目的：建立13～18岁国人正常眼经光学相干断层扫描(OCT)检测的视盘周围视网膜神经纤维层厚度(RNFLT)参考值范围； 研究 RNFLT各相关参数与性别、年龄、眼别、民族的关系。

方法：应用OCT对13～18岁正常国人201例402眼正常眼，采用视网膜神经纤维层(RNFL)平均厚度分析程序，测量视盘为中心直径3.4mm的全周平均以及不同象限和不同钟点位的RNFLT。所得资料应用SPSS 19.0软件进行统计学处理，分析年龄、眼别、性别、民族等多个因素对RNFLT的影响。

结果：13，14，15，16，17，18岁各年龄段受检者的全周平均RNFLT分别为108.32±9.42，109.23±9.67，110.36±11.14，111.27±10.21，109.23±9.67，112.11±8.83μm，13～18右眼全周平均RNFLT为109.82±8.93μm，左眼全周平均RNFLT为110.33±9.89μm。13～18岁男性受检者的全周平均RNFLT为110.14±10.02μm，女性受检者的全周平均RNFLT为109.96±11.22μm； 13～18汉族受检者的全周平均RNFLT为110.22±9.31μm，非汉族受检者的全周平均RNFLT为109.87±8.65μm。所有检查者的全周平均RNFLT为110.02±9.87μm，上方、鼻侧、下方和颞侧的RNFLT分别为146.56±18.88，76.49±13.28，136.64±16.29，82.01±12.55μm。13～18岁各年龄组之间的RNFLT组间比较，以及男/女比较、左/右眼比较、汉族/非汉族比较无统计学意义(P均>0.05)； 全周RNFLT与数据库中的成人RNFLT平均值比较，有统计学意义(P<0.05)。男/女的左右眼比较，右眼1：00及左眼的1：00，2：00，3：00之间的RNFLT比较有统计学意义(P<0.05)，左眼上方象限RNFLT的比较有统计学意义(P<0.05)。

结论：本研究建立了13～18岁正常国人RNFLT和相关参数的正常参考值，年龄、眼别、性别、民族对该年龄段RNFL平均厚度无明显影响。检查结果与成人测量值有明显差异，涉及RNFL改变的疾病诊断和随诊时不应使用成人标准。

AIM: To establish a reference range of retinal nerve fiber layer(RNFL)thickness by optical coherence tomography(OCT)in Chinese teenagers aged from 13 to 18 years old, and investigate its relationship with age, eye side, gender, and ethnic group.

METHODS: A total of 402 eyes from 201 normal Chinese aged from 13 to 18 years old were recruited for this study. Optic disk with 3.4mm diameter circle in different global average, quadrant and part-time bit retinal nerve fiber layer thickness(RNFLT)was measured by RNFL thickness average analysis program. Their RNFLT at different part-time bit, quadrant and global average RNFLT around the disc were measured by OCT with 3.4mm diameter circle, using the RNFL thickness average analysis program. The data was analyzed with SPSS statistical 19.0. The influences of several factors(such as age, eye side, gender, and ethnic group)on RNFLT were also analyzed.

RESULTS: The global average RNFLT at 13, 14, 15, 16, 17, 18 years old was 108.32±9.42μm, 109.23±9.67μm, 110.36±11.14μm, 111.27±10.21μm, 109.23±9.67μm, 112.11±8.83μm respectively. RNFLT of right eyes was 109.82±8.93μm and of left eyes was 110.33±9.89μm. All of the male's average RNFLT was 110.14±10.02μm, and all of the female's average RNFLT was 109.96±11.22μm. The average RNFLT of Han nationality was 110.22±9.31μm and of non-Han nationality was 109.87±8.65μm. The average RNFLT of all was 110.02±9.87μm, the RNFLT at the superior, nasal, inferior and temporal quadrant was 146.56 ±18.88μm, 76.49±13.28μm, 136.64±16.29μm, 82.01±12.55μm respectively. There was no significant difference in gender, eye side, and ethnic group(all P<0.05), but the difference was significant compared with adult's data of the database.

CONCLUSION: This study has established a normal standard reference of RNFLT and its related indexes by OCT in Chinese teenagers aged 13-18 years old. Gender, age, eye side, and ethnic group have no effect on their RNFLT, which has significant difference with adult's data. And for the diagnosis and follow-up of diseases involving in RNFL changes, the adult's data can not be used.

桂林市科学研究与技术开发计划项目基金资助(No.20090112-2)