不同程度近视患者视网膜神经纤维层厚度和神经节细胞复合体参数的变化

Changes of ganglion cell complex and retinal nerve fiber layer thickness in different degrees of myopia

摘要:

目的：比较低度、中度和高度近视非青光眼受试者通过光谱域光学相干断层扫描技术(SD-OCT)测量的视网膜神经纤维层(RNFL)和黄斑神经节细胞复合体(GCC)参数的变化。

方法：选择2019-12/2022-11期间在我院就诊的近视受试者400例400眼参与本研究，根据受试者近视程度分为：低度近视组(142例142眼，35.5%)、中度近视组(139例139眼，34.8%)和高度近视组(119例119眼，29.8%)。测量RNFL厚度，包括均值、上方、下方、鼻侧、颞侧RNFL厚度。测量GCC参数，包括均值、上方、颞上方、下方、颞下方、鼻上方、鼻下方。评估OCT测量的RNFL厚度、GCC参数均值与眼轴长度之间的相关性。

结果：低度近视组和中度近视组的上方、下方、鼻侧、平均RNFL厚度明显高于高度近视组，颞侧RNFL厚度明显低于高度近视组(均P<0.05)； 低度近视组和中度近视组的上方、颞上方、下方、颞下方、鼻上方、鼻下方、平均GCC厚度明显高于高度近视组(均P<0.05)； 在中度近视组中，RNFL和GCC厚度均值与眼轴长度均呈负相关(r=-0.387、-0.309，均P<0.05)。在高度近视组中，RNFL和GCC厚度均值与眼轴长度均呈负相关(r=-0.499、-0.503，均P<0.01)。

结论：高度近视受试者的RNFL和GCC厚度往往比低度和中度近视受试者更薄。

Abstract:

AIM: To compare the changes in retinal nerve fiber layer(RNFL)and macular ganglion cell complex(GCC)measured by spectral domain optical coherence tomography(SD-OCT)in non-glaucoma subjects with low, moderate, and high myopia.

METHODS: A total of 400 subjects(400 eyes)with myopia who attended our hospital from December 2019 to November 2022 were selected to participate in this study, and the subjects were divided into the following groups according to their degree of myopia: low myopia group(142 cases, 142 eyes, 35.5%), moderate myopia group(139 cases, 139 eyes, 34.8%)and high myopia group(119 cases, 119 eyes, 29.8%). RNFL thickness profiles were measured, including mean, superior, inferior, nasal, and temporal RNFL thickness. GCC parameters were measured, including mean, superior, superior temporal, inferior, inferior temporal, superior nasal, and inferior nasal. Correlation between RNFL thickness measured by OCT, mean GCC parameters, and axial length was evaluated.

RESULTS: The mean RNFL thickness above, below and nasal side was significantly higher in the low and moderate myopia groups and the temporal RNFL thickness was significantly lower than the high myopia group(all P<0.05); the mean GCC thickness above, above temporal, below, below temporal, above nasal, below nasal and mean GCC thickness were significantly higher in the low and moderate myopia groups than in the high myopia group(all P<0.05); In the moderate myopia group, the mean RNFL and GCC thickness were both negatively correlated with axial length(r=-0.387, -0.309, all P<0.05). In the high myopia group, both RNFL and GCC thickness means were negatively correlated with eye axis length(r=-0.499, -0.503, all P<0.01).

CONCLUSION:RNFL and GCC thicknesses tend to be thinner in subjects with high myopia than in subjects with low and moderate myopia.