青光眼FD-OCT结构损害与视野功能损害关系研究
发布时间：2019-05-22 20:51
【摘要】：目的 应用频域-相干光断层扫描(frequence domain optical coherence tomography, FD-OCT)与标准自动视野检查法(standard automated perimetry, SAP)分别测量的视盘参数及六分区视网膜神经纤维层(retinal nerve fiber layer, RNFL)厚度与相对应六分区视野指标,研究早期发现与随访青光眼的敏感指标,分析聊城人群青光眼引起眼底结构损害与功能损害的关系及直线模型适用性。 研究方法 (1)选择2009年2月-2010年1月来我院确诊为原发性开角型青光眼患者14例19眼,可疑开角型青光眼23例40眼,健康对照组15例29眼。分别用FD-OCT视盘固视3D扫描模式与Humphrey 720中心24-2标准阈值模式作为SAP检查入选对象视盘参数及六分区视网膜神经纤维层厚度(R值)与相对应六分区视野线性光敏感度值(T值)及视野光敏感度缺损值(D值)。(2)FD-OCT测量并分析视盘参数视盘面积(DA),视杯面积(CA),盘沿面积(RA),视杯容积(CV),盘沿容积(RV),杯盘比(CDR),线性杯盘比(LCDR),视盘深度(DH),视盘宽度(DW),记录并保存所有数据：六分区平均R值分别记为视盘颞侧(R1),颞上(R2),鼻上(R3),鼻侧(R4),鼻下(R5),颞下(R6),记录并保存所有数据；与R值对应SAP六分区T值/D值分别记为乳头黄斑区(T1/D1),下方弓状易损区(T2/D2),下方区(T3/D3),颞区(T4/D4),上方区(T5/D5),上方弓状易损区(T6/D6),记录并保存所有数据。(3)用SPSS13.0统计软件分析收集数据资料,视盘参数、六分区R值、六分区T值组间差异分析选择单因素方差分析,组间两两差异分析选择q检验；各视盘参数与六分区R值及T值两两关系用Pearson相关分析。视盘参数和六分区R值与相对应六分区D值关系用Spearman秩相关分析。(4)六分区R值对应到六分区T值,建立直线模型如下：R=soT+b。R是区域R值,T是与R值对应区域T值,so是健康人群轴索厚度组成R值部分,b是所有敏感度和轴索丢失时剩余厚度。(5)根据研究结果分析早期诊断和长期随访青光眼发生发展的敏感指标,分析FD-OCT测量结构指标和SAP测量功能指标在聊城人群中的直线模型适用性。 结果 (1)原发性开角型青光眼组,可疑青光眼组与健康对照组三组视盘参数除RV,DH显示三组之间差别无统计学意义之外,所有视盘参数组间差异有统计学意义(P0.01)；其中CA,RA,CV,CDR,LCDR三组研究对象两两组间对比差异均有统计学意义(P0.05)。(2)六分区平均R值都显示组间差异有统计学意义(P0.01),其中R1在三组研究对象两两组间对比差异有统计学意义(P0.05)：R2-R6在原发性开角型青光眼组分别与可疑青光眼组及健康对照组差异有统计学意义(P0.05)。(3)六分区平均T值都显示组间差异有统计学意义(P0.01),其中T1,T5在两两组间差异有统计学意义(P0.05)；T2-T4,T6在原发性开角型青光眼组分别与可疑青光眼组及健康对照组差异有统计学意义(P0.05)。(4)CA,RA,CDR,LCDR分别与六分区R值(R1-R6),六分区T值/D值(T1-T6,D1-D6)不同程度相关(P0.05),其余视盘参数与六分区R值,T值,D值之间无明显相关性；六分区各R值与相对应T值/D值呈中高度正相关(P0.001)其中R1-T1,R2-T2,R6-T6,R1-D1,R2-D2, R6-D6表现出高度正相关,相关系数分别为0.812,0.858,0.751,0.742,0.746,0.725(P0.001)。(5)建立直线模型：视盘颞下区R6=100.59T6+50.30(T61)；R6=150.89 (T6≥1);颞上区R2=92.60T2+46.30(T21)；R2=138.90(T2≥1)；颞侧区R1=54.80 T1+33.03(T11);R1=87.83(T1≥1)。 结论 (1)FD-OCT测量视盘参数视杯面积CA,盘沿面积RA,杯盘比CDR,线性杯盘比LCDR是早期诊断和长期随访青光眼进展的重要敏感指标。(2)FD-OCT测量的六分区的视网膜神经纤维层厚度改变有利于早期发现青光眼引起的局限区域性神经节细胞损伤与改变。(3)SAP测量并计算的乳头黄斑区,下方弓状纤维易损区和上方弓状纤维易损区光敏感度改变利于早期发现青光眼引起的局限性视功能损伤与改变。(4)结构-功能相关性：视盘颞侧R1-乳头黄斑束T1/D1、颞上R2-下方弓状纤维易损区T2/D2、颞下区R-上方弓状纤维易损区T6/D6有高度的相关性,分区域结构损伤与功能损伤研究成为可能。(5)聊城地区人群总体上适用于FD-OCT结构损伤与SAP功能损伤直线模型。能够利用该模型深入分析青光眼结构损伤与功能损伤的相互关系。
[Abstract]:Purpose The optic disc parameters and the corresponding six-zone retinal nerve fiber layer (RFL) thickness of the six-zone retinal nerve fiber layer (RFL) and the corresponding six-zone field of view were measured by frequency-domain-optical coherence tomography (FD-OCT) and standard automatic visual field (SAP), respectively. In this paper, the sensitive index of early detection and follow-up of glaucoma is studied, and the relationship between the damage of the fundus structure and the function damage caused by glaucoma in Liaocheng population and the application of the linear model are analyzed. Sex. Methods (1) From February 2009 to January 2010,14 patients with primary open-angle glaucoma were diagnosed as primary open-angle glaucoma,23 patients with open-angle glaucoma,40 eyes, and healthy control group 1. Five cases (29 eyes) were treated with FD-OCT, 3D scan pattern and Humphrey 720-center 24-2 standard threshold pattern as the target optic disc parameter of the subject and the thickness (R value) of the six-zone retinal nerve fiber layer (R-value) and the corresponding six-zone visual field linear light sensitivity (T-value) and the field-of-view light sensitivity. loss Value (D-value). (2) FD-OCT measures and analyzes the disc area (DA), the apparent cup area (CA), the disc-edge area (RA), the apparent cup volume (CV), the disc-edge volume (RV), the cup-to-plate ratio (CDR), the linear cup-to-plate ratio (LCDR), the disc depth (DH), the disc width, Degree (DW), record and keep all data: the average R value of the six-zone is recorded as the video disk drive side (R1), the upper (R2), the nose (R3), the nasal side (R4), the nose (R5), the lower (R6), the record and the protection, respectively. All data is stored; the value/ D value of the SAP 6-section corresponding to the R value is recorded as the papilla-related macular area (T1/ D1), the lower bow-like vulnerable area (T2/ D2), the lower area (T3/ D3), the crotch area (T4/ D4), the upper area (T5/ D5), the upper bow-like vulnerable area (T6/ D6), the record and the protection All the data were stored. (3) The data, the video disc parameters, the six-zone R value and the six-zone T-value group were analyzed by using the SPSS13.0 statistical software to select one-factor analysis of variance, and the two-to-group difference analysis and selection q-test were selected; each video disc parameter and the six-zone R value and the T-value were used as the Pearson. n-correlation analysis. The video disc parameter and the six-zone R value and the corresponding six-zone D-value relation are used in Spearman Rank correlation analysis. (4) The six-zone R value corresponds to the six-zone T value, and the linear model is established as follows: R = soT + b. R is the area R value, T is the area T value corresponding to the R value, so is the healthy population axis cable thickness, and the R value part, b is all the sensitivity and the axial cable loss (5) To analyze the sensitive index of early diagnosis and long-term follow-up glaucoma according to the results of the study, and to analyze the linear relationship between the measurement structure of FD-OCT and the function of SAP measurement in Liaocheng population. model Results (1) There was no significant difference between the two groups of optic disc parameters except RV and DH in the primary open-angle glaucoma group, the suspected glaucoma group and the healthy control group (P0.01). There was a statistical difference between the two groups in the three groups: RA, CV, CDR and LCDR. The significance (P0.05). (2) The mean R value of the six-zone group showed statistical significance between the groups (P0.01), in which the difference between the two groups in R1 in the three groups was statistically significant (P0.01). Significance (P0.05): The difference of R2-R6 in primary open-angle glaucoma group and the group of suspected glaucoma group and healthy control group was statistically significant. The difference of T1 and T5 between the two groups was statistically significant (P0.05), and the difference between T2-T4 and T6 in the primary open-angle glaucoma group was statistically significant (P0.05). The significance (P0.05). (4) CA, RA, CDR and LCDR were related to the different degrees of the six-zone R value (R1-R6), the six-zone T-value/ D (T1-T6, D1-D6) (P0.05), the other video disc parameters and the six-zone R-value, the T-value, the D-value, There was no significant correlation between the values of R1-T1, R2-T2, R6-T6, R1-D1, R2-D2 and R6-D6. The correlation coefficient was 0.812, 0.858, 0.751, 0.742, 0.746, 0.72, respectively. 5 (P0.001). (5) Establishment of a linear model: the lower region of the optic disc is R6 = 100.59 T6 + 50.30 (T61); R6 = 150.89 (T6-1); the upper region R2 = 92.60 T2 + 46.30 (T21); R2 = 138.90 (T2-1); the primary side region R1 = 54.80 T1 + 33.03 (T11); R1 = 87 .8 Conclusion (1) FD-OCT is used to measure the visual cup area CA of the optic disc, the area RA, the ratio of the cup to the CDR, the linear cup and the LCDR are the early diagnosis and the long-term follow-up. (2) The change of the thickness of the retinal nerve fiber layer in the six-zone measured by FD-OCT is beneficial to the early detection of the limitation of glaucoma The damage and change of regional ganglion cells. (3) The change of the sensitivity of light sensitivity in the papilla area, the lower arch-shaped fiber vulnerable area and the upper arch-shaped fiber vulnerable area measured and calculated by the SAP is beneficial to the early detection of the glaucoma. (4) Structure-function correlation: the relationship between the two-side R1-papilla-related macular bundles T1/ D1, the upper R2-lower arch-shaped fiber vulnerable region T2/ D2 and the lower region R-upper arch-shaped fiber vulnerable region T6/ D6 has a high correlation, and the sub-region structure Damage and functional damage studies have become possible. (5) The Liaocheng area population is generally applicable to FD-OCT structural loss A linear model of injury and SAP functional damage. The model can be used to analyze the glaucoma knot.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R775
本文编号：2483252
[Abstract]:Purpose The optic disc parameters and the corresponding six-zone retinal nerve fiber layer (RFL) thickness of the six-zone retinal nerve fiber layer (RFL) and the corresponding six-zone field of view were measured by frequency-domain-optical coherence tomography (FD-OCT) and standard automatic visual field (SAP), respectively. In this paper, the sensitive index of early detection and follow-up of glaucoma is studied, and the relationship between the damage of the fundus structure and the function damage caused by glaucoma in Liaocheng population and the application of the linear model are analyzed. Sex. Methods (1) From February 2009 to January 2010,14 patients with primary open-angle glaucoma were diagnosed as primary open-angle glaucoma,23 patients with open-angle glaucoma,40 eyes, and healthy control group 1. Five cases (29 eyes) were treated with FD-OCT, 3D scan pattern and Humphrey 720-center 24-2 standard threshold pattern as the target optic disc parameter of the subject and the thickness (R value) of the six-zone retinal nerve fiber layer (R-value) and the corresponding six-zone visual field linear light sensitivity (T-value) and the field-of-view light sensitivity. loss Value (D-value). (2) FD-OCT measures and analyzes the disc area (DA), the apparent cup area (CA), the disc-edge area (RA), the apparent cup volume (CV), the disc-edge volume (RV), the cup-to-plate ratio (CDR), the linear cup-to-plate ratio (LCDR), the disc depth (DH), the disc width, Degree (DW), record and keep all data: the average R value of the six-zone is recorded as the video disk drive side (R1), the upper (R2), the nose (R3), the nasal side (R4), the nose (R5), the lower (R6), the record and the protection, respectively. All data is stored; the value/ D value of the SAP 6-section corresponding to the R value is recorded as the papilla-related macular area (T1/ D1), the lower bow-like vulnerable area (T2/ D2), the lower area (T3/ D3), the crotch area (T4/ D4), the upper area (T5/ D5), the upper bow-like vulnerable area (T6/ D6), the record and the protection All the data were stored. (3) The data, the video disc parameters, the six-zone R value and the six-zone T-value group were analyzed by using the SPSS13.0 statistical software to select one-factor analysis of variance, and the two-to-group difference analysis and selection q-test were selected; each video disc parameter and the six-zone R value and the T-value were used as the Pearson. n-correlation analysis. The video disc parameter and the six-zone R value and the corresponding six-zone D-value relation are used in Spearman Rank correlation analysis. (4) The six-zone R value corresponds to the six-zone T value, and the linear model is established as follows: R = soT + b. R is the area R value, T is the area T value corresponding to the R value, so is the healthy population axis cable thickness, and the R value part, b is all the sensitivity and the axial cable loss (5) To analyze the sensitive index of early diagnosis and long-term follow-up glaucoma according to the results of the study, and to analyze the linear relationship between the measurement structure of FD-OCT and the function of SAP measurement in Liaocheng population. model Results (1) There was no significant difference between the two groups of optic disc parameters except RV and DH in the primary open-angle glaucoma group, the suspected glaucoma group and the healthy control group (P0.01). There was a statistical difference between the two groups in the three groups: RA, CV, CDR and LCDR. The significance (P0.05). (2) The mean R value of the six-zone group showed statistical significance between the groups (P0.01), in which the difference between the two groups in R1 in the three groups was statistically significant (P0.01). Significance (P0.05): The difference of R2-R6 in primary open-angle glaucoma group and the group of suspected glaucoma group and healthy control group was statistically significant. The difference of T1 and T5 between the two groups was statistically significant (P0.05), and the difference between T2-T4 and T6 in the primary open-angle glaucoma group was statistically significant (P0.05). The significance (P0.05). (4) CA, RA, CDR and LCDR were related to the different degrees of the six-zone R value (R1-R6), the six-zone T-value/ D (T1-T6, D1-D6) (P0.05), the other video disc parameters and the six-zone R-value, the T-value, the D-value, There was no significant correlation between the values of R1-T1, R2-T2, R6-T6, R1-D1, R2-D2 and R6-D6. The correlation coefficient was 0.812, 0.858, 0.751, 0.742, 0.746, 0.72, respectively. 5 (P0.001). (5) Establishment of a linear model: the lower region of the optic disc is R6 = 100.59 T6 + 50.30 (T61); R6 = 150.89 (T6-1); the upper region R2 = 92.60 T2 + 46.30 (T21); R2 = 138.90 (T2-1); the primary side region R1 = 54.80 T1 + 33.03 (T11); R1 = 87 .8 Conclusion (1) FD-OCT is used to measure the visual cup area CA of the optic disc, the area RA, the ratio of the cup to the CDR, the linear cup and the LCDR are the early diagnosis and the long-term follow-up. (2) The change of the thickness of the retinal nerve fiber layer in the six-zone measured by FD-OCT is beneficial to the early detection of the limitation of glaucoma The damage and change of regional ganglion cells. (3) The change of the sensitivity of light sensitivity in the papilla area, the lower arch-shaped fiber vulnerable area and the upper arch-shaped fiber vulnerable area measured and calculated by the SAP is beneficial to the early detection of the glaucoma. (4) Structure-function correlation: the relationship between the two-side R1-papilla-related macular bundles T1/ D1, the upper R2-lower arch-shaped fiber vulnerable region T2/ D2 and the lower region R-upper arch-shaped fiber vulnerable region T6/ D6 has a high correlation, and the sub-region structure Damage and functional damage studies have become possible. (5) The Liaocheng area population is generally applicable to FD-OCT structural loss A linear model of injury and SAP functional damage. The model can be used to analyze the glaucoma knot.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R775
【共引文献】
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1 王宁利;;北京同仁医院眼科中心8年发展历程回顾[J];首都医科大学学报;2010年04期
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相关博士学位论文 前1条
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1 刘宇;OCT在原发性青光眼早期诊断中的临床应用研究[D];大连医科大学;2011年
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