摘要： 目的 分析高度近视患者黄斑区视网膜神经节细胞复合体（GCC）厚度的分布特征及其对黄斑区病变的影响。方法 应用RTVue SD-OCT对2018年1月至5月在北京协和医院眼科就诊的15例（27眼）高度近视患者进行黄斑区GCC厚度测量，分析眼轴长度（AL）及等效球镜（SE）和GCC厚度参数的相关性。根据有无黄斑区病变，把受检眼分为黄斑病变组（n=10）和无黄斑病变组（n=17），比较2组GCC参数。采用二元logistic回归分析黄斑区病变的危险因素。采用GCC厚度参数绘制受试者工作特征（ROC）曲线，根据ROC曲线下面积（AUC）预测GCC厚度参数对高度近视并发黄斑病变的诊断效能。结果 纳入本研究的高度近视患者年龄平均（29.44±9.81）岁，SE平均（-10.84±3.19）D，AL平均（27.97±1.55）mm。黄斑区GCC厚度与SE呈显著正相关（P < 0.05），与AL呈显著负相关（P < 0.05）。局部丢失体积（FLV）、整体丢失体积（GLV）与SE呈显著负相关（均P < 0.05），与AL呈显著正相关（均P < 0.05）；黄斑病变组和无黄斑病变组的总体GCC、上方GCC、下方GCC厚度以及GLV均存在统计学差异（均P < 0.05）；回归分析显示，GLV是高度近视并发黄斑病变的危险因素（P=0.01）；ROC曲线显示，AUC值由大到小依次为总体GCC厚度（P < 0.001）、GLV（P < 0.001）、下方GCC厚度（P < 0.001）、上方GCC厚度（P < 0.001）和FLV（P=0.045）。结论 高度近视患者黄斑区GCC厚度与SE呈正相关，与AL呈负相关。GCC厚度的缺失是高度近视并发黄斑病变的危险因素，部分GCC厚度参数对于高度近视并发黄斑病变具有较好的预测效能。

高度近视黄斑区视网膜神经节细胞复合体的相关参数分析

陈晨, 李东辉, 王静怡, 龙琴

中国医学科学院, 北京协和医学院, 北京协和医院眼科, 北京 100730

收稿日期:2019-12-10出版日期:2020-08-30发布日期:2020-08-04
通讯作者:龙琴E-mail:longqinbj@hotmail.com
作者简介:陈晨(1995-),女,硕士研究生.
基金资助:国家自然科学基金（81870685）；北京市自然科学基金（7172173）；国家卫生健康委员会近视眼重点实验室开发课题（EENTM-15-01）


关键词: 高度近视, 神经节细胞复合体, 黄斑病变, 光学相干断层扫描血管成像
Abstract: Objective To analyze the characteristics of macular ganglion cell complex (GCC) thickness in eyes with high myopia and the relationship between GCC thickness and maculopathy. Methods Fifteen patients (27 eyes) with high myopia were included and divided into maculopathy and no maculopathy groups. The macular GCC thickness was measured with RTVue SD-OCT. We then analyzed between-group differences in GCC thickness,the correlation between eye axis length (AL),spherical equivalent (SE) and GCC thickness,risk factors of maculopathy,and the predictive value of GCC thickness for maculopathy in eyes with high myopia. Results The patients' average age was 29.44 ±9.81 years. The average SE was -10.84 ±3.19 D,and the average AL was 27.97 ±1.55 mm. GCC thickness,focal loss volume (FLV) and global loss volume (GLV) were significantly correlated with SE and AL (P all < 0.05). The between-group differences in total GCC,superior GCC,inferior GCC and GLV were statistically significant (P all < 0.05). Regression analysis showed that GLV was a risk factor for maculopathy in eyes with high myopia (P=0.01). The ROC curve demonstrated that AUC was decreased from total GCC (P < 0.001),GLV (P < 0.001),inferior GCC (P < 0.001),superior GCC (P < 0.001) to FLV (P=0.045). Conclusion In eyes with high myopia,GCC thickness is positively correlated with SE,but negatively correlated with AL. A lack of GCC appears to be a risk factor of maculopathy. Some GCC thickness parameters hold predictive value for maculopathy in eyes with high myopia.
Key words: high myopia, ganglion cell complex, maculopathy, optical coherence tomography angiography
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