目的：观察不同中央角膜厚度(CCT)的高眼压症(OHT)患者环视盘神经纤维层厚度(CP-RNFL)、视盘及黄斑区参数的差异，并与正常人群对比，探讨CCT与各参数的关系。

方法：前瞻性临床病例对照分析。纳入2016-01/2019-01在广东医科大学附属医院眼科确诊的OHT患者77例124眼进行研究。所有患者均未曾用药治疗。依据CCT的厚度分为3组：组1(CCT<555μm)25例38眼，组2(CCT 555～590μm)26例44眼，组3(CCT >590μm)26例42眼，选取同期年龄、性别、眼别均与高眼压组相匹配的健康体检者77例124眼为正常对照组。所有受检者均行视盘及黄斑三维光相干断层扫描(OCT)检查。运用系统自带软件计算平均CP-RNFL及各象限CP-RNFL的厚度及视盘、黄斑区各参数。

结果：组1的OHT患者比正常对照组盘沿面积变小； 相比组2，组3的患者，其下方CP-RNFL厚度变薄，盘沿的面积变小； 相比组3的患者，其黄斑区内环颞侧视网膜厚度变薄。三组高眼压组患者的黄斑中心凹、中心1mm、内环颞侧视网膜厚度较正常对照组变薄； CCT与盘沿面积呈正相关(均P<0.05)。

结论：尽管OHT患者的RNFL和视盘及黄斑区各参数在正常范围，但与正常人群对比还是有差异； CCT<555μm可能是OHT向开角型青光眼(POAG)转变的危险因素，临床上需要加强随诊及早期干预。

METHODS: This is a prospective study including 124 eyes of 77 OHT patients classified as group 1(CCT<555μm)including 38 eyes of 25 patients, group 2(CCT 555-590μm)including 44 eyes of 26 patients and group 3(CCT>590μm)including 42 eyes of 26 patients according to CCT. Totally 124 eyes of 77 normal healthy subjects, matching patients with age and gender, were divided into group four. The CP-RNFL thickness,optic nerve head and macular parameters were measured by 3D-OCT. There were no significant difference in gender, age between four groups and in intraocular pressure among three OHT patients groups.

RESULTS: The optic rim area was significantly smaller in group one than in other three groups, and the thickness of inferior CP-RNFL was significantly thinner than group two and group three, while the thickness of the temporal inner ring of macular was thinner than group three. All the thickness of the central fovea, macular center 1mm, the temporal inner ring of macular in OHT patients were significantly thinner than healthy subjects. The CCT and the rim area in OHT patients were significantly positively correlated.

CONCLUSION: The OHT patients are considered to be different from normal persons in optic nerve head and macular parameters though the parameters are still in normal range. CCT<555μm may be a risk factor of OHT patients converting to POAG, so we should pay more attention to following up these patients and intervention in time.