Measurement and variation of thickness of retinal nerve fiber layer in normal Chinese people by optical coherence tomography

目的 应用相干光断层扫描仪(OCT)测量中国正常人视网膜神经纤维层(RNFL)厚度并探讨年龄、屈光度、性别及视盘面积对平均RNFL厚度的影响.方法 运用Stratus OCT 4.0测量202例不同年龄及不同屈光度正常人(年龄8～74岁,屈光度-8～+4D)各钟点、象限及平均RNFL厚度,建立多元线性回归方程探讨年龄、屈光度、性别及视盘面积对平均RNFL厚度的影响;同时采用方差分析的方法比较不同年龄及屈光度者平均RNFL厚度的差异.结果 ①正常人RNFL平均厚度为(108.63±9.70)μm,下方象限RNFL(I):(139.17+15.79)μm最厚,其次为上方象限(S):(134.61±17.80)μm,颞侧象限(T):(85.37+21.25)μm,鼻侧象限(N):(75.19±17.06)μm最薄,即I＞S＞T＞N.②所得多元线性回归方程为y=-0.262 x1+1.588 x2+121-690(P1=0.000,P2=0.000;y代表平均RNFL厚度,x1代表年龄,x2代表屈光度),即平均RNFL厚度随着年龄的增长或近视度数的增加而变薄,未发现RNFL厚度与性别或视盘面积有关;方差分析表明50岁以 上者平均RNFL厚度显著变薄,高度近视者平均RNFL厚度显著薄于正视者.结论 OCT测得的正常人平均RNFL厚度主要与年龄、屈光度有关;未发现RNFL厚度与性别或视盘面积有关;应用规范、统一的OCT测量标准,建立人群为基础的并经相关影响因素校正的中国人RNFL正常值数据库对青光眼的早期诊断是非常必要的.Abstract:[Objective] To measure the thickness of peripapillary retinal nerve fiber layer(RNFL) in normal Chinese subjects with optical coherence tomography(OCT) and to identify the factors that might affect RNFL thickness.[Methods]Total of 202 randomly selected normal eyes from 202 subjects of both genders with different age(8～74 years) and refraction error(-8.00 to +4.00 D)underwent Stratus OCT 4.0 examination.RNFL thickness in four quadrants,twelve clock-hours and average RNFL thickness were determined.Meanwhile,the effects of age,refraetion,gender and disc area on average RNFL thickness were statistically investigated with multiple linear regression analysis.Also,comparison of average RNFL thickness among different age and refraction groups was statistically estimated by One-way AVON analysis.[Results] ① Average RNFL thickness was(108.63±9.70)μm.RNFL was thickest in the inferior quadrimt[(139.17±15.79)μm],followed by superior[(134.61±17.80) μm],temporal[(85.37±21.25)μm] and nasal[(75.19±17.06)μm]quadrants.②Average RNFL thickness decreased with age and inereasing myopia;gender and optic disc area had no effect On it.The multiple linear regression equation was:y=-0.262 x1+1.588 x2+ 121.690(P1=0.000,P2=0.000;y=average RNFL thickness,x1=age,x2=refraction). Meanwhile,average RNFL became signitleantly thinner either for people older than 50 or for high myopic eyes.[Conclusions] RNFL thickness measurement in normal Chinese population was estimated;average RNFL thickness was mainly affected by age and refraction;Our results proved the importance and impendence of building a RNFL normative database based on Chinese population and adjusted by possibly affecting factors (age,refraction and so on)to aid the evaluation and monitor of glaucoma in China.中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)06673-6781