单侧弱视患者的视网膜神经纤维层厚度
Retinal nerve fiber layer thickness in unilateral amblyopia.
作者信息
Yen May-Yung, Cheng Ching-Yu, Wang An-Guor
机构信息
Department of Ophthalmology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan, Republic of China.
出版信息
Invest Ophthalmol Vis Sci. 2004 Jul;45(7):2224-30. doi: 10.1167/iovs.03-0297.
PURPOSE
To test the hypothesis that eyes with amblyopia may have thicker retina, retinal nerve fiber layer thickness (RNFLT) was investigated in patients with unilateral amblyopia.
METHODS
Thirty-eight patients with unilateral amblyopia were studied. Among them, 20 patients had amblyopia with strabismus and 18 had refractive amblyopia without strabismus. Nineteen of 38 had anisometropia of 2.0 D or more. In addition, 17 patients with anisometropia of 2.0 D or more but without amblyopia were enrolled as control subjects. RNFLT was measured by optical coherence tomography with scan pattern "Nerve Head 2.0R" (Carl Zeiss Meditec, Dublin, CA). Average RNFLT was multiplied with their corresponding scan circumferences to estimate the integral values of the total RNFL area (RNFLT(estimated integrals)).
RESULTS
In all 38 patients with unilateral amblyopia, the difference in RNFLT and in RNFLT(estimated integrals) between the amblyopic eyes and the normal fellow eyes were statistically significant. Multivariate regression analysis with adjustment for axial length, spherical equivalence, age, and sex indicated significant differences as well. In the group of strabismic amblyopia, the difference in RNFLT and in RNFLT(estimated integrals) between the amblyopic eyes and the normal fellow eyes did not reach statistical significance. However, in the group of refractive amblyopia, the difference in RNFLT and in RNFLT(estimated integrals) between the amblyopia eyes and the normal fellow eyes both had a statistical significance. In the 19 patients with anisometropic amblyopia, the difference in RNFLT and in RNFLT(estimated integrals) between the amblyopic eyes and the normal fellow eyes were statistically significant. In the control group of 17 patients with nonamblyopic anisometropia, the difference in RNFLT and in RNFLT(estimated integrals) between both eyes did not reach statistical significance.
CONCLUSIONS
RNFLT may be affected by refractive amblyopia, but further histopathologic confirmation is needed.
目的
为验证弱视眼视网膜可能更厚这一假说，对单侧弱视患者的视网膜神经纤维层厚度（RNFLT）进行了研究。
方法
对38例单侧弱视患者进行研究。其中，20例患者为斜视性弱视，18例为屈光不正性弱视且无斜视。38例患者中有19例有2.0 D或更高的屈光参差。此外，选取17例有2.0 D或更高屈光参差但无弱视的患者作为对照。采用“视乳头2.0R”扫描模式（卡尔·蔡司医疗技术公司，加利福尼亚州都柏林）的光学相干断层扫描测量RNFLT。将平均RNFLT与其相应的扫描周长相乘，以估计总RNFL面积的积分值（RNFLT（估计积分））。
结果
在所有38例单侧弱视患者中，弱视眼与健侧正常眼之间的RNFLT及RNFLT（估计积分）差异具有统计学意义。经眼轴长度、等效球镜度、年龄和性别校正的多因素回归分析也显示出显著差异。在斜视性弱视组中，弱视眼与健侧正常眼之间的RNFLT及RNFLT（估计积分）差异未达到统计学意义。然而，在屈光不正性弱视组中，弱视眼与健侧正常眼之间的RNFLT及RNFLT（估计积分）差异均具有统计学意义。在19例屈光参差性弱视患者中，弱视眼与健侧正常眼之间的RNFLT及RNFLT（估计积分）差异具有统计学意义。在17例非弱视性屈光参差对照组患者中，双眼之间的RNFLT及RNFLT（估计积分）差异未达到统计学意义。
结论
RNFLT可能受屈光不正性弱视影响，但需要进一步的组织病理学证实。
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