OCT检测原发性开角型青光眼神经纤维层厚度与视野光敏感度相关性分析  

Correlative analysis between retinal nerve fiber layer thickness measured by OCT and mean sensitivity of visual field in POAG

作　　者：丁琦[1] 杨蕾[1] 严良[1] 陆豪[1] 张红英[1] 熊毅[1] 

机构地区：[1]上海市宝山中心医院眼科,201900

出　　处：《眼科新进展》2007年第5期366-368,共3页Recent Advances in Ophthalmology

摘　　要：目的探讨光学相干断层成像(optical coherence tomography,OCT)检测原发性开角型青光眼(primary open an-gle glaucoma,POAG)视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度与视野光敏感度均值(meansensitivity,MS)的相关性。方法分别采用Zeiss-Humphrey,Stratus TM,Ver-sion3.0OCT和OCTOPUS101全自动电脑视野分析仪中对正常组患者(25例30眼)和POAG组患者(52例81眼)进行检测,将各个POAG组中心30°视野内全视网膜MS和OCT检测的RNFL厚度值与正常组进行比较,并做相关性分析。结果早、中期和晚期POAG组MS分别为(22·13±1·96)dB、(18.22±2.66)dB、(12.75±4.05)dB均低于正常组(26.55±2.11)dB,P<0·05;中期和晚期POAG组RNFL值(87.95±15.60)μm、(65.31±15.88)μm均低于正常组(99.65±12·17)μm,P<0.05;早期POAG组总RNFL值虽低于正常组,但与正常组相比差异无统计学意义(P>0.05)。将其RNFL厚度测量值按4个象限进行独立分析,发现在早期PO-AG组其颞上(95.06±23.46)μm和颞下(92.52±24.31)μmRNFL值与正常组(106.37±16.12)μm、(107.32±12.70)μm分别相比差异有统计学意义(P<0.05)。所有被检测者视野MS与RNFL厚度呈正的直线相关(r=0.648,P=0·000);POAG组MS与RNFL厚度呈正的直线相关(r=0.634,P=0.000);正常组MS与RNFL厚度无直线相关性(r=0·263,P=0.168)。结论MS与RNFL厚度有很好的直线相关性,通过OCT对RNFL厚度的检测,有助于了解和监测POAG对RNFL的损伤,是一种很有价值和潜力的POAG客观辅助诊断方法。Objective To evaluate the relationship between mean sensitivity （MS） of visual field and retinal nerve fiber layer（RNFL） thickness measured by optical coherent tomography（OCT） in the primary open angle glaucoma（POAG）. Methods Twenty-five normals（36 eyes） and 52 patients with POAG （81 eyes） were examined by OCT （ Zeiss-Humphrey, Stratus TM,Version 3.0 ） and OCTOPUS101 automated perimetry respectively. The cases with POAG were divided into early, advanced and late stages. MS and RNFL thickness values were compared among all groups. The correlation between MS and RNFL thickness was also analyzed. Results MS in early, advanced and late stages of POAG were （ 22.13 ± 1.96 ） dB, （22.13 ± 1.96） dB, （ 12.75 ±4.05） dB respectively, which all were lower than that in normals （ 26.55 dB ± 2.11 dB, P 〈 0.05 ）. RNFL in advanced and late stages of POAG were （87.95 ± 15.60） μm,（65.31 ± 15.88） μm, respectively, which all were lower than that in norreals （99.65 μm ± 12. 17 μm, P 〈 0.05 ）. There was no statistically significant difference in RNFL thickness between early stage of POAG and normals （ P 〉 0.05 ）, but there was significant difference in superior and inferior of temporal RNFL thickness between early stage of POAG（95.06 μm ± 23.46 μm,92.52 μm ±24.31 μm） and normals（ 106.37 μm± 16.12 μm ,107.32 μm ± 12.70 μm,P 〈 0.05 ）. MS and RNFL thickness in all cases had a positive linear correlation （related coefficient was 0.648,P=0.000）. MS and RNFL thickness in POAG had a positive linear correlation （related coefficient was 0. 634, P = 0.000） ,but there was no linear correlation in normal （ related coefficient was 0. 263, P = 0. 168 ）. Conclusion The correlation between MS and RNFL thickness has good linear. By measuring the RNFL thickness, OCT can understand and monitor the RNFL damage,which is a kind of very useful and objective method in the diagnosis of POAG.

关 键 词：原发性开角型青光眼 神经纤维层厚度 光敏感度 相关性 

分 类 号：R775.2[医药卫生—眼科]