OCT检测视盘形态及视网膜神经纤维层厚度在开角型青光眼早期诊断中的应用

发布时间：2018-03-25 06:39

本文选题：RTVue　切入点：OCT　出处：《眼科新进展》2014年09期

【摘要】：目的采用RTVue OCT测量正常人和青光眼患者的视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度以及视盘的各项参数并进行分析,探讨频域OCT在青光眼诊断中的作用。方法收集正常人40例(40眼)、原发性开角型青光眼(primary open-angle glaucoma,POAG)早中期患者30例(30眼)、POAG晚期患者38例(38眼),OCT测量所有研究对象视盘各参数、视盘各象限的RNFL厚度、平均RNFL厚度。对各参数与视野平均缺损(mean defect,MD)值进行相关分析,对检测结果进行评价。结果 OCT检测结果表明,正常组和POAG早中期组、POAG晚期组上方、颞侧、下方、鼻侧象限RNFL厚度和平均RNFL厚度的差异均有统计学意义(均为P=0.000),各组RNFL厚度从厚到薄依次为视盘下方、上方、颞侧、鼻侧象限。在视盘形态参数中,正常组、POAG早中期组和POAG晚期组患者视杯面积、盘沿面积、盘沿容积、视杯容积、视盘容积、杯盘面积比、水平杯盘比以及垂直杯盘比之间的差异均有统计学意义(均为P=0.000),组间两两比较差异也均有统计学意义(均为P0.05);而视盘面积差异无统计学意义(P=0.497)。对POAG患者的检测表明,视盘上方、颞侧、下方象限RNFL厚度以及平均RNFL厚度与视野MD值之间存在着负相关关系(r=-0.455、-0.211、-0.493、-0.425,均为P0.05),而鼻侧象限RNFL厚度与视野MD值无相关性(r=-0.106,P0.05);视盘参数中,视杯面积和杯盘面积比与视野MD值呈正相关(r=0.057、0.394,均为P0.05),而盘沿面积、盘沿容积和视盘容积与视野MD值呈负相关(r=-0.275、-0.306、-0.418,均为P0.05)。结论 RNFL厚度和视盘各参数是早期青光眼的敏感指标,RTVue OCT检测RNFL厚度和视盘参数有助于青光眼早期诊断。
[Abstract]:Objective to measure and analyze the thickness of retinal nerve fiber layerus and the parameters of optic disc in normal subjects and glaucoma patients by RTVue OCT. To investigate the role of frequency-domain OCT in the diagnosis of glaucoma. Methods 40 normal subjects (40 eyes) and 30 patients (30 eyes) with primary open angle glaucoma (PCG) in early and middle stage were studied by Oct. The parameters of optic disc were measured by Oct in 38 patients (38 eyes) with late stage of Poag. The RNFL thickness and mean RNFL thickness of each quadrant of the optic disc were analyzed and the results were evaluated by correlation analysis between the parameters and the mean mean mean defectMD value of the visual field. Results the results of OCT test showed that the normal group and the early and middle POAG group were superior to the late Poag group and the temporal side. The difference of RNFL thickness and average RNFL thickness in nasal quadrant was statistically significant (P < 0. 000). The thickness of RNFL in each group was below, above, temporal and nasal quadrants from thickness to thickness. The visual cup area, disc edge area, disc edge volume, visual cup volume, optic disc volume, cup area ratio of patients with Poag in early and middle stage group and late POAG group were measured. The difference of horizontal cup / disc ratio and vertical cup / disc ratio was statistically significant (both P0. 000 and P 0. 05), but there was no significant difference in optic disc area between the two groups (P 0. 05, P 0. 497). The examination of the patients with POAG showed that above the optic disc, there was no significant difference in the area of the optic disc, and there was no significant difference in the area of the optic disc between the two groups (P < 0. 05). There was a negative correlation between the thickness of RNFL in temporal and inferior quadrants and the mean thickness of RNFL and the MD value of visual field. There was a negative correlation between the thickness of RNFL in the nasal quadrant and the MD value of the visual field, and there was no correlation between the thickness of RNFL in the nasal quadrant and the MD value of the visual field, and there was no correlation between the thickness of RNFL in the nasal quadrant and the MD value of the visual field, and in the optic disk parameters, there was no correlation between the thickness of RNFL in the nasal quadrant and the value of MD. There was a positive correlation between the visual cup area and the area ratio of cup and disc and the MD value of visual field. There was a negative correlation between the disc volume and visual disc volume and the MD value of visual field, both of which were P0.05.Conclusion the thickness of RNFL and the parameters of optic disc are sensitive indexes of early glaucoma. The thickness of RNFL and the parameters of optic disc are helpful for the early diagnosis of glaucoma.
【作者单位】：常熟市第二人民医院眼科;
【分类号】：R775

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