CAJ | 학술논문

目的通过对青年女性近视眼视网膜神经纤维层厚度的测量,分析其与眼轴长度和屈光度的相关关系,探讨青年女性近视的眼底微细结构的变化规律.方法临床病例对照研究.对2010年7～10月在抚顺市眼病医院就诊的病人中收集107例青年女性(年龄为19～30岁),214只眼,按屈光度(SE)进行分组,A组,低度近视组:-0.25D≥SE≥-3 D(67只眼)；B组,中度近视组:-3D＞SE≥-6 D(83只眼)；C组,高度近视组:SE＜-6 D(64只眼).检测每个受试眼的眼轴长度(AL),上方(SRNFL)、下方(IRNFL)、鼻侧(NRNFL)、颞侧(TRNFL)四象限以及平均(MRNFL)视网膜神经纤维层厚度.各组间采用样本均数间的两两比较的方法对资料进行处理.所测的视网膜神经纤维层厚度与眼轴长度和屈光度进行直线相关分析.结果相关性:TRNFL与AL呈正相关(r=0.318,P ＜0.01),与SE呈负相关(r=-0.278,P＜0.01).MRNFL、SRNFL、NRNFL、IRNFL与AL呈负相关(r值分别是-0.388,-0.441,-0.416,-0.362,P＜0.01),与SE呈正相关(r值分别是0.414,0.440,0.460,0.368,P＜0.01).组间两两比较:A组与B、C组的TRNFL比较有统计学意义(P＜0.05),B组与C组无统计学意义(P=0.243).NRNFL及SRNFL各组之间均有统计学意义(P＜0.05).C组与A、B组的MRNFL和IRNFL结果均有统计学意义(P＜0.01),A组与B组比较无统计学意义(P＞0.05).结论随着近视度数的增加和眼轴的增长,青年女性的TRNFL增厚,SRNFL、NRNFL、IRNFL和MRNFL变薄.青年女性NRNFL和SRNFL在近视进展早中期就己变薄.青年女性近视与早期青光眼IRNFL及MRNFL厚度的变化不同,利用此点,可以进行近视与青光眼的鉴别诊断.
목적 통과대청년녀성근시안시망막신경섬유층후도적측량,분석기여안축장도화굴광도적상관관계,탐토청년녀성근시적안저미세결구적변화규률.방법 림상병례대조연구.대2010년7～10월재무순시안병의원취진적병인중수집107례청년녀성(년령위19～30세),214지안,안굴광도(SE)진행분조,A조,저도근시조:-0.25D≥SE≥-3 D(67지안)；B조,중도근시조:-3D＞SE≥-6 D(83지안)；C조,고도근시조:SE＜-6 D(64지안).검측매개수시안적안축장도(AL),상방(SRNFL)、하방(IRNFL)、비측(NRNFL)、섭측(TRNFL)사상한이급평균(MRNFL)시망막신경섬유층후도.각조간채용양본균수간적량량비교적방법대자료진행처리.소측적시망막신경섬유층후도여안축장도화굴광도진행직선상관분석.결과 상관성:TRNFL여AL정정상관(r=0.318,P ＜0.01),여SE정부상관(r=-0.278,P＜0.01).MRNFL、SRNFL、NRNFL、IRNFL여AL정부상관(r치분별시-0.388,-0.441,-0.416,-0.362,P＜0.01),여SE정정상관(r치분별시0.414,0.440,0.460,0.368,P＜0.01).조간량량비교:A조여B、C조적TRNFL비교유통계학의의(P＜0.05),B조여C조무통계학의의(P=0.243).NRNFL급SRNFL각조지간균유통계학의의(P＜0.05).C조여A、B조적MRNFL화IRNFL결과균유통계학의의(P＜0.01),A조여B조비교무통계학의의(P＞0.05).결론 수착근시도수적증가화안축적증장,청년녀성적TRNFL증후,SRNFL、NRNFL、IRNFL화MRNFL변박.청년녀성NRNFL화SRNFL재근시진전조중기취기변박.청년녀성근시여조기청광안IRNFL급MRNFL후도적변화불동,이용차점,가이진행근시여청광안적감별진단.
Objective To investigate the thickness of the retinal nerve fiber layer (RNFL) associated with myopia in young women and observe the relationship of the thickness of RNFL with the axial length and the diopter.To analysis the variational rule of retinal minute structure of myopia in young women.Methods A total of 107 young women (214 eyes) between 19 and 30 years of age were selected.Those selected were divided into three groups according to the diopter.Group A (low myopia):-0.25D ≥ SE ≥ -3D (67 eyes).Group B (moderate myopia):-3 D ＞SE ≥ -6 D (83eyes).Group C (highly myopia):SE ＜-6 D (64 eyes).The axial length (AL) and the thickness of RNFL of every eye were measured.The thickness of RNFL included MRNFL,SRNFL,IRNFL,NRNFL,and TRNFL.The sample mean data of every group were dealt with the methods of multiple comparisons.The linear correlation analysis was used to analyze the relationship of RNFL with AL and the diopter.Results The thickness of TRNFL was positively correlated with axial length (r =0.318,P ＜ 0.01) and negative correlated with diopter (r =-0.278,P ＜ 0.01).The RNFL thickness in mean, superior, nasal, and inferior were negative correlated with axial length (r =-0.388,-0.441,-0.416,-0.362,respectively,P ＜ 0.01) and positively correlated with diopter (r=0.414,0.440,0.460,0.368,respectively,P ＜ 0.01).There were no statistically significant differences of the thickness of TRNFL between Group B and Group C (P =0.243).The TRNFL thickness of Group A and Group B were statistically significant differences with the RNFL thickness in temporal of Group C (P ＜ 0.05).There were statistically significant differences of NRNFL thickness and SRNFL thickness in every group (P ＜ 0.05).The MRNFL and IRNFL thickness of Group A and Group B were statistically significant differences with the MRNFL and IRNFL thickness of Group C (P ＜0.01).There were no statistically significant differences of MRNFL and IRNFL thickness between Group A and Group B (P ＞ 0.05).Conclusions In young women,increasing axial length and myopia diopter is associated with the increased thickness of TRNFL and the reduced thickness of MRNFL,IRNFL,NRNFL and SRNFL.The changes of the MRNFL and the IRNFL thickness of myopia in young women and early period of glaucoma are different which can distinguish myopia from glaucoma.