正常国人121例视网膜神经纤维层OCT参数的特点
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Characteristics of the parameters of retinal nerve fiber layer thickness in normal Chinese with optical coherence tomography
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    目的:分析OCT检测的40岁以下正常人视盘周围RNFL各参数的特点。方法:符合纳入标准的自愿受试者121例,应用光学相干断层成像仪StratusOCTTM3000,采用RNFL3.4程序对受试者以视盘为中心直径3.4mm的RNFL进行检测。资料分析应用SPSS13.0统计软件。结果:5~40岁正常人1~12各钟点位RNFL厚度(μm)分别为130.6±24.9,87.3±20.6,58.5±11.9,75.9±15.6,119.6±21.3,155.4±25.5,158.1±21.7,85.8±17.1,65.3±10.5,96.9±15.9,148.4±18.7,143.3±25.9;S,N,I,T各象限平均厚度(μm)分别为140.8±16.6,73.9±13.1,144.3±16.3,82.7±12.5;全周平均厚度(Avg)110.4±9.3μm。Smax,Imax,Smax/Imax,Smax/Tavg,Imax/Tavg,Smax/Navg,Max-Min分别为174.9±19.7,184.6±20.3,0.96±0.14,2.16±0.37,2.27±0.34,2.44±0.52,143.1±19.4μm。RNFL各参数的变异系数(%):1~12点依次为19.06,23.56,20.33,20.52,17.80,16.39,13.72,19.93,16.01,16.42,12.63,18.06;S,N,I,T,Avg依次为11.84,17.71,11.26,15.15,8.43;Smax,Imax,Smax/Imax,Smax/Tavg,Imax/Tavg,Smax/Navg,Max-Min分别为11.26,11.00,14.53,17.33,15.12,21.11,13.58。不同性别间2,3,7,10,N,T,Smax/Tavg差异有统计学意义(t=2.257~3.344,P=0.025~0.001),其余大部分参数间的差异无显著性。不同眼别间4,5,6,7,9点,I,Smax,Imax,Smax/Imax,Max-Min参数组无显著性差异(t=1.706~0.030,P=0.091~0.976),而其它14个参数组(58.3%)差异有统计学意义。不同年龄段的18个参数(75%)组间两两比较差异不显著(P>0.05)。1,4,9点,N,Imax,Imax/Tavg这些参数在4个年龄段差异有统计学意义(P<0.05)。5~40岁正常人OCT扫描RNFL24个参数中Avg最稳定。在钟点位中7,11点稳定,而2,3,4点变异较大。在象限平均值中S,I的稳定性好,N变异较大。其余参数中,Smax,Imax,Max-Min相对稳定,Smax/Navg的变异较大。结论:5~40岁不同性别、眼别和年龄段的正常人对应RNFL的OCT参数存在不同程度的差异。

    Abstract:

    ·AIM:To quantitatively assess the peripapillary retinal nerve fiber layer thickness(RNFLT)in Chinese subjects whose ages ranged from 5 to 40 years old with optical coherence tomography(OCT)and to analyze the characteristics of the variation of the RNFLT parameters.·METHODS:We chose 242 eyes of 121 normal subjects whose ages ranged from 5 to 40 years.After being inquired of medical history and proceeding the routine examination of ophthalmology,which include vision,slit-lamp,ophthalmoscope,intraocular pressure,and optometry,we examined the eyes of the volunteers who met the standards of being examined by OCT.The peripapillary RNFL of all participants was imaged on Stratus OCTTM 3000.RNFLT around the disc was determined with 3.4 mm diameter circling scan,and it was measured and analyzed with the RNFLT average analysis program.The data were analyzed with SPSS 13.0 commercial statistical software.·RESULTS:The RNFLT(μm)of the normal subjects whose ages ranged from 5 to 40 years old in clock type(1-12)were 130.6±24.9,87.3±20.6,58.5±11.9,75.9±15.6,119.6±21.3,155.4±25.5,158.1±21.7,85.8±17.1,65.3±10.5,96.9±15.9,148.4±18.7,143.3±25.9,respectively.The average RNFLT(μm)of those in the superior(S),nasal(N),inferior(I)and temporal(T)quadrant were 140.8±16.6,73.9±13.1,144.3±16.3,and 82.7±12.5,respectively,and Avg.Thick was 110.4±9.3μm.The normative values of Smax,Imax,Smax/Imax,Smax/Tavg,Imax/Tavg,Smax/Navg,Max-Min were 174.9±19.7,184.6±20.3,0.96±0.14,2.16±0.37,2.27±0.34,2.44±0.52,143.1±19.4μm,respectively.The coefficient of variation(%)of the RNFLT parameters of clock type(1-12)of normal subjects whose ages ranged from 5 to 40 years old were 19.06,23.56,20.33,20.52,17.80,16.39,13.72,19.93,16.01,16.42,12.63,and 18.06,respectively.Those in the superior,nasal,inferior,temporal quadrant and the mean of whole circle were 11.84,17.71,11.26,15.15,and 8.43,respectively.Some RNFLT parameters including 2,3,7,10,N,T,and Smax/Tavg had statistically significant differences(t=2.257-3.344,P=0.025-0.001,P<0.05),and the differences among the other 17 parameters were not statistically significant between different gender in the normal subjects whose ages ranged from 5 to 40 years old.Some RNFLT parameters including 4,5,6,7,9 o’clock,I,Smax,Imax,Smax/Imax,and Max-Min did not have statistically significant differences(t=1.706-0.030,P=0.091-0.976,P>0.05).The differences among the other 14 parameters were statistically significant(t=2.242-4.478,P=0.027-0.000,P<0.05)between right eyes and left eyes of the normal subjects whose ages ranged from 5 to 40 years old.Some RNFLT parameters including 1,4,9,N,Imax,and Imax/Tavg had statistically significant differences(P<0.05),and the differences among the other 18 parameters were not statistically significant(P>0.05),between different groups according to age in the normal subjects whose ages ranged from 5 to 40 years old.The variation of the RNFLT parameters in the normal subjects was unequal.Among the 24 parameters,the variation of the Avg.Thickness is the least.Among the 12 clocks,the variation of 7 and 9 o’clock was the least.The variation of S and I was less than N in different quadrant,and the variation of Smax/Navg was greater than others in the remaining parameters.·CONCLUSION:Some RNFLT parameters have statistically significant differences in the following factors:different gender,right or left eyes,groups according to age of the normal subjects whose ages ranged from 5 to 40 years old.·

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曹东,贺翔鸽,刘莛,等.正常国人121例视网膜神经纤维层OCT参数的特点.国际眼科杂志, 2010,10(11):2103-2106.

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