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目的:观察分析隐匿性高度近视儿童黄斑区脉络膜厚度变化及其影响因素。方法:前瞻性非随机同期对照试验研究。2019年9月至2020年10月在承德医学院附属医院眼科门诊首次就诊且之前未进行过任何近视矫正训练的儿童56例110只眼纳入研究。其中，男性33例64只眼，女性23例46只眼；年龄6~12岁，平均年龄（8.62±1.87）岁。根据儿童近视的临床表现分为隐匿性高度近视组（27例52只眼）和对照组（29例58只眼）。隐匿性高度近视组52只眼中，等效球镜度数（SER）为-0.00～-1.00 D、>-1.00～-2.00 D、>-2.00～-3.00 D者分别为15、16、21只眼。对照组58只眼中，SER为-0.00～-1.00 D、>-1.00～-2.00 D、>-2.00～-3.00 D者分别为21、18、19只眼。将黄斑中心凹6 mm范围内划分为以黄斑中心凹为中心的3个同心圆，直径为1 mm的中心区、1~3 mm的内环区、3~6 mm的外环区，共9个区。内环、外环4区分别为上方、下方、鼻侧、颞侧。观察隐匿性高度近视组和对照组儿童黄斑各分区的脉络膜厚度变化。两组间黄斑各分区脉络膜厚度比较采用独立样本n t检验。隐匿性高度近视组黄斑中心凹平均脉络膜厚度与性别、年龄、眼压、眼轴、屈光度、角膜曲率的相关性采用Pearson相关性分析。n 结果:隐匿性高度近视组儿童黄斑区脉络膜厚度以鼻侧最薄，颞侧最厚。与对照组比较，隐匿性高度近视组儿童黄斑9个分区平均脉络膜厚度均较对照组明显变薄，差异均有统计学意义（n P-2.00～-3.00 D儿童黄斑中心凹内环颞侧、外环颞侧平均脉络膜厚度之间的差异无统计学意义外（n P>0.05），其余各分区平均脉络膜厚度之间的差异均有统计学意义（n P-1.00 to -2.00 D, > -2.00 to -3.00 D were 15, 16 and 21 eyes. Among 58 eyes in the control group, the SER of -0.00 to -1.00 D, > -1.00 to -2.00 D, >-2.00 to -3.00 D were 21, 18 and 19 eyes, respectively. The macular fovea within 6 mm was divided into three concentric circles centered on the macular fovea, which included the central area with a diameter of 1 mm, the inner ring area with a diameter of 1-3 mm, and the outer ring area with a diameter of 3-6 mm, totally 9 areas. The inner ring and outer ring were divided into upper, lower, nasal and temporal areas. The changes of choroidal thickness in each macular area of children in occult high myopia group and control group were observed. The choroidal thickness in each macular area was compared between the two groups using independent sample n t-test. Pearson correlation analysis was used to analyze the correlation between mean foveal choroidal thickness and gender, age, intraocular pressure, ocular axis, diopter and corneal curvature in occult high myopia group.n Results:Choroidal thickness in macular area of children in occult high myopia group was thinnest in nasal side and thickest in temporal side. Compared with the control group, the mean choroidal thickness in the 9 macular zones of children in the occult high myopia group was significantly thinner than that in the control group, and the difference was statistically significant (n P-2.00 to -3.00 D (n P>0.05), but there were significant differences among the other regions (n P<0.05). Pearson correlation analysis results showed that the average choroidal thickness of the fovea in children with occult high myopia was negatively correlated with age (n r=-3.410, n Rn 2=11.630, n P=0.010), eye axis (n r=1.420, n Rn 2=2.016, n P=0.030) and diopter (n r=-2.680, n Rn 2=7.182, n P=0.040), but not significantly correlated with gender (n r=0.166, n Rn 2=0.028, n P=0.240), intraocular pressure (n r=0.330, n Rn 2=0.109, n P=0.800) and corneal curvature (n r=-0.260, n Rn 2=0.068, n P=0.850).n Conclusions:The thickness of macular choroidal in children with occult high myopia is the thinnest on the nasal side of the macular fovea and the thickest on the temporal side of the macular fovea. The mean choroidal thickness in each region of the macular is thinner than that in the common myopia children with the same diopter. The mean choroidal thickness of fovea is negatively correlated with age, ocular axis and diopter.