利用谱域光学相干断层扫描评估营养不良对儿科患者眼参数的影响。
Evaluation Using Spectral-Domain Optical Coherence Tomography of the Effects of Malnutrition on Ocular Parameters in Pediatric Patients.
机构信息
Department of Ophthalmology, School of Medicine, Adiyaman University, Adiyaman, Turkey.
Department of Pediatrics, School of Medicine, Adiyaman University, Adiyaman, Turkey.
出版信息
Optom Vis Sci. 2020 Mar;97(3):154-161. doi: 10.1097/OPX.0000000000001490.
SIGNIFICANCE
We determined decreases in choroidal thickness and retinal nerve fiber layer (RNFL) thickness in all quadrants. Our findings show that the choroid and RNFL are affected before the emergence of ocular symptoms in malnourished children.
PURPOSE
We aimed to determine whether the RNFL, a component of the neuronal structure, and the choroid, supplying the retina, are affected in children with malnutrition using spectral-domain optical coherence tomography.
METHODS
One hundred twenty-six malnourished patients without ocular symptoms, aged between 5 and 10 years, and 116 healthy children were included in the study. Age, sex, weight-for-age (WFA) z score, height-for-age z score, body mass index-for-age z score, and spectral-domain optical coherence tomography data were recorded.
RESULTS
Average RNFL thickness was 96.5 μm (82.0 to 128.0 μm) in the malnutrition group and 111.0 μm (95.0 to 128.0 μm) in the control group (P < .001). Retinal nerve fiber layer thickness was statistically significantly lower in all quadrants in malnourished patients compared with the control group. Median choroidal thickness in the foveal center was 304.0 μm (250.0 to 375.0 μm) in the malnutrition group and 345.0 μm (280.0 to 403.0 μm) in the control group (P < .001). Choroidal thickness in all quadrants was also statistically significantly lower in malnourished patients. Positive correlation was determined between average RNFL thicknesses and WFA z score. Average RNFL thickness decreased as WFA z score decreased (r = 0.730 and P < .001). Positive correlation was also observed between choroidal thickness in the foveal center and WFA z score. Foveal center choroidal thickness decreased in line with WFA z score (r = 0.786 and P < .001).
CONCLUSIONS
Our results show that the retinal nerve fiber layer and choroidal thickness decreased in malnourished children without clinically reported ocular symptoms. A decreased retinal nerve fiber layer and choroidal thickness may be an important clue to the prevention of retinal pathologies that may develop at later ages if the malnutrition is not addressed.
意义
我们发现所有象限的脉络膜厚度和视网膜神经纤维层（RNFL）厚度均减少。我们的研究结果表明，在营养不良儿童出现眼部症状之前，脉络膜和 RNFL 就受到了影响。
目的
我们旨在使用谱域光相干断层扫描来确定营养不良儿童的 RNFL（神经元结构的组成部分）和脉络膜（为视网膜提供营养）是否受到影响，后者是为视网膜提供营养的结构。
方法
研究纳入了 126 名无眼部症状、年龄在 5 至 10 岁之间的营养不良患者和 116 名健康儿童。记录了年龄、性别、体重年龄（WFA）z 评分、身高年龄 z 评分、体重指数年龄 z 评分和谱域光相干断层扫描数据。
结果
营养不良组的平均 RNFL 厚度为 96.5μm（82.0 至 128.0μm），对照组为 111.0μm（95.0 至 128.0μm）（P＜0.001）。与对照组相比，营养不良患者所有象限的视网膜神经纤维层厚度均显著降低。营养不良组黄斑中心凹脉络膜厚度中位数为 304.0μm（250.0 至 375.0μm），对照组为 345.0μm（280.0 至 403.0μm）（P＜0.001）。营养不良患者所有象限的脉络膜厚度也明显较低。平均 RNFL 厚度与 WFA z 评分呈正相关。随着 WFA z 评分的降低，平均 RNFL 厚度降低（r=0.730，P＜0.001）。黄斑中心凹脉络膜厚度与 WFA z 评分也呈正相关。随着 WFA z 评分的降低，黄斑中心凹脉络膜厚度也随之降低（r=0.786，P＜0.001）。
结论
我们的研究结果表明，无临床报告眼部症状的营养不良儿童的视网膜神经纤维层和脉络膜厚度降低。如果不解决营养不良问题，RNFL 和脉络膜厚度的降低可能是预防日后发生视网膜病变的重要线索。
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