目的：观察分析隐匿性高度近视儿童黄斑区视网膜厚度变化及其相关因素。

方法：前瞻性非随机对照研究。选取2019-09/2020-09在承德医学院附属医院眼科门诊首次就诊且未进行过任何近视矫正训练的儿童56例110眼纳入研究，根据儿童近视的临床表现分为隐匿性高度近视组(27例52眼)和对照组(29例58眼，普通近视儿童)。比较两组儿童黄斑各分区视网膜厚度情况，分析隐匿性高度近视儿童黄斑中心凹平均视网膜厚度与基线资料的相关性。

结果：隐匿性高度近视儿童黄斑区视网膜厚度以黄斑中心凹最薄，内环区上方最厚。隐匿性高度近视组儿童黄斑9个分区平均视网膜厚度均较对照组变薄，其中黄斑中心凹、外环区下方和颞侧处视网膜厚度有显著差异(均P<0.05)。随着隐匿性高度近视儿童屈光度的增高，黄斑各分区的平均视网膜厚度值均降低。与对照组相同屈光度儿童比较，隐匿性高度近视组除0.00D≤屈光度≤-1.00D儿童外环区颞侧、-2.00D<屈光度≤-3.00D儿童黄斑中心凹平均视网膜厚度有明显差异(均P<0.05)，其余各分区平均视网膜厚度均无差异(P>0.05)。Pearson相关分析结果显示，隐匿性高度近视儿童黄斑中心凹平均视网膜厚度与性别、年龄、眼轴、眼压、角膜曲率均无相关性(P>0.05)，与屈光度呈负相关性(r=-0.201，P<0.05)。

结论：隐匿性高度近视儿童黄斑视网膜厚度以黄斑中心凹最薄，内环区上方最厚，黄斑各分区平均视网膜厚度较相应屈光度数近视儿童薄。隐匿性高度近视儿童黄斑中心凹平均视网膜厚度与屈光度呈负相关。

METHODS: A prospective, non-randomized, contemporaneous controlled trial. From September 2019 to September 2020, 56 children(110 eyes)who first visited the ophthalmic clinic of the Affiliated Hospital of Chengde Medical College without any myopia correction training were enrolled in this study. According to the clinical manifestations of myopia in children, they were divided into occult high myopia group(27 cases, 52 eyes)and control group(29 cases, 58 eyes, children with common myopia). The retina thickness in each macular area was compared between the two groups, and we will analyze the correlation between macular fovea mean retinal thickness and baseline data in children with occult high myopia.

RESULTS: The average retinal thickness of 9 macular regions in the occult high myopia group was thinner than that in the control group, and there were significant differences in the macular fovea, the blow and temporal side of the outer ring area of macular fovea(P<0.05). Compared with the control group with the same spherical equivalent, there was significant difference in area that the temporal side of the outer ring of the macular fovea in the occult high myopia of 0.00D to -1.00D and the fovea in the occult high myopia group of >-2.00D to -3.00D(P<0.05), but there was no significant difference among the other regions(P>0.05). Pearson correlation analysis results showed that the average retinal thickness under macular fovea in children with secretive high myopia had no significant correlation with gender, age, eye axis, intraocular pressure and corneal curvature(P>0.05), but was negatively correlated with diopter(r=-0.201, P<0.05).

CONCLUSION: The thickness of macular retinal in children with occult high myopia is thinnest under macular fovea and the thickest above macular fovea in inner ring area. The average retinal thickness in each region of the macular is thinner than that in the common myopia children with the same diopter. The mean retinal thickness of macular fovea is negatively correlated with the diopter.