目的：观察12～18岁青少年视网膜神经纤维层厚度(RNFLT)，并分析其与眼轴长度(AL)、等效球镜(SE)的相关性。

方法：横断面研究。收集2019-07/12在我院眼科就诊的汉族青少年145例145眼(均取左眼数据分析)，根据SE情况分为对照组(-0.25～+0.25D，52眼)、低度近视组(-0.5～-3.0D，60眼)、中度近视组(-3.25～-6.0D，25眼)及高度近视组(-6.25～-12.0D，8眼)。应用SD-OCT检测RNFLT，并对检测结果行光学放大效应校正，比较各组受检者的RNFLT差异，分析其与AL、SE的相关性。

结果：本研究纳入受检者年龄越大，眼轴越长，近视度数越高。低度、中度近视组校正后鼻侧和平均RNFLT均较对照组增厚； 中度、高度近视组校正后颞侧RNFLT均较对照组、低度近视组增厚； 中度、高度近视组校正后上方1：00位及颞侧2：00～4：00位RNFLT均较对照组和/或低度近视组增厚，下方6：00～7：00位均较对照组和/或低度近视组变薄； 中度近视组校正后鼻侧9：00位RNFLT较对照组增厚(均P<0.05)。相关性分析显示，本研究纳入受检者校正后颞侧及1：00～4：00位RNFLT与AL呈正相关(r=0.220、0.259、0.356、0.237、0.335，均P<0.01)，与SE呈负相关(r=-0.386、-0.276、-0.307、-0.254、-0.260，均P<0.01)； 6：00～7：00位RNFLT与AL呈负相关(r=-0.296、-0.327，均P<0.01)，与SE呈正相关(r=0.245、0.295，均P<0.05)。

结论：青少年眼球处于塑形期，RNFLT判别有特殊性，需考虑光学放大效应、AL及SE对RNFLT的影响。当颞侧1：00～4：00位校正后RNFLT较正常变薄，应考虑青光眼可能。

METHODS: Cross-sectional observational study. High-definition(HD), spectral-domain Cirrus OCT(Cirrus HD-OCT; Carl Zeiss, Dublin, CA)was used to analyze RNFLT in 145 healthy juveniles(145 eyes). The data for left eye were selected for analysis. The magnification effect was adjusted by the modified axial length method. The subjects were divided into four groups by spherical equivalent(SE): normal group(52 eyes, -0.25-+0.25D), low myopia group(60 eyes, -0.5--3.0D), moderate myopia group(25 eyes, -3.25--6.0D)and high myopia group(8 eyes,-6.25--12.0D). The correlations between RNFLT and axial length(AL)or SE was tested with linear regression analysis.

RESULTS: The older the age, the longer the eye axis length, the higher the degree of myopia. Comparison of adjusted RNFLT among the four groups: after adjustment, the average RNFLT of the low myopia group and the moderate myopia group were thicker than those of the normal control group(P<0.05). The adjusted RNFLT of temporal quadrant in the moderate myopia group and the high myopia group were significantly thicker than those in the normal group and the low myopia group, as well as the adjusted RNFLT of nasal quadrant in the low, moderate myopia group were significantly thicker compared with those in the normal group(P<0.05). There were statistically significant difference of adjusted RNFLT at 1-4 o'clock, 6 o'clock, 7 o'clock and 9 o'clock among multiple groups(P<0.05). The adjusted values of RNFLT at 1-4 o'clock all showed positively correlated with AL(r=0.220, 0.259, 0.356, 0.237, 0.335, all P<0.01)and negatively correlated with SE(r=-0.386, -0.276,-0.307, -0.254, -0.260, all P<0.01); The adjusted RNFLT at 6, 7 o'clock showed negatively correlated with AL(r=-0.296,-0.327, all P<0.01)and positively correlated with SE(r=0.245,0.295, all P<0.05).

CONCLUSION: Teenagers' eyeballs are still in the shaping stage. When judging RNFLT in myopic juveniles, effects of ocular magnification effect, AL and SE should be considered. When adjusted temporal RNFLT at 1-4 o'clock are thinner than normal, glaucoma should be considered.