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目的探讨高度近视眼视网膜神经纤维层(RNFL)厚度光学相干断层成像(OCT)各参数的变化规律,为临床正确使用OCT检测RNFL的结构性改变来诊断和鉴别青光眼提供依据。方法对询问病史符合条件者进行眼科常规检查,符合纳入标准者选定为受检者,继而对受检者中高度近视患者32例43眼和正视眼受试者30例40眼进行眼部OCT检查。结果二组受检者RNFL厚度对照显示:钟点位7、11点P>0.05,显示二组间这2个参数差异无统计学意义,其余15个参数P<0.05,差异有统计学意义。高度近视眼组与正常对照组相比RNFL平均厚度变薄,其中上方、下方、鼻侧三个象限变薄,但颞侧反而增厚。结论高度近视屈光不正RNFL的OCT参数中7、11点参数的影响不大,,对颞侧影响为增厚而非变薄,在其余参数点则有显著的RNFL变薄,在临床评价RNFL改变时要重视高度近视RNFL的规律性特征。
Objective To investigate the changes of various parameters of retinal nerve fiber layer (RNFL) thickness optical coherence tomography (OCT) in high myopia and provide the basis for the clinical diagnosis and differential diagnosis of glaucoma by using OCT to detect structural changes of RNFL. Methods The subjects who met the medical history were examined by ophthalmology routinely and those who met the inclusion criteria were selected as the subjects. Then 32 eyes (43 eyes) and 30 eyes (40 eyes) an examination. Results The thickness of RNFL in the two groups showed that there was no significant difference between the two groups at 7 and 11 points of P> 0.05. The other 15 parameters had statistical significance (P <0.05). Compared with the normal control group, the average thickness of RNFL in the high myopia group was thinner, in which the three quadrants of the upper, lower and nasal sides became thinner, but the temporal sides were thickened instead. Conclusions The OCT parameter of RNFL in high myopia has little effect on the parameters of 7 and 11 points, the influence on the temporal side is thickening rather than thinning, while the other parameters have significant thinning of RNFL. In the clinical evaluation of RNFL Changes should pay attention to the regularity of high myopia RNFL characteristics.