视神经炎患者脉络膜厚度的分析
发布时间：2019-05-21 15:55
【摘要】：目的 使用Angio-OCT对视神经炎(Optic neuritis, ON)患者的脉络膜厚度(Choroidal thickness, CT)进行测量评估,探究患者的脉络膜厚度与临床特征的相关性。同时,比较患者的脉络膜厚度与健康人之间是否具有差异,以协助诊断、评价治疗效果及预测预后。方法我们对25位确诊视神经炎的患者的患眼、健眼进行视功能及OCT检查；同时对年龄、性别相匹配的25位健康人进行视功能的基础评估、脉络膜的扫描及厚度的测量。利用Angio-OCT对黄斑区及视乳头周围的脉络膜进行扫描,获取脉络膜厚度及视乳头周围神经纤维层厚度的数据进行分析研究。脉络膜厚度的测量包括黄斑区的17个位点及视乳头周围的8个位点,神经纤维层的厚度由系统自动计算得出。我们比较视神经炎组的健眼、患眼与对照组对应位点的脉络膜厚度有无差异,并分析视乳头周围脉络膜厚度与神经纤维层厚度的相关性。数据使用SPSS20.0软件进行多元线性回归分析,秩检验等。结果视神经炎患者患眼黄斑区中心凹下的脉络膜厚度(Subfoveal choroidal thickness,SFCT)与眼轴长度呈负相关(P=0.003,相关系数B=-45.36),与眼球转痛、相对性传入性瞳孔障碍(relative afferent pupillary defect, RAPD)、杯盘比(C/D)、视杯容积(CV)、盘缘面积(Rim area)、视盘面积(Disc area)、视野平均缺损(MD)无显著相关性(P0.05)。视乳头周围区域不同位点的脉络膜厚度(peripapillary choroidal thickness, PPCT)与不同因素相关。视乳头颞侧(P=0.01),上颞侧(P=0.000),上方(P=0.015),上鼻侧(P=0.014),鼻侧(P=0.035)的脉络膜厚度均与性别呈正相关。视乳头上颞侧(P=0.021),下方(P=0.017),下颞侧(P=0.013)的脉络膜厚度均与年龄呈正相关。视乳头鼻侧(P=0.011),下鼻侧(P=0.003)的脉络膜厚度均与视杯容积呈正相关。视乳头下方(P=0.005),下颞侧(P=0.007)的脉络膜厚度均与RAPD(+)呈正相关。在脉络膜厚度的比较中,视神经炎组的患眼、健眼及对照组的SFCT分别为307.56±61.95 μm,327.60±47.56 μm,315.48±84.29 μm。在校正年龄、性别、眼轴(Axial length, AL)、最佳矫正视力(Best Corrected Visual Acuity, BCVA)、非接触眼压(non-contact tonometer measurement of intraocular pressure, NCT)之后,比较视神经炎组的患眼、健眼与对照组的黄斑区脉络膜厚度及视乳头周围脉络膜厚度,结果提示：视神经炎患者的患眼、健眼分别与对照组在I1500 u m处有显著差异,对照组视神经炎祖的患眼健眼,其余黄斑区脉络膜厚度均无显著差异(P0.05)；视乳头周围脉络膜厚度均无显著性差异(P0.05)。视乳头周围脉络膜厚度与神经纤维层厚度的也无明显相关性。结论视神经炎患者不同位置的脉络膜厚度与不同因素具有相关性。视神经炎患者的患眼、健眼与对照组在黄斑区(除中心凹下方1500 μm处)和视乳头周围的脉络膜厚度均无显著性差异。视乳头周围脉络膜厚度与神经纤维层厚度无明显相关性。我们推断,视神经炎患者的脉络膜厚度在疾病中无明显变化,是否能够协助诊断、评价治疗效果及预测预后,尚需进一步深入的研究。
[Abstract]:Objective To evaluate the choroidal thickness (choroid thickness, CT) of the patients with optic neuritis (ON) using the Angio-OCT, and to explore the correlation between the choroidal thickness and the clinical characteristics of the patients. At the same time, whether there is a difference between the choroid thickness of the patient and the healthy person is compared, so as to assist in the diagnosis, evaluate the therapeutic effect and predict the prognosis. Methods We performed the visual function and the OCT examination on the eyes and the eye of the 25 patients with the confirmed optic neuritis, and the basic assessment of the visual function, the scanning of the choroid and the measurement of the thickness of the 25 healthy controls matched with the age and the sex were performed. The choroidal thickness and the thickness of the nerve fiber layer around the papilla were analyzed by Anio-OCT, and the choroidal thickness and the thickness of the nerve fiber layer around the papilla were obtained. The measurement of the choroidal thickness included 17 sites in the macular region and 8 sites around the papilla, and the thickness of the nerve fiber layer was calculated automatically by the system. We compared the choroidal thickness of the corresponding sites in the eye of the optic neuritis group with the control group, and analyzed the correlation between the choroidal thickness around the papilla and the thickness of the nerve fiber layer. The data was subjected to multiple linear regression analysis, rank test and so on using the SPSS10.0 software. Results The foveal choroidal thickness (SFCT) in the central depression of the eye-related macular area in the patients with neuritis was negatively correlated with the length of the eye (P = 0.003, the correlation coefficient B =-45.36), the eye-to-eye pain, the relative afferent pupillary defect (RAPD), the cup-to-plate ratio (C/ D), the apparent cup volume (CV), There was no significant correlation between the area of the disc rim (Rim area), the disc area (Disc area) and the visual field average defect (MD) (P0.05). The choroidal thickness (PPCT) at different sites in the peripapillary region is associated with different factors. The choroidal thickness of the upper nasal side (P = 0.000), upper (P = 0.015), upper nasal side (P = 0.014) and nasal side (P = 0.035) was positively correlated with sex. The choroidal thickness of the inferior (P = 0.021), lower (P = 0.017) and lower (P = 0.013) was positively correlated with age. The choroidal thickness of the lower nasal side (P = 0.003) was positively correlated with the volume of the cup, depending on the nasal side of the nipple (P = 0.011). The choroidal thickness of the lower (P = 0.007) was positively correlated with RAPD (+) under the papilla (P = 0.005). In the comparison of the choroidal thickness, the SFCT in the eyes of the optic neuritis group, the healthy eye and the control group were 307.56, 61.95. m, 327.60, 47.56. m, 315.48 and 84.29. m After non-contact tonometer (NCT), the choroidal thickness and the choroidal thickness around the papilla in the eyes of the optic neuritis group, the eye and the control group were compared. There was no significant difference in the choroidal thickness of the other macular areas (P0.05), and there was no significant difference in the choroidal thickness around the papilla (P0.05). There was no significant correlation between the thickness of the choroid around the papilla and the thickness of the nerve fiber layer. Conclusion The choroidal thickness in different positions of patients with optic neuritis has a correlation with different factors. In the eyes of the patients with neuritis, there was no significant difference between the eye and the control group in the macular area (1500. mu.m below the central recess) and the choroid thickness around the optic nipple. There was no significant correlation between the thickness of the choroid around the papilla and the thickness of the nerve fiber layer. We conclude that the choroidal thickness of the patients with optic neuritis has no significant change in the disease, can assist in the diagnosis, evaluate the therapeutic effect and predict the prognosis, still needs to be further studied.
【学位授予单位】：北京协和医学院
【学位级别】：博士
【学位授予年份】：2015
【分类号】：R774.6
[Abstract]:Objective To evaluate the choroidal thickness (choroid thickness, CT) of the patients with optic neuritis (ON) using the Angio-OCT, and to explore the correlation between the choroidal thickness and the clinical characteristics of the patients. At the same time, whether there is a difference between the choroid thickness of the patient and the healthy person is compared, so as to assist in the diagnosis, evaluate the therapeutic effect and predict the prognosis. Methods We performed the visual function and the OCT examination on the eyes and the eye of the 25 patients with the confirmed optic neuritis, and the basic assessment of the visual function, the scanning of the choroid and the measurement of the thickness of the 25 healthy controls matched with the age and the sex were performed. The choroidal thickness and the thickness of the nerve fiber layer around the papilla were analyzed by Anio-OCT, and the choroidal thickness and the thickness of the nerve fiber layer around the papilla were obtained. The measurement of the choroidal thickness included 17 sites in the macular region and 8 sites around the papilla, and the thickness of the nerve fiber layer was calculated automatically by the system. We compared the choroidal thickness of the corresponding sites in the eye of the optic neuritis group with the control group, and analyzed the correlation between the choroidal thickness around the papilla and the thickness of the nerve fiber layer. The data was subjected to multiple linear regression analysis, rank test and so on using the SPSS10.0 software. Results The foveal choroidal thickness (SFCT) in the central depression of the eye-related macular area in the patients with neuritis was negatively correlated with the length of the eye (P = 0.003, the correlation coefficient B =-45.36), the eye-to-eye pain, the relative afferent pupillary defect (RAPD), the cup-to-plate ratio (C/ D), the apparent cup volume (CV), There was no significant correlation between the area of the disc rim (Rim area), the disc area (Disc area) and the visual field average defect (MD) (P0.05). The choroidal thickness (PPCT) at different sites in the peripapillary region is associated with different factors. The choroidal thickness of the upper nasal side (P = 0.000), upper (P = 0.015), upper nasal side (P = 0.014) and nasal side (P = 0.035) was positively correlated with sex. The choroidal thickness of the inferior (P = 0.021), lower (P = 0.017) and lower (P = 0.013) was positively correlated with age. The choroidal thickness of the lower nasal side (P = 0.003) was positively correlated with the volume of the cup, depending on the nasal side of the nipple (P = 0.011). The choroidal thickness of the lower (P = 0.007) was positively correlated with RAPD (+) under the papilla (P = 0.005). In the comparison of the choroidal thickness, the SFCT in the eyes of the optic neuritis group, the healthy eye and the control group were 307.56, 61.95. m, 327.60, 47.56. m, 315.48 and 84.29. m After non-contact tonometer (NCT), the choroidal thickness and the choroidal thickness around the papilla in the eyes of the optic neuritis group, the eye and the control group were compared. There was no significant difference in the choroidal thickness of the other macular areas (P0.05), and there was no significant difference in the choroidal thickness around the papilla (P0.05). There was no significant correlation between the thickness of the choroid around the papilla and the thickness of the nerve fiber layer. Conclusion The choroidal thickness in different positions of patients with optic neuritis has a correlation with different factors. In the eyes of the patients with neuritis, there was no significant difference between the eye and the control group in the macular area (1500. mu.m below the central recess) and the choroid thickness around the optic nipple. There was no significant correlation between the thickness of the choroid around the papilla and the thickness of the nerve fiber layer. We conclude that the choroidal thickness of the patients with optic neuritis has no significant change in the disease, can assist in the diagnosis, evaluate the therapeutic effect and predict the prognosis, still needs to be further studied.
【学位授予单位】：北京协和医学院
【学位级别】：博士
【学位授予年份】：2015
【分类号】：R774.6
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