, the differences were statistically significant(P<0.05). The refractive degree and axial length of the myopia group were significantly higher than control group, and the high myopia group were significantly higher than moderate myopia group and the low myopia group, the moderate myopia group were significantly higher than low myopia group, the differences were statistically significant(P<0.05). According to the correlation analysis of the Pearson method, the RNFL thickness in upper, lower and nasal quadrant of the myopia patients were negatively correlated with the refractive degree and the axial length of the eyes. Conclusion: Using OCT technique to detect the RNFL thickness of myopia, we should consider the influence of refraction and axial length of the eye, and make a comprehensive analysis to get the best value.