多发性硬化眼部OCT检查视网膜神经纤维层厚度变化与视野相关性研究

发布时间：2018-05-16 13:12

本文选题：多发性硬化症 + 光学相干断层扫描　；参考：《新疆医科大学》2012年硕士论文

【摘要】：目的：通过正常人和多发性硬化患者视网膜神经纤维层厚度的差异以及多发性硬化患者视网膜神经纤维层厚度与视野缺损的相关性研究,探讨多发性硬化患者早期诊断及随访的方法。方法：了解多发性硬化患者及正常健康人在年龄,性别构成,病程以及眼压之间相关性。分析多发性硬化患者性别构成及RNFL不同损害范围组在患者年龄,发病年龄及病程方面的相关性。采用OCT检测并比较多发性硬化患者及正常人视网膜上方、下方、颞侧及鼻侧的神经纤维层厚度、多发硬化患者视野正常组及正常人组上方、下方、颞侧及鼻侧的神经纤维层厚度。采用全自动视野计检测MS患者,探讨视网膜神经纤维层厚度改变与视野损害的相关性。结果：MS组和正常人组在年龄,性别构成以及眼压之间差别无统计学意义,说明两组之间均衡可比。MS组男性患者和女性患者在发病年龄上,差别无统计学意义；男性患者和女性患者在病程上差别有统计学意义,男性患者较女性患者病程短。MS组患者视网膜神经纤维层损害在年龄,发病年龄之间,差别无统计学意义。伴有任意象限损害的MS患者较无象限损害的MS患者病程长。MS组患者与正常人组眼部上方的神经纤维层的厚度分别为117.24±10.34μm,140.15±8.24μm,P≤0.05；下方分别为117.24±10.34μm,137.31±10.03μm,P=0.000；颞侧分别为74.98±1.21μm,89.9±14.14μm,P=0.000；鼻侧分别为89.9±14.12μm,88.45±1.01μm,P=0.000,差别均有统计学意义。MS组患者中RNFL厚度正常眼与正常人组眼部上方的神经纤维层的厚度分别为135.00±3.89μm,140.15±8.24μm,P≤0.05;下方分别为131.33±6.34μm,137.31±10.03μm,P=0.000；颞侧分别为91.66±9.30μm,89.9±14.14μm,P=0.734；鼻侧分别为87.00±8.03μm,88.45±1.01μm,P=0.171,上方及下方差别均有统计学意义,鼻侧及颞侧差别均无统计学意义。MS组患者中RNFL厚度正常眼与异常眼在眼部上方的神经纤维层的厚度分别为135.00±3.89μm,123.24±10.76μm,P≤0.05；下方分别为131.33±6.34μm,117.05±10.74μm,P=0.001；颞侧分别为91.66±9.30μm,72.33±15.96μm,P=0.002；鼻侧分别为87.00±8.03μm,61.19±11.47μm,P=0.000,差别均有统计学意义。MS组视野正常组及正常人组上方的神经纤维层的厚度分别为128.28±12.31μm,140.15±8.24μm,P≤0.05；下方分别为120.31±13.03μm,137.31±10.03μm,P=0.000；颞侧分别为78.9±10.12μm,89.9±14.12μm,P=0.000；鼻侧分别为75.45±14.01μm,88.45±1.01μm,P≤0.05,差别均有统计学意义。MS组中不同视网膜神经纤维层异常范围组的平均视野损害之间,差别有统计学意义(P≤0.05)。MS组伴随视网膜神经纤维异常范围的增大,平均视野损害也在增大。MS组随着视神经纤维层损害范围的增大其眼部平均RnFL厚度在变薄。结论：OCT可以准确的测量视网膜神经纤维层厚度；多发性硬化患者的视网膜神经纤维层厚度的改变早于视野的改变；视神经纤维层厚度改变与视野平均缺损存在一定的对应关系；OCT测量RNFL厚度具有较好可重复性,有助于多发性硬化的早期诊断和随访观察；MS患者RNFL厚度异常程度与病程存在相关性。
[Abstract]:Objective: To investigate the correlation of retinal nerve fiber layer thickness between normal and multiple sclerosis patients and the correlation between retinal nerve fiber layer thickness and visual field defect in patients with multiple sclerosis, and to explore the methods of early diagnosis and follow-up in patients with multiple sclerosis. Methods: to understand the age of multiple sclerosis and normal healthy people in age. Correlation between gender composition, course of disease and intraocular pressure. Analysis of the sex composition of multiple sclerosis patients and the correlation of different RNFL lesion groups in the age, age and course of disease in patients with multiple sclerosis and comparison of the thickness of the nerve fiber layer above the retina, the lower side, the temporal and nasal sides of the patients with multiple sclerosis and normal people, the temporal and nasal sides. The thickness of the nerve fiber layer in the lower, inferior, temporal and nasal side of the normal group and the normal group. The correlation between the retinal nerve fiber layer thickness change and the visual field damage was examined by the full automatic perimeter. Results: there was no statistical difference between the MS group and the normal group in age, sex composition and intraocular pressure in MS. It shows that the balance between the two groups is comparable to that of the.MS group and the female patients at the age of onset. The difference in the course of disease between male and female patients is statistically significant, and there is no statistical difference between the age and age of the age and the age of onset of the retinal nerve fiber layer in the male patients and the short course of the.MS group. MS patients with arbitrary quadrant damage were 117.24 + 10.34 mu m, 140.15 + 8.24 mu m, P < 0.05, respectively, the thickness of the nerve fiber layer above the eye of the MS patients with no quadrant damage, respectively, 140.15 + 8.24 mu m and P < 0.05, respectively, and 74.98 + 1.21 mu m, 89.9 + 14.14 in the temporal side, respectively. M, P=0.000; the nasal side was 89.9 + 14.12 m, 88.45 + 1.01 m, P=0.000, and the difference was statistically significant. The thickness of the normal eyes of the.MS group was 135 + 3.89 u m, 140.15 + 8.24 mu, P < 0.05, respectively. The lower part was 131.33 + 6.34 mu m, 137.31 + 10.03 mu m, temporal lateral fraction. The difference was 91.66 + 9.30 m, 89.9 + 14.14, m, P=0.734, and the nasal side was 87 + 8.03 m, 88.45 + and P=0.171, P=0.171, and the difference between the upper and the lower was statistically significant. There was no statistically significant difference between the nasal side and the temporal side in.MS group. The thickness of RNFL thickness normal eyes and abnormal eyes in the eye area was 135 + 3.89 mu, 12, respectively. 3.24 + 10.76 mu m, P < 0.05, 131.33 + 6.34 mu m, 117.05 + 10.74 mu m, P=0.001, respectively, 91.66 + 9.30 mu, 72.33 +, P=0.002, respectively, 87 + 8.03, m, P=0.000, respectively. There were significant differences in the thickness of the nerve fiber layer above the normal group and the normal group. 128.28 + 12.31 mu m, 140.15 + 8.24 mu m and P < 0.05, respectively, 120.31 + 13.03 mu m, 137.31 + 10.03 mu m, respectively, respectively, 78.9 + 120.31 mu m, 89.9 + 14.12 mu m and P=0.000, respectively. There was a significant difference between the average visual field damage (P < 0.05) and the increase in the abnormal range of retinal nerve fibers in the.MS group. The average visual field damage was also increased in the.MS group with the increase of the optic nerve fiber layer damage. Conclusion: OCT can be used to accurately measure the thickness of the retinal nerve fiber layer. The changes in the thickness of the retinal nerve fiber layer in the patients with hair sclerosis were earlier than the changes in the visual field; the thickness of the optic nerve fiber layer was related to the average defect of the visual field; the thickness of the RNFL was better repeatable by OCT, and was helpful to the early diagnosis and follow-up of the multiple sclerosis; the degree of RNFL thickness abnormality in the patients with MS and the degree of the abnormality of the thickness of the patients. There was a correlation between the course of the disease.

【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R771.3

【参考文献】