老年原发性青光眼中心视功能与HRT-Ⅱ盘沿参数的相关性研究
发布时间：2018-07-27 09:56
【摘要】：第一部分：老年原发性青光眼低对比度视力与HRT—Ⅱ盘沿参数及黄斑阈值的相关性 目的研究老年原发性青光眼患者在不同发展时期低对比度视力的改变特点,初步探讨低对比度视力与海德堡视网膜断层成像仪Ⅱ型(HRT-Ⅱ)测得的颞侧盘沿参数及黄斑阈值在青光眼不同时期有无相关性,探讨低对比度视力检查能否成为检测老年青光眼中心视功能损害的有效方法。 方法选择老年原发性青光眼患者46例(88眼),正常对照组23例(40眼)。对所有受试者行屈光矫正后,采用多功能视力测量仪检查测得100%、25%、10%和5%4个对比度视力,应用德国产Humphrey—750i型视野分析仪的中心30-2程序及黄斑阈值视野(MTP)检测程序进行静态阈值视野检查,根据中心30-2视野平均缺损(MD)将青光眼患者分为早期组23例(45眼)和中晚期组23例(43眼)。用海德堡视网膜断层成像仪Ⅱ型进行视乳头扫描分析,选择颞侧盘沿面积(RA)、颞侧盘沿容积(RV)两个视盘参数。分析青光眼早期组、中晚期组及正常对照组之间各对比度视力有无统计学差异(P0.05)；分析青光眼早期组、中晚期组各低对比度视力与HRT-Ⅱ测得的颞侧RA、RV有无相关性及与MTP的平均光敏感度(MS)有无相关性,。 结果对照组、青光眼早期组及中晚期组25%、10%及5%对比度视力均依次下降,三组间总体比较差异有统计学意义(P0.05)；青光眼早期组各低对比度视力较对照组下降,但差异无统计学意义(P0.05)；25%低对比度视力与颞侧RV呈负相关(r=-0.301,P0.05)；25%、10%低对比度视力与MTP的MS呈负相关(r=-0.307；r=-0.298；,P均0.05),中晚期组各低对比度视力较对照组和早期组均下降,差异有统计学意义(P0.05),10%、5%低对比度视力与颞侧RA呈负相关(r=-0.361；r=-0.318,P均0.05)、与颞侧RV呈负相关(r=-0.303；r=-0.377,P均0.05),10%、5%低对比度视力与MTP的MS呈负相关(r=-0.314；r=-0.397,P均0.05)。 结论老年原发性青光眼病情进展导致低对比度视力下降,与盘沿结构参数和黄斑光阈值相关的低对比度视力的对比度水平逐渐降低,早期与中晚期患者不同低对比度视力与HRT-Ⅱ颞侧盘沿参数RA、RV及黄斑阈值有相关性,对比度视力检查结合视乳头结构检测及其它视功能检查能够对青光眼中心视功能的病情评估和监测提供重要依据。 第二部分：老年原发性青光眼黄斑阈值与HRT—Ⅱ盘沿参数的相关性 目的研究原发性青光眼老年患者各发展时期并结合青年患者早期的黄斑阈值变化特点,分析老年黄斑阈值与视盘盘沿结构改变的相关性,探讨黄斑阈值在检测老年青光眼中心视功能方面的客观性和可靠性。 方法选择原发性青光眼老年患者51例(97眼),青年患者22例(40眼),老年正常对照组23例(40眼)。对所有受试者行屈光矫正后,采用Humphrey—750i型视野分析仪进行静态阈值视野检查,选择中心30-2程序及黄斑阈值视野(MTP)检测程序,根据中心30-2视野平均缺损(MD)将青光眼患者分为老年早期组23例(45眼),老年中晚期组28例(52眼),青年早期组22例(40眼)。采用海德堡视网膜断层成像仪Ⅱ型(HRT-Ⅱ)进行视乳头结构分析,测得颞侧盘沿面积(RA)、盘沿容积(RV)两个视盘参数。统计分析老年早期组、中晚期组及正常对照组之间黄斑阈值有无统计学差异(P0.05)；分析青光眼各组MTP的平均光敏感度(MS)与HRT-Ⅱ测得的颞侧盘沿参数RA、RV有无相关性。 结果黄斑阈值在对照组、老年早期组及老年中晚期组依次下降,三组间总体比较差异有统计学意义(P0.05)；老年早期组黄斑阈值与对照组比较差异有统计学意义(P0.05)；MTP的MS与颞侧RA、RV无相关性(P0.05)；老年中晚期组MTP的MS较对照组和老年早期组均下降,差异有统计学意义(P0.05),MTP的MS与颞侧RV呈正相关(r=0.308,P0.05)；青年早期组黄斑阈值与颞侧RA、RV无相关性(P0.05)。 结论随着老年青光眼患者病情发展,黄斑阈值逐渐升高,中晚期患者黄斑阈值与HRT-Ⅱ颞侧盘沿参数RV有相关性。黄斑阈值检测在老年早期诊断方面不够敏感,但在中晚期患者的随访监测及病情评估方面有效。
[Abstract]:Part one: correlation between low contrast visual acuity and HRT - II disc rim parameters and macular thresholds in elderly primary glaucoma.
Objective to study the characteristics of low contrast visual acuity at different developmental stages in the elderly patients with primary glaucoma, and to explore the correlation between the temporal disc edge parameters and the macular threshold of the low contrast visual acuity and the Heidelberg retina tomography II imaging instrument (HRT- II) in different periods of glaucoma. It is an effective method to detect visual impairment in senile glaucoma patients.
Methods 46 cases (88 eyes) and 23 cases (40 eyes) of the normal control group were selected and 23 cases (40 eyes) of the normal control group. After the refractive correction of all subjects, the 100%, 25%, 10% and 5%4 contrast visual acuity were measured by the multifunction visual instrument. The center 30-2 program and the macular threshold field of vision (MTP) were detected by the German Humphrey 750i field analyzer. The program carried out static threshold visual field examination, divided glaucoma patients into early group 23 cases (45 eyes) and middle and late group 23 cases (43 eyes) according to the center 30-2 visual field defect (MD). The visual papilla scanning of the Heidelberg retina tomography type II was used to select the temporal disc along surface product (RA), and the temporal disc along the volume (RV) two disc parameters. There was no significant difference in contrast between the early light eye group, the middle and late group and the normal control group (P0.05). Analysis of the early glaucoma group, the low contrast visual acuity of the middle and late stage group and the temporal RA of the HRT- II, the correlation of RV and the mean light sensitivity of MTP (MS) had no correlation.
Results in the control group, the visual acuity of 25%, 10% and 5% in the early and middle stage groups decreased in turn, and there was a significant difference between the three groups (P0.05). The low contrast visual acuity in the early glaucoma group was lower than the control group, but the difference was not statistically significant (P0.05); 25% low contrast visual acuity was negatively correlated with temporal RV (r=-0.301, P0. 05); (05) 25%, 10% low contrast visual acuity was negatively correlated with MS of MTP (r=-0.307; r=-0.298; P 0.05). The low contrast visual acuity of the middle and late group decreased compared with the control group and the early group, the difference was statistically significant (P0.05), 10%, 5% low contrast vision was negatively correlated with the temporal RA (r=-0.361; r=-0.318, P 0.05), and was negatively correlated with the temporal RV (r=-0.303). ; r=-0.377, P all 0.05), 10%, 5% low contrast visual acuity was negatively correlated with MS of MTP (r=-0.314, r=-0.397, P 0.05).
Conclusion the progression of primary glaucoma in the elderly leads to low contrast visual acuity, the contrast of low contrast visual acuity associated with the parameters of the disc and the Huang Banguang threshold, and the correlation between the low contrast visual acuity and the HRT- II temporal disc along the parameters RA, RV and macula threshold in the early and middle stage patients, and the contrast vision examination. Examination combined with the examination of optic disc structure and other visual function tests can provide important basis for the assessment and monitoring of the central visual function of glaucoma.
The second part: the correlation between macular threshold and HRT - II disc parameters in elderly patients with primary glaucoma.
Objective to study the characteristics of the changes in the early macular threshold of the elderly patients with primary glaucoma and to analyze the correlation between the age-related macular thresholds and disc disc changes, and to explore the objectivity and reliability of the macular threshold in the detection of the central visual function of the elderly glaucoma.
Methods 51 elderly patients with primary glaucoma (97 eyes), 22 young patients (40 eyes) and 23 elderly normal controls (40 eyes) were selected. After refraction correction, the static threshold visual field examination was performed by Humphrey 750i visual field analyzer, and the center 30-2 program and the macular threshold visual field (MTP) detection program were selected, according to center 30-2. The average visual field defect (MD) was divided into 23 cases (45 eyes) of the early aged group, 28 cases (52 eyes) in the middle and advanced age group and 22 cases (40 eyes) in the early young group. The optic papillary structure analysis was carried out by the Heidelberg retina tomography II (HRT- II). The temporal disc area (RA) and the disc along volume (RV) two disc parameters were measured. Statistics and analysis of the elderly There was no statistical difference in the macular threshold between the early group, the middle and late group and the normal control group (P0.05), and the mean light sensitivity (MS) of MTP in each group was correlated with the parameters RA and RV of the temporal disc, which was measured by HRT- II.
Results the macular threshold in the control group, the early aged group and the middle and late aged group decreased in turn, and there was a significant difference between the three groups (P0.05). The macular threshold of the early aged group was significantly different from the control group (P0.05); the MS of MTP and the temporal RA, RV were not correlated (P0.05), and the MS in the middle and late elderly group was more than the control group and the control group. In the early age group, the difference was statistically significant (P0.05). The MS of the MTP was positively correlated with the temporal RV (r=0.308, P0.05), and there was no correlation between the macular threshold and the temporal RA and RV (P0.05) in the early young group.
Conclusion with the development of the elderly glaucoma patients, the macular threshold increased gradually. The macular threshold was correlated with the HRT- II temporal disc along the parameter RV. The macular threshold detection was not sensitive to the early diagnosis of the elderly, but it was effective in the follow-up monitoring and evaluation of the patients in the middle and late stages.
【学位授予单位】：山东大学
【学位级别】：博士
【学位授予年份】：2011
【分类号】：R775.2
本文编号：2147461
[Abstract]:Part one: correlation between low contrast visual acuity and HRT - II disc rim parameters and macular thresholds in elderly primary glaucoma.
Objective to study the characteristics of low contrast visual acuity at different developmental stages in the elderly patients with primary glaucoma, and to explore the correlation between the temporal disc edge parameters and the macular threshold of the low contrast visual acuity and the Heidelberg retina tomography II imaging instrument (HRT- II) in different periods of glaucoma. It is an effective method to detect visual impairment in senile glaucoma patients.
Methods 46 cases (88 eyes) and 23 cases (40 eyes) of the normal control group were selected and 23 cases (40 eyes) of the normal control group. After the refractive correction of all subjects, the 100%, 25%, 10% and 5%4 contrast visual acuity were measured by the multifunction visual instrument. The center 30-2 program and the macular threshold field of vision (MTP) were detected by the German Humphrey 750i field analyzer. The program carried out static threshold visual field examination, divided glaucoma patients into early group 23 cases (45 eyes) and middle and late group 23 cases (43 eyes) according to the center 30-2 visual field defect (MD). The visual papilla scanning of the Heidelberg retina tomography type II was used to select the temporal disc along surface product (RA), and the temporal disc along the volume (RV) two disc parameters. There was no significant difference in contrast between the early light eye group, the middle and late group and the normal control group (P0.05). Analysis of the early glaucoma group, the low contrast visual acuity of the middle and late stage group and the temporal RA of the HRT- II, the correlation of RV and the mean light sensitivity of MTP (MS) had no correlation.
Results in the control group, the visual acuity of 25%, 10% and 5% in the early and middle stage groups decreased in turn, and there was a significant difference between the three groups (P0.05). The low contrast visual acuity in the early glaucoma group was lower than the control group, but the difference was not statistically significant (P0.05); 25% low contrast visual acuity was negatively correlated with temporal RV (r=-0.301, P0. 05); (05) 25%, 10% low contrast visual acuity was negatively correlated with MS of MTP (r=-0.307; r=-0.298; P 0.05). The low contrast visual acuity of the middle and late group decreased compared with the control group and the early group, the difference was statistically significant (P0.05), 10%, 5% low contrast vision was negatively correlated with the temporal RA (r=-0.361; r=-0.318, P 0.05), and was negatively correlated with the temporal RV (r=-0.303). ; r=-0.377, P all 0.05), 10%, 5% low contrast visual acuity was negatively correlated with MS of MTP (r=-0.314, r=-0.397, P 0.05).
Conclusion the progression of primary glaucoma in the elderly leads to low contrast visual acuity, the contrast of low contrast visual acuity associated with the parameters of the disc and the Huang Banguang threshold, and the correlation between the low contrast visual acuity and the HRT- II temporal disc along the parameters RA, RV and macula threshold in the early and middle stage patients, and the contrast vision examination. Examination combined with the examination of optic disc structure and other visual function tests can provide important basis for the assessment and monitoring of the central visual function of glaucoma.
The second part: the correlation between macular threshold and HRT - II disc parameters in elderly patients with primary glaucoma.
Objective to study the characteristics of the changes in the early macular threshold of the elderly patients with primary glaucoma and to analyze the correlation between the age-related macular thresholds and disc disc changes, and to explore the objectivity and reliability of the macular threshold in the detection of the central visual function of the elderly glaucoma.
Methods 51 elderly patients with primary glaucoma (97 eyes), 22 young patients (40 eyes) and 23 elderly normal controls (40 eyes) were selected. After refraction correction, the static threshold visual field examination was performed by Humphrey 750i visual field analyzer, and the center 30-2 program and the macular threshold visual field (MTP) detection program were selected, according to center 30-2. The average visual field defect (MD) was divided into 23 cases (45 eyes) of the early aged group, 28 cases (52 eyes) in the middle and advanced age group and 22 cases (40 eyes) in the early young group. The optic papillary structure analysis was carried out by the Heidelberg retina tomography II (HRT- II). The temporal disc area (RA) and the disc along volume (RV) two disc parameters were measured. Statistics and analysis of the elderly There was no statistical difference in the macular threshold between the early group, the middle and late group and the normal control group (P0.05), and the mean light sensitivity (MS) of MTP in each group was correlated with the parameters RA and RV of the temporal disc, which was measured by HRT- II.
Results the macular threshold in the control group, the early aged group and the middle and late aged group decreased in turn, and there was a significant difference between the three groups (P0.05). The macular threshold of the early aged group was significantly different from the control group (P0.05); the MS of MTP and the temporal RA, RV were not correlated (P0.05), and the MS in the middle and late elderly group was more than the control group and the control group. In the early age group, the difference was statistically significant (P0.05). The MS of the MTP was positively correlated with the temporal RV (r=0.308, P0.05), and there was no correlation between the macular threshold and the temporal RA and RV (P0.05) in the early young group.
Conclusion with the development of the elderly glaucoma patients, the macular threshold increased gradually. The macular threshold was correlated with the HRT- II temporal disc along the parameter RV. The macular threshold detection was not sensitive to the early diagnosis of the elderly, but it was effective in the follow-up monitoring and evaluation of the patients in the middle and late stages.
【学位授予单位】：山东大学
【学位级别】：博士
【学位授予年份】：2011
【分类号】：R775.2
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