偏振激光扫描仪(GD_XVCC)和Octopus自动视野计在垂体瘤检查中的比较  

Comparison of GDXVCC and Octopus Automated Perimetry as the Diagnostic Tests of Visual Function in Pituitary Tumor Patients

作　　者：钟勇[1] 施维[1] 艾凤荣[1] 赵鹏[1] 任祖渊[2] 

机构地区：[1]北京协和医院眼科,北京100730 [2]北京协和医院神经外科,北京100730

出　　处：《中国神经肿瘤杂志》2007年第2期84-89,共6页Chinese Journal of Neuro-Oncology

摘　　要：背景与目的:视野缺损的发现在垂体瘤的诊断和随访中仍占一定地位,本研究比较偏振激光扫描仪(GDXVCC)和Octopus自动视野计在垂体瘤检查中的相关性及两种检查方法对检测垂体瘤的敏感性。方法:对2004年1月至2006年8月在我院经病理或内分泌检查、MRI确诊的56例垂体瘤患者(112只眼)分别行GDXVCC和视野(VF)检查,所有患者VF检查使用Octopus自动视野计TOP程序。分析GDXVCC检查所得的双眼视网膜神经纤维层(RNFL)平均厚度、上方厚度、下方厚度与相对应的视野检查所得的双眼平均敏感度(MS)、丢失方差(LV)的平方根及神经纤维指数(NFI)与平均缺陷度(MD)这6组参数,并分析这两种方法分别针对神经纤维结构和功能在垂体瘤视功能损害情况下的相关性和敏感性。结果:所有相关参数比较,均有统计学意义。双眼GDXVCC的RNFL平均厚度与VF检查的MS,上、下方的RNFL平均厚度分别与下、上方的MS比较均呈线性正相关(整体P<0.01、上方P<0.05、下方右眼P<0.05,左眼P<0.01);双眼RNFL平均厚度与LV的平方根呈线性负相关(P<0.05),左眼均较右眼明显。双眼GDXVCC的NFI与MD呈线性正相关(右眼P<0.05,左眼P<0.01);双眼RNFL平均厚度Octopus自动视野计检测垂体瘤的敏感性为69.64%,GDXVCC检测的敏感性为59.82%(P>0.05),两种方法联合检测的敏感性为80.36%(P<0.05)。结论:GDXVCC操作简单,可重复性强,可以有效地定量检测出RNFL的受损部位及程度,客观反映垂体瘤患者RNFL结构的损害,并与视野检查发现的缺损有一定的相关性,但无法定位肿瘤。两者联合大大提高了对垂体瘤检测的敏感性,便于临床监测视功能的变化,更好地追踪垂体瘤患者RNFL的信息。BACKGROUND ＆ OBJECTIVE： To investigate the sensitivity of GDxVCC and Octopus automated perimetry in the diagnosis and follow up of pituitary tumor patients and the correlation between them. METHODS： Fifty-six pituitary tumor patients（112 eyes） of Peking Union Medical College Hospital were included in the study from January, 2004 to August, 2006. These patients were examined with both GDxVcc and Octopus automated perimetry （VF）. All the patients received VF test by Octopus 101 perimeter with the TOP program. The correlation between the two methods with six parameters in 3 pairs （mean thickness, superior mean thickness and inferior mean thickness of GDxVcc, in comparision with mean sensitivity and square root of lossvariance of VF, nerve fiber indicator and mean defect respectively） were explored. Data of GDxVcc for neural fiber structure and VF for the function of visual pathway in pituitary tumor patients were analyzed. RESULTS： The correlation in terms of all paired parameters from GDxVcc and VF are statistically significant. The RNFL mean thickness, superior mean thickness and inferior mean thickness of GDxVcc are positively correlated with the mean sensitivity （MS）, modified superior and inferior MS （global P〈 0.01, superior P〈0.05, inferior right eyes： P〈0.05）; left eyes changes showed the strongest correlation between the inferior sectoral RNFL and the superior VF indexes （left eyes：P〈0.01）. In addition, the RNFL mean thickness of GDxVxx was negatively correlated with the square root of the loss variance （LS） of VF （right eyes： P〈0.05, left eyes： P〈0.01）. Nerve fiber indicator was positively correlated with the mean defect （MD） （right eyes： P〈0.05, left eyes： P〈 0.01） and VF for PPT patients had a sensitivity of 69.64% and GDXVCC had a sensitivity of 59.82%（no statistically significant difference）. The sensitivity of GDxVxx and VF combo method was 80.36%（ with statistically significantly different from GDxVxx or VF alone）. CO

关 键 词：偏振激光扫描仪(CDxVCC) Octopus自动视野计 敏感性 垂体瘤 

分 类 号：R739.41[医药卫生—肿瘤]