视盘旁视网膜神经纤维层厚度与近视进展的关系—内蒙古兴安盟蒙古族青少年近视队列研究

doi:10.13281/j.cnki.issn.1004-4469.2026.03.004.

眼科 ›› 2026, Vol. 35 ›› Issue (3): 203-208.doi: 10.13281/j.cnki.issn.1004-4469.2026.03.004.

视盘旁视网膜神经纤维层厚度与近视进展的关系—内蒙古兴安盟蒙古族青少年近视队列研究

王子尧¹ 吴旭昇² 潘哲³ 陈璐筱³ 袁继轩³ 陈筱东³ 张纯³ 王亚星³ 朱丹² 李学民¹

¹北京大学第三医院眼科，北京100191；²内蒙古医科大学附属医院眼科，呼和浩特010030；³北京视觉科学与转化医学研究中心清华大学附属北京清华长庚医院，北京102218

收稿日期:2025-12-22 出版日期:2026-05-25 发布日期:2026-05-25
通讯作者: 李学民，Email：lxmlxm66@sina.com
基金资助:
国家自然科学基金（81860178）

Peripapillary retinal nerve fiber layer thickness and myopia progression: a cohort study of mongolian adolescents in Hinggan League, Inner Mongolia

Wang Ziyao^1, Wu Xusheng², Pan Zhe³, Chen Luxiao³, Yuan Jixuan³, Chen Xiaodong³, Zhang Chun³, Wang Yaxing³, Zhu Dan², LiXuemin¹

¹ Department of Ophthalmology, Peking University Third Hospital, Beijing100191, China; ²Department of Ophthalmology,Affiliated Hospital of Inner Mongolia Medical University, Huhehaote 010030, China; ³ Beijing Visual Science and Translational Eye Research Institute(BERI); Beijing Tsinghua Changgung Hospital, Tsinghua Medicine, Tsinghua University, Beijing 102218, China.

Received:2025-12-22 Online:2026-05-25 Published:2026-05-25
Contact: Li Xuemin, Email: lxmlxm66@sina.com
Supported by:
National Natural Science Foundation of China (81860178)

摘要/Abstract

摘要： 目的探索青少年人群中基线视盘旁神经纤维层（pRNFL）厚度与未来一年眼轴长度（AL）增长的关联性。设计前瞻性队列研究。研究对象内蒙古兴安盟巴彦呼舒市的353名青少年。方法分别于2023年5月及2024年9月进行两次标准化眼科检查。根据AL年增长量是否≥0.2 mm将受试者分为快速进展组与非快速进展组。采用稳健回归模型评估了基线pRNFL厚度对AL年增长量的预测作用，后使用协方差分析结合估算边际均值比较快速进展与非快速进展组间的基线pRNFL厚度差异。此外，依据基线等效球镜度（SE）是否≤-3.0 D进行了分层分析。主要指标基线整体及各分区pRNFL厚度与未来一年AL快速进展的相关性。结果 353 名受试者中快速进展组 93 人，非快速进展组 260 人。在校正年龄、性别、基线AL及身高后，多因素稳健回归提示基线颞下区（β=-0.016，P=0.003）及颞侧（β=-0.014，P=0.009）pRNFL厚度与未来一年 AL 增长量呈显著负相关。校正协变量后，快速进展组基线颞下区（146.97 μm、155.34 μm，P=0.001）及颞侧（86.69 μm、92.59 μm，P=0.009）pRNFL显著薄于非快速进展组。分层分析证实，该预测效应在中高度近视组中稳健。结论基线较薄的颞下区及颞侧pRNFL厚度是青少年人群未来一年AL快速增长的独立预测因子，且在中高度近视人群中预测价值更高。该发现为识别近视快速进展高危人群的新型影像学生物标志物的探索提供了新思路。

关键词: 近视进展, 视网膜神经纤维层, 队列研究

Abstract: Objective To evaluate the association between baseline peripapillary retinal nerve fiber layer (pRNFL) thickness and axial length (AL) elongation over a subsequent one-year period in adolescents. Design A prospective cohort study. Participants 353 adolescents from Bayan Hushu, Hinggan League, Inner Mongolia. Methods Standardized ophthalmological examinations were performed in May 2023 and September 2024. Participants were categorized into a rapid progression group (AL increase≥0.2 mm/year) and a non-rapid progression group. A robust linear regression model was employed to evaluate the longitudinal relationship between baseline pRNFL thickness and annual AL elongation. Analysis of covariance (ANCOVA) with estimated marginal means (EMMs) was used to compare the baseline pRNFL differences between the two groups. Additionally, stratified analysis was performed based on baseline spherical equivalent (SE≤-3.0 D) to verify the robustness of these associations. Main Outcome Measures Independent associations between baseline global and sectoral pRNFL thickness and rapid AL growth over the following year. Results Among 353 participants, 93 were in the rapid progression group and 260 were in the non-rapid progression group. After adjusting for age, sex, baseline AL, and height, multivariate robust linear regression indicated that baseline pRNFL thickness in the temporal-inferior (TI) (β=-0.016, P=0.003) and temporal (T) (β=-0.014, P=0.009) sectors was significantly and negatively associated with annual AL growth. After adjusting for covariates, baseline pRNFL in the TI (146.97μm vs. 155.34 μm, P=0.001) and T (86.69 μm vs. 92.59 μm, P=0.009) sectors were significantly thinner in the rapid progression group. Stratified analysis confirmed that this predictive effect remained robust in the moderate-to-high myopia group. Conclusion Thinner baseline pRNFL in the TI and T sectors is independently associated with rapid axial elongation over the following year in adolescents, with this longitudinal association being more robust among those with moderate-to-high myopia. These findings provide new insights into the potential of pRNFL thickness as an imaging biomarker for identifying individuals at high risk of rapid myopia progression.

Key words: Myopia progression, Retinal nerve fiber layer (RNFL), Cohort study

王子尧吴旭昇潘哲陈璐筱袁继轩陈筱东张纯王亚星朱丹李学民. 视盘旁视网膜神经纤维层厚度与近视进展的关系—内蒙古兴安盟蒙古族青少年近视队列研究[J]. 眼科, 2026, 35(3): 203-208.

Wang Ziyao, Wu Xusheng, Pan Zhe, Chen Luxiao, Yuan Jixuan, Chen Xiaodong, Zhang Chun, Wang Yaxing, Zhu Dan, Li Xuemin. Peripapillary retinal nerve fiber layer thickness and myopia progression: a cohort study of mongolian adolescents in Hinggan League, Inner Mongolia[J]. Ophthalmology in China, 2026, 35(3): 203-208.

[1]	姜晶贾超王新宇徐威张妍 . 急性闭角型青光眼急性发作后视网膜神经纤维层厚度与视盘血流变化的相关性[J]. 眼科, 2020, 29(1): 26-31.
[2]	张寒峭乔荣华朱赛楠吴海龙. FD-OCT及HRT-III测量近视性屈光不正的青光眼诊断参数比较[J]. 眼科, 2017, 26(5): 317-322.
[3]	王伟伟王怀洲刘建荣霍妍佼李猛杨新光. 频域OCT检测视野前青光眼黄斑区视网膜神经节细胞复合体厚度的初步研究[J]. 眼科, 2017, 26(1): 10-14.
[4]	王丽娜杨柳瞿远珍. 鞍结节脑膜瘤患者视盘及视网膜神经纤维层的形态研究[J]. 眼科, 2015, 24(6): 414-418.
[5]	张莉徐亮杨桦燕飞王宇恒罗琳娜李建军. 眼底指标改变与脑卒中患病的相关性[J]. 眼科, 2015, 24(1): 13-18.
[6]	朱丽平任晓磊王亚星徐亮张晓君. 轻度认知障碍和阿尔茨海默病患者视网膜神经纤维层厚度的研究[J]. 眼科, 2014, 23(4): 231-234.
[7]	任杰, 王亚星, 杨桦, 张莉, 李建军, 徐亮, Jonas Jost B.. 40岁以上人群局限性视网膜神经纤维层缺损10年发病率及其危险因素[J]. 眼科, 2014, 23(1): 9-12.
[8]	霍妍佼郭彦洪洁王怀洲王宁利. 高分辨率 OCT测量神经节细胞-内丛状层厚度在青光眼早期诊断中的作用[J]. 眼科, 2013, 22(6): 374-377.
[9]	张译心, 戴艳丽, 黄厚斌, 魏世辉. 特发性脱髓鞘性视神经炎所致视神经萎缩盘周视网膜神经纤维层厚度及黄斑厚度的定量研究[J]. 眼科, 2013, 22(2): 130-134.
[10]	党光福, 雷玉琳, 郑秀云, 孟小丽, 张建华. 飞秒激光LASIK手术负压吸引对视网膜厚度的影响[J]. 眼科, 2012, 21(5): 340-343.

视盘旁视网膜神经纤维层厚度与近视进展的关系—内蒙古兴安盟蒙古族青少年近视队列研究

Peripapillary retinal nerve fiber layer thickness and myopia progression: a cohort study of mongolian adolescents in Hinggan League, Inner Mongolia

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 10

编辑推荐

Metrics

本文评价