目的：通过对4～8岁远视性屈光不正性弱视患儿注视性质、黄斑各分区视网膜厚度的测量、眼轴长度的检查，探讨远视性弱视儿童注视性质与其黄斑各分区视网膜厚度间的相关性； 并进行远视性弱视儿童视网膜厚度及其相关因素的研究。

方法：前瞻性非随机同期对照研究试验。将2018-09/12首次就诊且之前未进行过任何弱视训练的患儿共计44例57眼纳入该研究。选取屈光不正性远视性弱视儿童36眼作为远视性弱视组，视力正常儿童21眼作为正常对照组，两组均利用光学相干断层扫描技术(OCT)进行黄斑各分区视网膜厚度测量； 同时将入组患儿在直接眼底镜检查下分为黄斑中心注视组32眼，旁中心注视组25眼，进行黄斑各分区视网膜厚度测量； 用SPSS19.0统计软件分别分析两组间视网膜厚度及差异。

结果：黄斑中心注视组在黄斑中心凹、黄斑内环鼻侧处视网膜厚度均小于旁中心注视组(P<0.05)； 而两组间余黄斑各分区视网膜厚度对比均无差异(P>0.05)。远视性弱视组的黄斑中心凹、黄斑内环鼻侧、黄斑内环下方及黄斑外环上方处视网膜厚度均大于正常对照组(P<0.05)； 而两组黄斑区内环颞侧、上方、外环鼻侧、外环颞侧、外环下方处视网膜厚度比较均无差异(P>0.05)。远视性弱视组眼轴长度较正常对照组短(P<0.05)。

结论：黄斑中心注视儿童在黄斑区中心凹、内环鼻侧处视网膜厚度增加； 远视性弱视儿童在黄斑区中心凹、内环鼻侧、内环下方、外环上方处视网膜厚度增加； 远视性弱视儿童眼轴长度变短。

AIM: To discuss the correlation between fixation nature and macular thickness, in addition, to investigate the variations of macular thickness and other related factors in hyperopic ametropic amblyopic children ranged from 4 to 8 years old by measuring each area's macular thickness, fixation nature and length of optic axis.

METHODS: Prospective, non-randomized, contemporaneous controlled study trials. Totally 44 children with 57 eyes who admitted to the hospital for the first time without any amblyopia training before from September 2018 to December were included in this study.36 eyes from hyperopic ametropic amblyopic children were enrolled in hyperopia group and 21 eyes from children with normal vision were enrolled in healthy controls. The optical coherence tomography(OCT)was used to measure the macular retinal thickness in both. Meanwhile, the OCT was also used to measure the macular retinal thickness in 29 central fixation patients(32 eyes)and 15 eccentric fixation(25 eyes)which examined by direct ophthalmoscope, and the data were analyzed by SPSS19.0 statistical software.

RESULTS: The length of optic axis in hyperopic amblyopic eyes is shorter than it in normal eyes(P<0.05). The retinal thickness of central sector and nasal quadrant in inner ring of central fixation group was thinner than it of eccentric fixation which represents the statistical significance. However, there is no significance of two groups' retinal thickness differences between other sectors of the macular(P<0.05). Besides, hyperopia amblyopia group's retinal thickness of central sector or region and nasal, inferior quadrant in inner ring and superior quadrant in outer ring was thicker than it of normal control groups which reveals the statistical meaning(P<0.05). Otherwise, the data of two groups' retinal thickness in other sectors of the macular shows no significance(P>0.05)

CONCLUSION: The retinal thickness of central sector and nasal quadrant in inner ring of central fixation children was increase. Hyperopia amblyopia children's retinal thickness of central sector or region and nasal、inferior quadrant in inner ring and superior quadrant in outer ring was increase. The length of optic axis in hyperopic amblyopic children is decrease.

河北省自然科学基金项目(No.H2015406054)