儿童弱视眼与正常眼视网膜光学相干断层成像的对比研究

发布时间：2018-05-06 06:09

本文选题：弱视 + 光学相干断层扫描　；参考：《中南大学》2010年硕士论文

【摘要】： 目的对比分析儿童弱视眼与正常眼视网膜神经纤维层(Retinal Nerve Fiber Layer, RNFL)光学相干断层成像的差异,探讨弱视眼OCT的变化特征在弱视视网膜形态学及发病机制中的价值。方法采用德国Carl-Zeiss Meditec生产的Stratus OCT3000成像仪对正常儿童组19例38眼、弱视儿童组88例176眼的视乳头周围RNFL进行扫描,弱视眼组按弱视类型分斜视性弱视组、屈光参差性弱视组、屈光不正性弱视组；按弱视程度分轻、中、重度弱视组。将RNFL厚度的检测值进行统计学分析。结果儿童正常眼与弱视眼RNFL厚度曲线图呈双驼峰状。正常眼视乳头周围RNFL全周厚度为106.42±11.75um,上方、鼻侧、下方、颞侧象限RNFL厚度分别为132.32±10.39um、75.32±16.75um、136.37±15.53um、81.68±17.41um。弱视眼RNFL厚度全周为118.87±10.54um,上方、鼻侧、下方、颞侧象限RNFL厚度分别为146.59±17.03um、85.89±16.71um、148.34±18.74um、94.66±22.82um,两者比较差异有统计学意义(P0.05)。儿童正常眼与弱视自身正常眼RNFL全周及各象限厚度比较,差异无统计学意义(P0.05)。不同类型弱视组视乳头周围RNFL全周厚度分别为：斜视性弱视为110.19±12.38um,屈光参差性弱视为121.89±9.03um,屈光不正性弱视为120.22±8.98um。屈光参差性弱视眼与屈光不正性弱视眼较斜视性弱视眼RNFL厚,差异有统计学意义(P0.05)。不同程度弱视组视乳头周围RNFL全周厚度在轻、中、重度弱视眼分别为117.51±12.14um、118.99±9.60um、120.28±9.60um,有逐渐增厚趋势,但组间比较差异无统计学意义(P0.05)。弱视眼RNFL厚度与视力作相关分析,二者呈负相关(r=-0.353,P0.05)。结论儿童正常眼与弱视眼RNFL厚度图呈双驼峰分布,以上下方最厚为波峰,鼻颞侧最薄为波谷,RNFL由厚至薄依次为下方、上方、颞侧、鼻侧。儿童弱视眼RNFL厚度较正常眼偏厚。儿童屈光参差性弱视、屈光不正性弱视RNFL较斜视性弱视眼增厚。斜视性弱视眼RNFL厚度与正常眼无明显差异。随弱视程度加重,弱视眼RNFL厚度有偏厚趋势。
[Abstract]:Objective to compare and analyze the difference of Retinal Nerve Fiber Layer, RNFL) optical coherence tomography in amblyopia and normal eyes, and to explore the role of OCT in the morphology and pathogenesis of amblyopia. Methods using the Stratus OCT3000 imager produced by Carl-Zeiss Meditec in Germany, 19 cases 38 eyes of normal children and 88 cases 176 eyes of amblyopic children around papilla were scanned. Amblyopia group was divided into strabismus amblyopia group and anisometropia amblyopia group according to the type of amblyopia. Ametropia amblyopia group, according to the degree of amblyopia, mild, moderate and severe amblyopia group. The measured values of RNFL thickness were analyzed statistically. Results the RNFL thickness curves of normal eyes and amblyopic eyes were double hump. The thickness of RNFL around the optic papilla in normal eyes was 106.42 卤11.75um. the thickness of RNFL in the superior, nasal, inferior and temporal quadrants was 132.32 卤10.39um, 75.32 卤16.75umn, 136.37 卤15.53umn, 81.68 卤17.41um. respectively. The thickness of RNFL in amblyopia eyes was 118.87 卤10.54um. the thickness of RNFL in the upper, nasal, inferior and temporal quadrants was 146.59 卤17.03ummtr, 85.89 卤16.71um, 148.34 卤18.74umn, 94.66 卤22.82um. the difference between the two groups was statistically significant (P 0.05). There was no significant difference in the total circumference and quadrant thickness of RNFL between normal children and amblyopic normal eyes (P 0.05). The total circumferential thickness of RNFL around the papilla in different amblyopia groups was 110.19 卤12.38 umps for strabismus amblyopia, 121.89 卤9.03umfor anisometropic amblyopia and 120.22 卤8.98umfor ametropia amblyopia. Anisometropia amblyopia and ametropia amblyopia were thicker than strabismus amblyopia eyes (P 0.05). In the amblyopia group with different degrees of amblyopia, the total circumferential thickness of RNFL around the optic papilla was 117.51 卤12.14 umn / 118.99 卤9.60 um.28 卤9.60 um.There was a gradual increase in thickness, but the difference between the two groups was not statistically significant (P 0.05). The correlation analysis between RNFL thickness and visual acuity in amblyopic eyes showed a negative correlation between the thickness of RNFL and the visual acuity of amblyopia. Conclusion the distribution of RNFL thickness in normal eyes and amblyopia eyes is double hump distribution, the thickest wave peak is below the upper side, and the thinnest of the nasal temporal side is the bottom, the upper temporal side and the nasal side are the lower, upper, temporal and nasal sides from thick to thin. The thickness of RNFL in amblyopia in children was thicker than that in normal eyes. In children with anisometropia amblyopia, ametropia amblyopia (RNFL) was thicker than strabismus amblyopia. There was no significant difference in RNFL thickness between strabismus amblyopia and normal eyes. With the aggravation of amblyopia, the thickness of RNFL in amblyopia tends to be thicker.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R777.44

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