视盘水肿患者视盘周围区域厚度参数的改变

发布时间：2018-08-18 09:49

【摘要】：目的采用光学相干断层扫描(optical coherence tomography,OCT)观察视盘水肿患者视盘周围区域厚度参数的改变,为视盘水肿的临床评估寻找新方法。方法选取2012年10月至2015年10月在我院门诊就诊和住院的视盘水肿患者36例(36眼)作为研究对象,同时选取在我院体检的无眼科疾病的正常人51人(51眼)作为对照组。所有研究对象均检测视力、裂隙灯、眼底及眼底照相,全部研究眼均行OCT扫描检测视盘周围视网膜神经纤维厚度(circumpapillary retinal nerve fiber layer thickness,cpRNFLT)及视盘周围视网膜总厚度(circumpapillary total retinal thickness,cp TRT)。结果本研究选取的36例视盘水肿患者中轻度5例,中度15例,重度16例。OCT扫描后,连续检查3次均不能获得满意图像或计算机无法正确分析者将被剔除,最后有25例视盘水肿患者(轻度5例,中度14例,重度6例)符合分析cpRNFLT的要求;30例视盘水肿患者(轻度5例,中度15例,重度10例)符合分析cp TRT的要求;对照组有50人符合条件纳入研究。两组受试者年龄以及性别构成差异均无统计学意义(均为P0.05)。OCT视网膜断面图显示视盘水肿组cpRNFLT及cp TRT光带明显增宽,神经纤维层下无反射区宽度增加;视盘水肿组患者的平均及各象限cpRNFLT明显增厚,cpRNFLT以上方增厚最明显,其次是下方,然后是鼻侧和颞侧,与对照组相比差异均有统计学意义(均为P0.001)。OCT检查结果显示,视盘水肿组患者平均及各象限cp TRT明显增厚,cp TRT以下方增厚最明显,其次是上方,然后是鼻侧和颞侧,与对照组相比差异亦均有统计学意义(均为P0.001)。结论视盘水肿患者视盘周围区域厚度参数均较正常人明显增厚,这些参数可作为视盘水肿诊断以及研究的参考指标。
[Abstract]:Objective to explore a new method for clinical evaluation of optic disc edema by using optical coherence tomography Oct (Oct) to observe the changes of the thickness parameters around optic disc in patients with optic disc edema. Methods from October 2012 to October 2015, 36 patients (36 eyes) with optic disc edema were selected from outpatients and inpatients in our hospital, and 51 normal subjects (51 eyes) without ophthalmic diseases were selected as control group. All subjects were examined for visual acuity, slit lamp, fundus and fundus photography. All eyes were examined by OCT scanning for the thickness of retinal nerve fibers around the disc (circumpapillary retinal nerve fiber layer thicknesscpRNFLT) and the total retinal thickness around the disc (circumpapillary total retinal thicknesscp TRT). Results among the 36 cases of optic disk edema, 5 cases were mild, 15 cases were moderate, 16 cases were severe. After Oct scan, those who could not obtain satisfactory images for 3 times or who could not be correctly analyzed by computer would be eliminated. Finally, 25 cases of optic disc edema (mild 5 cases, moderate 14 cases, severe 6 cases) met the requirements of cpRNFLT analysis. 30 cases of optic disc edema (mild 5 cases, moderate 15 cases, severe 10 cases) met the requirements of analysis of CP TRT. 50 subjects in the control group were eligible for inclusion in the study. There was no significant difference in age and sex composition between the two groups (P0.05). Oct retinogram showed that the cpRNFLT and CP TRT optical bands were significantly widened and the width of the non-reflex area under the nerve fiber layer was increased in the optic disc edema group. In the optic disc edema group, the average and quadrant cpRNFLT thickening was the most obvious, followed by the inferior side, then the nasal side and the temporal side. The difference was statistically significant compared with the control group (all P0.001). Oct showed that the thickness of cpRNFLT was higher than that of the control group. In the optic disc edema group, the mean and each quadrant cp TRT thickened most significantly under cp TRT, followed by the upper side, then the nasal side and the temporal side, and the difference was also statistically significant compared with the control group (P0. 001). Conclusion the thickness parameters of the perioptic area in the patients with optic disc edema are significantly thicker than those in the normal group. These parameters can be used as a reference index for the diagnosis and study of optic disc edema.
【作者单位】：广东医科大学附属医院眼科;
【分类号】：R774

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