视网膜断层扫描仪在青光眼性视神经病变中的诊断价值  

The diagnostic ability of Heidelberg retina tomography to detect glaucomatous optic neuropathy in Chinese

作　　者：刘杏[1] 梁远波[2] 凌运兰[1] 黄晶晶[1] 郑小平[1] 

机构地区：[1]中山大学中山眼科中心,广州510060 [2]首都医科大学北京同仁眼科中心

出　　处：《中华眼科杂志》2004年第11期737-740,共4页Chinese Journal of Ophthalmology

基　　金：广东省重点科技攻关基金资助项目 (A0 5 2 0 0 10 43 )

摘　　要：目的　评价视网膜断层扫描仪在青光眼性视神经病变中的诊断价值。方法　应用海德堡视网膜断层扫描仪 (HRT)检测 116例 (116只眼 )正常人和 6 3例 (99只眼 )原发性开角型青光眼(POAG)患者的视乳头地形图参数 ,比较两者间各参数的差异 ;将正常人与POAG患者的视乳头地形图参数进行逐步判别分析 ,建立判别函数 ,筛选出诊断POAG的敏感参数并进行回代分析。结果POAG患者的视盘面积 (DA)、视杯面积 (CA)、杯 /盘面积 (C/DAR)、盘沿面积 (RA)、视乳头轮廓线高度变化值 (HVC)、视杯容积 (CV)、盘沿容积 (RV)、平均视杯深度 (MCD)、最大视杯深度 (MxCD)、视杯形态测量 (CSM)、平均视网膜神经纤维层厚度 (mRNFLT)、视网膜神经纤维层截面面积 (RNFLA)与正常人比较差异有显著意义 (P <0 0 0 1) ;对POAG诊断敏感的视盘地形图参数为C/DAR、RA、CSM、CV和MxCD ;判别函数式为Y =- 2 0 83- 4 833×C/DAR - 2 0 379×CSM +2 0 35×RA +3 95 5×CV - 3 70 1×MxCD ;对POAG诊断的敏感性、特异性及诊断符合率分别为 81 8%、86 2 %及 84 2 % ,与HRT自动分析程序相当。结论　POAG患者视乳头地形图与正常人差异较大 ;利用我国人的数据资料建立的判别函数对POAG诊断效能与HRT自动分析程序相当 。Objective To evaluate the ability of Heidelberg retina tomogaphy (HRT) in the diagnosis of primary open angle glaucoma (POAG).Methods The topography of optic nerve head of 116 normal eyes and 99 eyes with POAG were examined using HRT. The differences of the optic disc parameters between two groups were compared. The topographic parameters of the optic nerve head were undergone stepwised discriminant analysis and the discriminant function was established. The sensitive diagnostic parameters of POAG were screened.Results The topographic parameters of optic nerve head, including disc area(DA), cup area(CA), cup/disc area ratio(C/DAR), rim area(RA), height variation contour(HVC), cup volume(CV), rim volume(RV), mean cup depth(MCD), maximum cup depth(MxCD), cup shape measure(CSM), mean retinal nerve fiber layer thickness(mRNFLT), retinal nerve fiber layer cross section area(RNFLA), showed significant (P<0.001) difference between normal subjects and patients with POAG. The sensitive diagnostic parameters of POAG were C/DAR, RA, CSM, CV, MCD. The discriminant function was Y=-2.083-4.833×C/DAR-20.379×CSM+2.035×RA+3.955×CV-3.701×MxCD. The sensitivity, specificity and diagnostic accuracy were 81.8%, 86.2% and 84.2%, respectively, which were comparable to the automatic analysis program of HRT. Conclusions The topographic parameters of optic nerve head in patients with POAG showed significant differences from that in normal people. The power of discriminant function established based on our data was comparable to the HRT automatic analysis program. Our results indicate that HRT automatic analysis program is applicable to Chinese.

关 键 词：POAG 诊断 视乳头 正常人 患者 HRT 视神经病变 面积 参数 中国 

分 类 号：R775[医药卫生—眼科] R774[医药卫生—临床医学]