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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P<0.05)。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P<0.05)。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。
Objective: To investigate the value of optical coherence tomography (OCT) in the thickness measurement of retinal nerve fiber layer (RNFL) in myopia. Methods: 73 patients (138 eyes) with myopia treated in the hospital from January 2016 to May 2016 were enrolled in this study. According to the myopia, the patients were divided into a total of -0.30D ~ -3.00D Totally 23 cases (43 eyes) were seen in 26 eyes (48 eyes), moderate myopia (-3.01 ~ -6.00 D), 24 eyes (47 eyes) and high myopia (> -6.00 D). In the same period, 25 healthy volunteers (45 eyes) with normal vision in hospital were selected as the control group. The RNFL thickness, diopter and axial length in different quadrants of each group were compared. The RNFL thickness and refractive index And the axial length of the correlation. Results: The RNFL thickness in the upper quadrant, lower quadrant and nasal quadrant in high myopia group were significantly lower than those in control group and moderate myopia group. RNFL thickness in lower quadrant and nasal quadrant of moderate myopia group was significantly lower than that in control group The RNFL thickness of the nasal quadrant in the low myopia group was significantly lower than that in the control group (all P <0.05). The myopia and axial length were significantly larger than the control group, and the high myopia group were significantly greater than the moderate myopia group and low myopia group, moderate myopia group were significantly greater than the low myopia group, the difference was statistically significant ( All P <0.05). Pearson analysis based on the correlation shows that patients with myopia upper quadrant, lower quadrant, nasal quadrant of the RNFL thickness and its diopter and axial length were negatively correlated. Conclusion: When using OCT technique to detect RNFL thickness of myopia, we should consider the possible influence of diopter and axial length, and make comprehensive analysis and judgment to get the best detection value.