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剥夺性弱视的光谱域光相干断层扫描分析:单侧小儿白内障患者的初步研究。

Spectral-domain optical coherence tomography analysis in deprivational amblyopia: a pilot study with unilateral pediatric cataract patients.

机构信息

Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2013 Dec;251(12):2811-9. doi: 10.1007/s00417-013-2494-1. Epub 2013 Oct 22.

Abstract

BACKGROUND

To investigate whether macular and peripapillary retinal nerve fiber layer (RNFL) structure differs among deprivational amblyopic eyes, fellow non-amblyopic eyes, and age-matched normal eyes, using spectral-domain optical coherence tomography (SD-OCT).

METHODS

Macula and optic disc of 14 unilateral pseudophakic children with deprivational amblyopia, and 14 age-matched normal children (mean age, 7.45 ± 2.57 years) were scanned with Cirrus(TM) HD-OCT. Macular, RNFL, and macular ganglion cell-inner plexiform layer (GCIPL) thicknesses were measured, and compared between the eyes after correction for axial length-related magnification errors.

RESULTS

The average RNFL thickness tended to be greater in amblyopic eyes (99.64 ± 10.11 μm) than in fellow non-amblyopic eyes (97.28 ± 12.34 μm) and normal eyes (95.38 ± 9.74 μm), but did not show statistical significance (p = 0.429, p = 0.286 respectively). The nasal RNFL thickness was significantly greater in amblyopic eyes (75.84 ± 19.22 μm) than in fellow non-amblyopic eyes (63.42 ± 14.05 μm, p = 0.037) and normal eyes (62.38 ± 9.65 μm, p = 0.043). The central macular thickness in amblyopic eyes (237.05 ± 37.74 μm) showed no significant differences compared to those of fellow non-amblyopic eyes (226.67 ± 34.71 μm) and normal eyes (233.74 ± 27.11 μm) (p = 0.137, p = 0.792 respectively). The macular GCIPL thickness showed no significant difference among the amblyopic, fellow non-amblyopic, and normal eyes (average; 78.94 ± 6.35 μm vs 78.77 ± 6.43 μm vs 82.22 ± 5.00 μm respectively, p > 0.05).

CONCLUSIONS

SD-OCT analysis of deprivational amblyopic eyes with unilateral pediatric cataract demonstrated significant increase in nasal RNFL thickness compared to fellow non-amblyopic eyes and age-matched normal eyes. The macular and macular GCIPL thickness did not show any significant difference. Taken together, monocular pattern deprivation in early childhood may have changed the nasal peripapillary RNFL structure.

摘要

背景

本研究旨在使用频域光学相干断层扫描(SD-OCT)技术,探讨剥夺性弱视眼、对侧非弱视眼和年龄匹配正常眼中黄斑和视盘神经纤维层(RNFL)结构是否存在差异。

方法

对 14 例单侧白内障剥夺性弱视儿童(平均年龄 7.45 ± 2.57 岁)和 14 例年龄匹配正常儿童的黄斑和视盘进行 Cirrus(TM)HD-OCT 扫描。测量黄斑、RNFL 和黄斑神经节细胞-内丛状层(GCIPL)厚度,并校正眼轴相关放大误差后进行比较。

结果

弱视眼的平均 RNFL 厚度(99.64 ± 10.11 μm)高于对侧非弱视眼(97.28 ± 12.34 μm)和正常眼(95.38 ± 9.74 μm),但差异无统计学意义(p = 0.429,p = 0.286)。弱视眼的鼻侧 RNFL 厚度(75.84 ± 19.22 μm)明显大于对侧非弱视眼(63.42 ± 14.05 μm,p = 0.037)和正常眼(62.38 ± 9.65 μm,p = 0.043)。弱视眼的中央黄斑厚度(237.05 ± 37.74 μm)与对侧非弱视眼(226.67 ± 34.71 μm)和正常眼(233.74 ± 27.11 μm)相比差异无统计学意义(p = 0.137,p = 0.792)。弱视眼、对侧非弱视眼和正常眼的黄斑 GCIPL 厚度无明显差异(平均分别为 78.94 ± 6.35 μm、78.77 ± 6.43 μm、82.22 ± 5.00 μm,p > 0.05)。

结论

单侧儿童白内障剥夺性弱视眼的 SD-OCT 分析显示,与对侧非弱视眼和年龄匹配正常眼相比,鼻侧 RNFL 厚度明显增加,而黄斑和黄斑 GCIPL 厚度无明显差异。综上所述,儿童早期单眼形觉剥夺可能改变了鼻侧视盘周围的 RNFL 结构。

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