作者简介：张艳明，博士在读，主治医师，研究方向：视光学、眼科基础。通讯作者：张艳明.【摘要】目的：运用光学相干断层成像技术(OCT)对高度近视患者进行黄斑区域不同象限视网膜厚度的测量，分析其分布特点和变化规律，并進一步探讨影响其变化的相关因素。方法：收集高度近视者68例 (38眼，男31眼，女37眼)，以及正常对照组40例（40眼，男20眼，女20眼），用IOL Master测量眼轴，用 Zeiss - Humphrey光学相干断层成像仪对黄斑区快速扫描，对性别、眼轴长度与黄斑区域各象限视网膜厚度之间进行相关分析。结果：1.正常对照组女性黄斑旁中心凹各部位（除上方）的视网膜神经上皮层厚度均低于男性组，而高度近视组中无性别差异。2.旁中心凹及旁周边中心凹下方对应的视网膜神经上皮层厚度与眼轴呈显著正相关；旁周边中心凹鼻侧对应的视网膜神经上皮层厚度与眼轴也呈正相关；中心凹最小厚度、中心凹平均厚度以及旁周边中心凹上方对应的视网膜神经上皮层厚度与眼轴无显著相关性。结论：黄斑区域视网膜神经上皮层厚度分布存在区域特异性，随眼轴延长出现区域选择性变薄，与性别无关。高度近视眼的视网膜变薄是确实存在的，主要是旁中心凹区，不是在中心凹。

【关键词】 高度近视；黄斑；视网膜厚度；眼轴；性别

【Abstract】PURPOSE: To investigate the relationship in macular retinal thickness of healthy Chinese myopic subjects by using optical coherence tomography (OCT). METHODS: A total of 40 normal subjects comprising 68 eyes with high myopia (spherical equivalent ［SE］ < –6.0 D) were underwent examination of optical coherence tomography. Fast macular thickness map OCT scans of 6 mm were done well on each eye. The minimum foveal and average foveal (1-mm ring on the OCT retinal thickness map) thicknesses , the inner ring (1–3-mm) macular thickness and the outer ring macular (3–6-mm) thicknesses of superior, nasal, temporal and inferior parafovea retinal thickness were recorded. RESULTS: 1.The inner ring (1–3-mm) and all(except the superior ) of the outer ring macular (3–6-mm) thicknesses were significantly lower in the normal women group than in the normal mem group. No significant difference was found in the high myopic group.(P < 0.05). 2. Negative correlations were found between axial length and the inner ring (1–3-mm) and all(except the superior ) of the outer ring macular (3–6-mm) macular thicknesses (P < 0.001). There was no correlation among the minimum foveal,average foveal (1-mm ring on the OCT retinal thickness map) thicknesses and the axial length(P < 0.05). CONCLUSIONS: Retinal thickness is related to axial length in normal subjects with regional variations in correlation within the 6-mm macular region,and not related to sex. The attenuation was really existed in high myopia. It was in parafovea area but not fovea.

【key words 】 High Myopia, macula, retinal thickness, sex, axial length

【中图分类号】R722.12 【文献标识码】B【文章编号】1004-4949(2014)07-0004-01

近视是全球发病率最高的屈光不正,尤其以亚洲地区为高。世界卫生组织已在“2020行动纲要”中将近视列为威胁视力的主要疾病之一［1］。……