Goh Jody P, Koh Victor, Chan Yiong Huak, Ngo Cheryl
*Department of Ophthalmology, National University Hospital †Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
J Glaucoma. 2017 Jul;26(7):619-625. doi: 10.1097/IJG.0000000000000683.
To study the distribution of macular ganglion cell-inner plexiform layer (GC-IPL) thickness and peripapillary retinal nerve fiber layer (RNFL) thickness in children with refractive errors.
Two hundred forty-three healthy eyes from 139 children with refractive error ranging from -10.00 to +5.00 D were recruited from the National University Hospital Eye Surgery outpatient clinic. After a comprehensive ocular examination, refraction, and axial length (AL) measurement (IOLMaster), macular GC-IPL and RNFL thickness values were obtained with a spectral domain Cirrus high definition optical coherence tomography system (Carl Zeiss Meditec Inc.). Only scans with signal strength of >6/10 were included. Correlation between variables was calculated using the Pearson correlation coefficient. A multivariate analysis using mixed models was done to adjust for confounders.
The mean spherical equivalent refraction was -3.20±3.51 D and mean AL was 24.39±1.72 mm. Average, minimum, superior, and inferior GC-IPL were 82.59±6.29, 77.17±9.65, 83.68±6.96, and 81.64±6.70 μm, respectively. Average, superior, and inferior peripapillary RNFL were 99.00±11.45, 123.20±25.81, and 124.24±22.23 μm, respectively. Average, superior, and inferior GC-IPL were correlated with AL (β=-2.056, P-value 0.000; β=-2.383, P-value 0.000; β=-1.721, P-value 0.000), but minimum GC-IPL was not (β=-1.056, P-value 0.115). None of the RNFL parameters were correlated with AL.
This study establishes normative macular GC-IPL and RNFL thickness in children with refractive errors. Our results suggest that high definition optical coherence tomography RNFL parameters and minimum GC-IPL are not affected by AL or myopia in children, and therefore warrants further evaluation in pediatric glaucoma patients.
研究屈光不正儿童黄斑神经节细胞 - 内丛状层（GC - IPL）厚度和视乳头周围视网膜神经纤维层（RNFL）厚度的分布情况。
从国立大学医院眼科门诊招募了139名屈光不正儿童的243只健康眼睛，屈光不正范围为 - 10.00至 + 5.00 D。经过全面的眼部检查、验光和眼轴长度（AL）测量（IOLMaster）后，使用光谱域Cirrus高分辨率光学相干断层扫描系统（卡尔·蔡司医疗技术公司）获取黄斑GC - IPL和RNFL厚度值。仅纳入信号强度>6/10的扫描图像。使用Pearson相关系数计算变量之间的相关性。采用混合模型进行多变量分析以调整混杂因素。
平均球镜等效屈光度为 - 3.20±3.51 D，平均眼轴长度为24.39±1.72 mm。黄斑GC - IPL的平均值、最小值、上方和下方厚度分别为82.59±6.29、77.17±9.65、83.68±6.96和81.64±6.70μm。视乳头周围RNFL的平均值、上方和下方厚度分别为99.00±11.45、123.20±25.81和124.24±22.23μm。黄斑GC - IPL的平均值、上方和下方厚度与眼轴长度相关（β = - 2.056，P值0.000；β = - 2.383，P值0.000；β = - 1.721，P值0.000），但最小值GC - IPL与眼轴长度无关（β = - 1.056，P值0.115）。RNFL的各项参数均与眼轴长度无关。
本研究建立了屈光不正儿童黄斑GC - IPL和RNFL厚度的正常参考值。我们的结果表明，高分辨率光学相干断层扫描的RNFL参数和最小GC - IPL不受儿童眼轴长度或近视的影响，因此值得在儿童青光眼患者中进一步评估。
