垂体瘤患者视网膜神经纤维层厚度和视野变化参数相关性研究  

Correlation between retinal neural fiber layer and visual field defect in pituitary tumor patients

作　　者：施维[1] 钟勇[1] 董方田[1] 艾凤荣[1] 赵鹏[1] 

机构地区：[1]北京协和医院眼科,北京100730

出　　处：《中国实用眼科杂志》2008年第1期19-23,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的 观察继发视功能损害的垂体瘤患者的视网膜神经纤维层厚度和视野变化参数之间的相关性，并比较偏振激光扫描仪（GDxVcc）和Octopus自动视野计在垂体瘤（PTT）患者检查中的敏感性及特异性。方法 对确诊为垂体瘤的70例患者（140只眼）分别行GDxVCC检查和Octopus自动视野计TOP程序视野（VF）检查。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）、平均缺陷度（MD）与丢失方差（LV）的平方根及神经纤维指数（NFI）与平均缺陷度（MD）的5组参数，探讨这两种检查方法对垂体瘤视功能损害的敏感性及特异性并比较相应参数的相关性。结果 Octopus自动视野计检测PTT的敏感性为70．00％，特异性为34．00％；GDxVCC检测PTT的敏感性为72．22％，特异性为56．00％；两种方法联合检测PTT的敏感性为83-33％，特异性为58．00％（差异有统计学意义）。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（p〈0．01）；左眼均较右眼明显。双眼GDxVCC的NFI与MD呈线性正相关（p〈0．01）双眼RNFL平均厚度与LV的平方根呈线性负相关（P〈0．01）。结论 GDxVCC联合视野检查有助于提高继发视功能损害的垂体瘤检测的敏感性及特异性。GDxVCC可以客观定量地反映视网膜神经纤维的结构性损害，并与视野的缺损有一定的相关性。Objective To study the correlation of retinal neural fiber layer and visual field defect and compare the sensitivity between GDxVCC and Octopus automated perimetry in the diagnosis and follow up of pituitary tumor patients. Methods 70 pituitary tumor patients （140 eyes）, which were diagnosed with endocrinologic examination ,MRI or surgical sample pathology in Peking Union Medical College hospital are included in the current study. These patients were examined with both GDxVcc and Octopus automated perimetry（VF）. 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 selected. The data of GDxVcc for neural fiber structure and VF for psychophysical function of visual pathway in pituitary tumor patients were analyzed. All the patients received VF test by Octopus 101 perimeter with the TOP program.Results VF for PPT patients posseses a sensitivity of 70.00%, specificity of 34.00%;GDxVCC has a sensitivity of 72.22%, specificity of 56. 00%; the sensitivity of GDxVxx and VF combo method is 83.33%, while the specificity of combo method is 58. 00% （ with statistically significantly different from GDxVxx or VF alone） .The correlation in terms of all paired parameters from GDxVcc and VF are statistically significant. The RNFL mean thickness, superior mean thickness, inferior mean thickness of GDxVcc are positively correlated with the mean sensitivity （MS） ,modified superior and inferior MS （P〈0.01）; left eyes changes showed the strongest correlation between the inferior sectoral RNFL and the superior VF indexes （P〈0.01）. On the other hand, the RNFL mean thickness of GDxVxx is negatively correlated to the square root of the loss variance （LS） ofVF （P〈0.01）. Nerve fiber indicator showed positively correlated with the mean defect （MD） （P〈0.01）. Conclusio

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

分 类 号：R779.63[医药卫生—眼科] R778.3[医药卫生—临床医学]