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目的：研究高度近视眼黄斑区神经上皮层厚度的变化，并分析其与屈光度的相关性。方法：选取高度近视患眼107 例，按屈光度不同分为Ⅰ组(-6 D至-8 D)、Ⅱ组(-8.25 D至-10. D)、Ⅲ组(＞-10 D)。采用光学相干断层扫描(optical coherence tomography， OCT)测量黄斑部9 个不同分区的视网膜神经上皮层厚度，即直径<1 mm(黄斑中心凹区)、1-3 mm(内环区：B1、B2、B3、B4)和3-6 mm(外环区：C1、C2、C3、C4)，比较期间的差别，并分析各区域神经上皮层厚度与屈光度之间的相关性。结果：Ⅰ组与Ⅱ组及Ⅲ组、 Ⅱ组与Ⅲ组黄斑中心凹区神经上皮层厚度比较差异具有统计学意义(P＜0.05)，Ⅲ组与Ⅰ组及Ⅱ组外环区神经上皮层比较差异具有统计学意义(P＜0.05)，Ⅰ、Ⅱ、Ⅲ组内环区神经上皮层厚度比较差异无统计学意义(P＞0.05)；黄斑中心凹及外环区视网膜神经上皮层厚度与近视屈光度呈显著负相关(r 分别为-0.233、0.248、0.278、0.383、0.336)，差异有统计学意义(P＜0.05)。结论：高度近视眼黄斑部视网膜神经上皮层厚度随近视屈光度的增高而呈区域选择性萎缩变薄。

英文摘要:

Objective:To investigate the changes of retinal nerve fiber thickness (RNFL) in eyes with high myopia and analyze its correlation with the diopter. Methods:According to spherical equivalent (SE), 107 eyes were divided into three groups: groupⅠwith SE from -6.0 to -8.0 D, groupⅡ with SE from -8.25 to -10.0 D, and groupⅢ with SE over -10 D. Retinal thickness in different regions of macular was measured and recorded by optical coherence tomography (OCT). In detail, the thickness of 9 regions, diameter within 1 mm (foveal region), diameter within 1-3mm (inner zones: B1, B2, B3, B4), diameter within 3-6mm (outer ring: C1, C2, C3, C4), were compared. At same time, the correlations of retinal thickness of various macular regions with SE were analyzed.Results:There were significant differences among 3 groups (data in foveal region)(P<0.05). There were significant differences between group Ⅲ and the other two groups(data in the outer zone)(P<0.05). There was no significant difference among 3 groups in data in the inner zone(P>0.05). Whether in foveal region or in outer regions, there were significant correlations of neurosensory retinal thickness with SE (r=-0.233, 0.248, 0.278, 0.383 and 0.336, P<0.05).Conclusion:With the increase of myopic diopter, the thickness of RNFL in macular regionally decreased.

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