| 目的 使用光学相干断层扫描(OCT)方法研究儿童单侧高度近视性弱视眼的黄斑视网膜神经上皮层厚度、黄斑容积变化，及其与眼轴之间的相关性,探讨弱视的发病机制及在诊断中的价值。
方法 采用OCT测定21例（21只眼）单侧高度近视性弱视眼（男性11例，女性10例，年龄5～14岁）及年龄相匹配的17例（34只眼）正常眼和 17例（30只眼）单纯高度近视儿童（男性10例，女性7例，年龄5～14岁）的以黄斑中心凹为圆心，定位施行6条夹角为30度的6mm放射状扫描。计算以中心凹中心为圆心显示为9个区域，依次编号为B1～B9的黄斑视网膜神经上皮层厚度及视网膜地形图各地区域平均厚度、黄斑容积值，并分别与对侧眼、正常眼和单纯高度近视眼比较，最后对结果进行统计学分析。
结果 黄斑视网膜神经上皮层厚度:单侧高度近视性弱视眼为225.18±10.33μm、对侧眼组为242.46±13.87μm、正常对照组为249.47±14.41μm、单纯高度近视组231.09±16.37μm，比较差异有显著性(p<0.05)；总体黄斑容积：单侧高度近视性弱视眼为6.419±0.408mm2、对侧眼组为6.873±0.474mm2、正常对照组为6.863±0.427mm2、单纯高度近视组6.434±0.443mm2 ，比较差异有显著性(p<0.05)；高度近视性弱视眼和高度近视眼的黄斑视网膜神经上皮层厚度、黄斑容积均随眼轴的增加逐渐变小,呈负相关(p<0.05)。
结论 OCT能精确测量儿童黄斑视网膜神经上皮层厚度、黄斑容积,单侧高度近视性弱视眼发病机制有待进一步组织病理学和神经细胞功能学研究。
Purpose：Use the optical coherence tomography (OCT) to study the macular thickness、the macular volume of the unilateral high myopia amblyopia of children and the correlation between the macular thickness、the macular volume and the axial length.To investigate the nosogenesis and diagnosis of high myopia amblyopia.
Methods:21 unilateral high myopia amblyopia cases (21 eyes),17 simple high myopia cases (34 eyes) and 17 normal cases (34 eyes) were tested by Optical Coherence Tomography(OCT）in the posterior pole of retina, six consecutive 6-mm radial line scans centered on the macula. An average retinal thickness and volume were reported for each of the nine regions. The relative macular thickness and volume of high myopia amblyopia was compared with those of fellow eyes、normal eyes and simple high myopia respectively. Finally, the results were analyzed statistically.
Results: the macular thickness:the unilateral high myopia amblyopia was 225.18±10.33μm、the fellow eyes was 242.46±13.87μm、the normal eyes was 249.47±14.41μm、the simple high myopia was 231.09±16.37μm, the difference between the high myopia amblyopia compared with fellow eyes and normal eyes had statistically significant (p﹤0.05); the macular volume: the unilateral high myopia amblyopia was 6.419±0.408mm3、the fellow eyes was 6.873±0.474mm3、the normal eyes was 6.863±0.427mm3、the simple high myopia was6.434±0.443mm3, the difference between the high myopia amblyopia compared with fellow eyes and normal eyes had statistically significant (p﹤0.05). The macular thickness and the macular volume decreased with axial length in high myopia amblyopia and high myopia, there were inverse linear correlation between the macular thickness、volume and axial length(p﹤0.05).
Conclusions:The macular thickness and macular volume of unilateral high myopia amblyopia of children were thinner than normal,but there was’t obvious compared with simple high myopia.The reasons for decreased corrected vision of unilateral high myopia amblyopia of children still need further research.
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