Department of Ophthalmology, Peking University People's Hospital;College of Optometry, Peking University Health Science Center;Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing 100044, China
摘要目的 应用Cirrus HD OCT观察成年人黄斑区视网膜神经节细胞内丛状层（mGCIPL）厚度的分布规律,探讨mGCIPL随着眼轴长度改变的变化规律。方法 系列病例研究。选取2017年9月至2018年4月就诊于北京大学人民医院眼科门诊的患者170例（276眼）,采用IOLMaster测量眼轴长度,Cirrus HD OCT测量mGCIPL厚度,得到平均,6个扇形区域（颞上、上方、鼻上、颞下、下方、鼻下）,最小mGCIPL厚度共8个参数。研究mGCIPL厚度的分布规律,采用Spearman进行mGCIPL厚度与眼轴长度的相关性分析,应用广义估计方程进行mGCIPL厚度的多因素分析。结果 该276只眼的6个扇形区域中鼻上mGCIPL厚度最大,为83.5（78.0,89.0）μm,下方mGCIPL厚度最小,为79.0（73.0,84.0）μm,分布规律为鼻上>上方>颞上≈颞下≈鼻下>下方。8个参数均与眼轴长度呈负相关 （r=-0.504~-0.395,P<0.001）。8个参数除了受眼轴长度（β=-3.201,P<0.001）影响外,还受年龄（β=-0.185,P<0.001）影响。结论 mGCIPL厚度分布规律为鼻上>上方>颞上≈颞下≈鼻下>下方。mGCIPL厚度与眼轴长度呈负相关。因此在应用mGCIPL厚度进行青光眼诊断时应考虑眼轴长度的影响,尤其在高度近视人群更应排除其干扰。
Abstract：Objective: To investigate the thickness distribution of the macular ganglion cell inner plexiform layer (mGCIPL) in normal eyes using Cirrus HD OCT; to study the correlation between mGCIPL thickness and axial length, in order to discuss variations in the thickness pattern of the mGCIPL as axial length varies. Methods: This was a case series study. Patients referred to the ophthalmology clinic from September 2017 to April 2018 who met the inclusion criteria were enrolled. A total of 276 eyes of 170 subjects were selected. All subjects underwent complete ophthalmic examination, IOL Master measurements of axial length, and Cirrus HD OCT measurements of mGCIPL thickness to obtain 8 parameters, including the average thickness of 6 mGCIPL sectors (superotemporal, superior, superonasal, inferotemporal, inferior, inferonasal), the mean mGCIPL thickness of the elliptical annulus and minimum mGCIPL thickness. To study the distribution of mGCIPL, a correlation analysis between mGCIPL thickness and axial length was calculated by Spearman as well as a multivariate analysis of mGCIPL thickness using generalized estimating equations (GEE). Results: mGCIPL thickness of the 6 sectors of all the subjects was not identical (P<0.001). The superonasal sector had the thickest [83.5(78.0, 89.0)μm] and the inferior had the thinnest [79.0(73.0, 84.0)μm] mGCIPL thickness. The relative thickness of the different sectors was as follows: superonasal>superior>superotemporal≈inferotemporal≈inferonasal>inferior. In correlation analysis, 8 parameters had a negative correlation with axial length (r<0, P<0.001). In GEE, 8 parameters were influenced by axial length (β=-3.201, P<0.001) and age (β=-0.185, P<0.001). Conclusions: mGCIPL thickness distribation as follow: superonasal>superior>superotemporal≈inferotemporal≈inferonasal>inferior. mGCIPL thickness has a negative correlation with axial length. Axial length should be taken into account when using mGCIPL to diagnose glaucoma, especially in high myopic eyes.
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