目的:用光学相干断层扫描仪(optical coherence tomography,OCT)分析不同类型屈光参差性弱视黄斑部视网膜地形图的变化。方法:前瞻性系列病例研究。连续收集52例104眼单眼屈光参差性弱视(包括远视性弱视和近视性弱视)儿童患者,其中弱视组1为远视性弱视41例,弱视组2为近视性弱视11例,对照组为对侧非弱视眼。用OCT-3分别对弱视组和对照组黄斑部进行放射状扫描,按糖尿病视网膜病变早期治疗研究组(ETDRS)定义的黄斑九格分区法测量黄斑部九个区域视网膜厚度及黄斑中央小凹厚度和黄斑部总的体积。结果:弱视组黄斑部各区域视网膜厚度中黄斑中央小凹F(157.00±17.21μm)比对照组(144.19±12.83μm)厚,差异有统计学意义(P<0.05);弱视组黄斑中央凹1mm区域A1(189.23±14.68μm)比对照组厚(182.73±13.60μm),差异有统计学意义(P<0.05),其余各区域差异无统计学意义。弱视组黄斑部各区域视网膜体积中黄斑中央凹1mm区域A1(0.15±0.01mm3)比对照组(0.14±0.01mm3)大,差异有统计学意义(P<0.05),其余各区域差异无统计学意义。弱视组中远视性组和近视性组各区域黄斑视网膜厚度中黄斑中央小凹F和黄斑中央凹1mm区域A1远视性比近视性薄,但差异无统计学意义;A2～A9区远视性比近视性厚,其中A2～A5区差异无统计学意义,A6～A9区差异有统计学意义(P<0.05)。结论:弱视可以影响黄斑部视网膜,引起视网膜的厚度和体积发生改变,主要影响黄斑中央凹1mm区域,导致中心视力的下降;弱视对两种不同类型屈光参差眼黄斑部(中央3mm区域内)视网膜厚度的影响无明显差别。

AIM:This prospective study was performed to measure the macular thickness and volume in patients with different kinds of monocular anisometropic amblyopia using optical coherence tomography.METHODS:A total of 52 pediatric cases with monocular anisometropic amblyopia were registered in our hospital from July 2009 to June 2010.Amblyopic group included hyperopic amblyopia eyes(41 cases) and myopic amblyopia eyes(11 cases).The control group was the non-amblyopic eyes in patients with monocular anisometropic amblyopia.After 104 eyes of 52 cases were scaned,the thickness and volume of macular retina were measured with OCT-3,including foveola and nine areas of macula.RESULTS:The difference of thickness of macular foveola F and fovea(<1mm)A1 areas showed statistical significance between amblyopic group and control group.The macular retinal(F and A1) thickness of amblyopic group were thicker than that of control group(P<0.05).The difference of volume of macular fovea(<1mm) A1 areas showed statistical significance between amblyopic group and control group.The macular retinal(A1)volume of amblyopic group was greater than that of control group(P<0.05).In amblyopic group,the difference of thickness of macular foveola fovea(<1mm) A1 and A2～A5 areas showed no statistical significance,while the difference of thickness of macular A6～A9 areas showed statistical significance between hyperopic amblyopia eyes and myopic amblyopia eyes.The macular retinal(A6～A9) thickness of hyperopic amblyopia eyes were thicker than that of myopic amblyopia eyes(P<0.05).CONCLUSION:Thickness and volume of the macular retina may be affected by amblyopia,including macular fovea and foveola,which induced the decrease of central vision.There was no significant difference of thickness of macular fovea(<3mm) area.which was affected by amblyopia,between hyperopic amblyopia eyes and myopic amblyopia eyes.

R777.44