Boberg-Ans Lars C, Munch Inger C, Larsen Michael, Gopinath Bamini, Wang Jie Jin, Mitchell Paul
*Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark; †Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; ‡Department of Ophthalmology, Roskilde Hospital, Zealand University Hospital, Roskilde, Denmark; §Centre for Vision Research, Department of Ophthalmology, Westmead Millennium Institute, Sydney, New South Wales, Australia; ¶University of Sydney, Darlington, New South Wales, Australia; and **Centre for Eye Research Australia, Department of Ophthalmology, University of Melbourne, Parkville, Victoria, Australia.
Retina. 2017 Feb;37(2):382-387. doi: 10.1097/IAE.0000000000001166.
To investigate the epidemiology of Gunn's dots and their associations in a population-based cohort of children.
Red-free fundus photographs from 2,286 children aged 11 years to 14 years from the Sydney Myopia Study were graded. Gunn's dots were manually marked and counted within a 6 mm grid centered on the optic disc.
One or more Gunn's dots were seen in at least one eye in 82.6% of children. The median number of Gunn's dots per eye was 46 (range 0-482). Most Gunn's dots were found inferior and superior of the optic disc (49.3% and 45.8%, respectively, of the total number of Gunn's dots in the population). The odds for having 1 or more Gunn's dots were 3-fold greater in children with dark brown irides compared with children with blue irides (odds ratio 2.99, 95% CI 1.81 to 4.94, P < 0.0001 adjusted for age, sex, retinal nerve fiber layer thickness, refraction, ethnicity, and axial length). In the same analysis, the presence of 1 or more Gunn's dots was less frequent in children with thin retinal nerve fiber layers (first quartile) compared with children with thick retinal nerve fiber layers (fourth quartile) (odds ratio 0.68, 95% CI 0.49-0.93, P = 0.016). No disease or disease-marker associations were identified.
Gunn's dots were visible on fundus photographs in most of the school children, most of the dots being located inferiorly and superiorly to the optic disc. Fundus photographically visible Gunn's dots were associated with darker irides and thicker retinal nerve fiber layers. Gunn's dots are a common and apparently harmless finding in children. Assessment of their clinical significance will require long-term follow-up.
在一个以人群为基础的儿童队列中研究冈恩氏点的流行病学及其关联因素。
对悉尼近视研究中2286名11至14岁儿童的无赤眼底照片进行分级。在以视盘为中心的6毫米网格内手动标记并计数冈恩氏点。
82.6%的儿童至少一只眼睛中可见一个或多个冈恩氏点。每只眼睛冈恩氏点的中位数为46个（范围0 - 482个）。大多数冈恩氏点位于视盘下方和上方（分别占人群中冈恩氏点总数的49.3%和45.8%）。与蓝色虹膜的儿童相比，深棕色虹膜的儿童出现一个或多个冈恩氏点的几率高3倍（优势比2.99，95%置信区间1.81至4.94，经年龄、性别、视网膜神经纤维层厚度、屈光、种族和眼轴长度调整后P < 0.0001）。在同一分析中，视网膜神经纤维层薄（第一四分位数）的儿童与视网膜神经纤维层厚（第四四分位数）的儿童相比，出现一个或多个冈恩氏点的频率较低（优势比0.68，95%置信区间0.49 - 0.93，P = 0.016）。未发现与疾病或疾病标志物的关联。
大多数学龄儿童的眼底照片上可见冈恩氏点，大多数点位于视盘下方和上方。眼底照片上可见的冈恩氏点与较深的虹膜颜色和较厚的视网膜神经纤维层有关。冈恩氏点在儿童中是常见且明显无害的发现。对其临床意义的评估需要长期随访。
