目的：探究屈光参差性弱视儿童视网膜神经纤维层(RNFL)和黄斑区视网膜厚度的变化情况及其相关性。

方法：选取2020-10/2021-06在我院眼科治疗的屈光参差性弱视儿童159例159眼作为研究组，选取同期、同年龄段于我院眼科检查视力正常的儿童159例159眼作为对照组。研究组在给予屈光矫正、遮盖健眼的基础上对弱视眼进行传统综合训练结合4D视觉训练。比较研究组治疗前后与对照组RNFL和黄斑区视网膜厚度，分析研究组治疗前RNFL与黄斑区视网膜厚度的相关性。

结果：研究组治疗前和治疗3mo后平均、上方、下方、鼻侧、颞侧RNFL厚度均高于对照组，且研究组治疗前平均、上方、下方、鼻侧、颞侧RNFL厚度均高于治疗3mo后(P<0.05)。研究组治疗前黄斑区外环平均、下方、鼻侧、颞侧、内环鼻侧及中心区视网膜厚度均高于治疗3mo后和对照组(P<0.05)。治疗前，研究组上方RNFL厚度与黄斑中心区视网膜厚度呈负相关(r=-0.330，P<0.05)，下方、鼻侧RNFL厚度与黄斑区外环和内环颞侧视网膜厚度呈正相关(均P<0.05)，颞侧RNFL厚度与黄斑区外环鼻侧和颞侧视网膜厚度呈负相关(r=-0.414、-0.462，均P<0.05)。

结论：屈光参差性弱视患儿RNFL与黄斑区视网膜厚度变化可阻碍视网膜正常发育，RNFL与黄斑区视网膜厚度存在一定的相关性。

METHODS: A total of 159 cases(159 eyes)children with anisometropic amblyopia treated in our ophthalmology department from October 2020 to June 2021 were selected as the study group, and 159 cases(159 eyes)children with normal vision who examined in the ophthalmology department of our hospital in the same period and age group were selected as the control group. The study group received traditional comprehensive training combined with 4D visual training for amblyopia based on refractive correction and covering of healthy eyes. The RNFL and macular retinal thickness before and after treatment between the study group and the control group was compared, and the correlation between RNFL and macular retinal thickness before treatment in the study group was analyzed.

RESULTS: The RNFL thickness of average, upper, lower, nasal and temporal in the study group before and after 3mo of treatment was higher than those of the control group, and the RNFL thickness of average, upper, lower, nasal and temporal before treatment in the study group was higher than those after 3mo of treatment(P<0.05). The average, inferior, nasal, temporal, nasal, and central retinal thickness of the outer ring of the macular area in the study group before treatment were higher than those in the same group after 3mo of treatment and the control group(P<0.05). Before treatment, there was a negative correlation between the thickness of the upper RNFL in the study group and the retinal thickness in the central macular area(r=-0.330, P<0.05), the thickness of the lower and nasal RNFL was positively correlated with the thickness of the temporal retina in the outer and inner rings of the macular area(all P<0.05), while the thickness of temporal RNFL was negatively correlated with the thickness of the nasal and temporal retina outside the macular area(r=-0.414, -0.462, all P<0.05).

CONCLUSION: The changes in RNFL and macular retinal thickness in children with anisometropic amblyopia can hinder normal retinal development, and there is a certain correlation between RNFL and macular retinal thickness.