海德堡视网膜断层扫描仪Ⅲ在双眼不对称性青光眼中的应用  

Application of Heidelberg retina tomography Ⅲ in glaucoma with unilateral visual field defects

作　　者：肖格格[1] 吴玲玲[1] 

机构地区：[1]北京大学第三医院北京大学眼科中心,100083

出　　处：《眼科研究》2008年第6期466-469,共4页Chinese Ophthalmic Research

摘　　要：目的探讨海德堡视网膜断层扫描仪Ⅲ（HRT-Ⅲ）检测青光眼性视盘改变的优越性，了解单眼视野异常的开角型青光眼的视盘改变。方法对52例单眼视野异常的开角型青光眼患者进行HRT-Ⅲ检测，将视野异常眼和正常眼的结果进行对比分析。结果视野异常眼的视盘面积（2．35±0．55）mm^2大于视野正常眼（2．25±0．43）mm^2（P=0．03）；视野异常眼的视杯测量值比视野正常眼大，而盘沿、视网膜神经纤维层等测量值比视野正常眼小（P=0．000～0．02）。视野异常眼中不符合ISNT法则的眼数显著多于视野正常眼。视野正常眼的视神经病变程度较视野异常眼轻。结论HRT-Ⅲ在比较青光眼患者双眼视盘对称性等方面具有优势。视野异常眼的视盘面积大于正常眼，提示开角型青光眼患者视盘大者更易发生青光眼视神经损害。Objective Asymmetric glaucomatous damage is one of the characteristics of open-angle glaucoma. Previous studies showed the different results in the relationship between glaucomatous neuropathy and optic disc size. Our study aimed to investigate the superiority of Heidelberg retina tomography Ⅲ （ HRT-Ⅲ ） in measuring asymmetric optic disc parameters of openangle glaucoma with unilateral visual field defects. Methods Fifiy-two patients with open-angle glaucoma and unilateral visual field defects were included in this study. The measurement parameters obtained by HRT-Ⅲ in the eyes with visual field defects were compared to the fellow eyes with normal visual field. Results The optic disc area of the eyes with visual field defects （2.35 ±0. 55 ）mm^2 was larger than that of the fellow eyes with normal visual field （2.25 ± 0. 43 ）mm^2（ P =0. 03 ）. Optic cup volume ,optic cup area,C/D area ratio,mean cup depth and cup shape in the eyes with visual field defects were bigger than those of the fellow eyes with normal visual field（P =0. 000-0. 020）. Optic rim area,rim volume,mean retinal nerve fiber layer（RNFL） , thickness,RNFL cross sectional area,rim/disc area ratio,CLM, FSM and RB discriminant function value in the eyes with visual field defects were less than those of the fellow eyes with normal visual field （ P = 0. 000-0. 036）. The new parameters based on ＂Based on the modified ISNT rule＂ showed the numbers of the eyes with visual field defects that do not fulfilled ISNT rule were more than the fellow eyes with normal visual field. Glaucoma probability score showed that all of the eyes presented glaucomatous optic damage but the eyes with normal visual field showed a less extent. HRT-Ⅲ symmetry parameters of binocular optic discs demonstrated a binocular difference in height variation contour, mean RNFL thickness,and rim area had the significant difference from the normal values. Conclusion HRT-Ⅲ has the advantages in comparison with the symmetry of glaucomatous optic disc. T

关 键 词：开角型青光眼 视野 视盘 视网膜断层扫描仪 

分 类 号：R775[医药卫生—眼科]