目的：探讨光学相干断层扫描(optical coherence tomography，OCT)在高度近视黄斑病变中的应用价值。

方法：前瞻性纳入2016-06/2017-05我院收治的高度近视患者作为观察组(50例50眼)，选择同期来我院体检的正常健康人(50例50眼)作为对照组，入院后所有对象均完成传统眼科检查和OCT检查，记录患者视力、眼压、屈光度、眼轴、黄斑部厚度及形态学改变情况，统计不同检查方式对高度近视黄斑病变检出情况。

结果：(1)观察组传统眼科检查黄斑区正常37眼，异常13眼(26%)； OCT检查正常12眼，异常38眼(76%)。OCT检出黄斑病变异常率高于传统眼科检查，差异有统计学意义(P<0.05)，OCT检出视网膜下或脉络膜新生血管、黄斑前膜率高于传统眼科检查，差异有统计学意义(P<0.05)； 对照组传统眼科检查与OCT检出正常所占比例比较，差异无统计学意义(P>0.05)。(2)高度近视黄斑病变患者眼压、屈光度、眼轴长度高于对照组，BVCA较对照组差，视网膜黄斑区厚度、视盘上方神经厚度、视盘下方神经厚度、视盘颞侧视神经厚度、视盘鼻侧视神经厚度均低于对照组，差异有统计学意义(P<0.05)。

结论：OCT可定量测定高度近视患者视网膜周围神经纤维层厚度，清晰显示黄斑区病变特点，可为高度近视黄斑病变诊断提供可靠的定量数据。

METHODS: Totally 50 patients(50 affected eyes)with high myopia who were admitted to our hospital during the period from June 2016 to May 2017 were prospectively enrolled in the observation group, and 50 normal healthy people(50 eyes)were selected as the control group at the same time. All subjects completed the conventional ophthalmic examination and OCT after admission. The visual acuity, intraocular pressure, diopter, eye axis, macular thickness and morphological changes were recorded, and detection of maculopathy of high myopia by different examination methods was statistically analyzed.

RESULTS: Conventional ophthalmic examination showed that the macular region was normal in 37 eyes and abnormal in 13 eyes(26%)while OCT showed that it was normal in 12 eyes and abnormal in 38 eyes(76%)in the observation group. The rate of maculopathy detected by OCT was higher than that by conventional ophthalmologic examination, with a significant difference(P<0.05). The rates of subretinal or choroidal neovascularization and macular epiretinal membrane detected by OCT were higher than those by conventional ophthalmologic examination, with significant differences(P<0.05). There was no significant difference in the proportion of normal results between conventional ophthalmologic examination and OCT in the control group(P>0.05). The intraocular pressure, diopter and axial length of patients with high myopia and maculopathy were higher/longer than those of the control group, the BVCA was worse than that of the control group, the thickness of retinal macular region, thickness of nerves above and below the optic disc, thickness of optic nerves on the bitamporal and nasal sides of the optic disc were lower than those of the control group, with significant differences(P<0.05).

CONCLUSION: OCT can quantitatively determine the thickness of nerve fiber layer around the retina in patients with high myopia, and clearly display the characteristics of maculopathy, which can provide reliable quantitative data for the diagnosis of maculopathy of high myopia.