原发性青光眼早期视盘参数与视野缺损的关系  

Relationship between parameters of optic disc and visual field defect in early primary glaucoma

作　　者：杨新光[1] 刘钊[2] 于敬妮[1] 刘建荣[1] 李沛[1] 肖燕[2] 

机构地区：[1]西安市第四医院陕西省眼科医疗中心,710004 [2]西安交通大学医学院

出　　处：《临床眼科杂志》2009年第4期295-299,共5页Journal of Clinical Ophthalmology

基　　金：陕西省卫生厅科学研究基金(08H17)

摘　　要：目的探讨应用海德堡视网膜断层扫描仪(HRT-Ⅱ)检测原发性青光眼患者视盘参数改变及其与Humphrey 750检测视野改变间的关系。方法49例原发性青光眼患者和30例对照个体分别行Humphrey 750视野与HRT-Ⅱ检查,每例患者的双眼间视盘损害与视野缺损间的对应关系彼此独立,双眼均被纳入研究。比较对照个体、慢性闭角型青光眼(CACG)、开角型青光眼(POAG)和正常眼压性青光眼(NTG)患者视乳头参数的差异,分析视乳头各项参数分别与各自视野指数(MD)间的相关性。将对照个体与原发性青光眼患者的视盘参数进行逐步判别分析,建立判别函数,筛选出诊断青光眼的敏感参数。结果HRT-Ⅱ和Humphrey 750检测对照组、CACG组、POAG组和NTG组四组间视野平均缺损(MD)、视杯面积(CA)、视盘面积(DA)、盘沿面积(RA)、视杯容积(CV)、盘沿容积(RV)、杯盘面积比(CDAR)、线性杯盘比(LCDR)、平均视杯深度(MCD)、最大视杯深度(max CD)、视杯形态(CSM)、视杯高度变异轮廓(HVC)、平均视网膜神经纤维层厚度(MRNFLT)、视神经纤维层横截面积(RCSA)等差异具有显著统计学意义(P<0.01)。对照组中LCDR和MD呈直线线性相关,POAG组中DA、CA和MD呈直线线性相关,NTG组中CA、RA、CV、CDAR、HVC和MD呈直线线性相关。经逐步回归筛选的变量中,CV和HVC是其中2个有意义的参数,得出回归方程MD=4.475×CV+5.338×HVC-0.480。诊断敏感的视盘参数为RA、RV、MRNFLT、CSM、HVC,判别函数式为D=2.767+0.312×RA+3.731×RV+4.294×MRNFLT-3.668×CSM-4.024×HVC。结论临床上应用HRT-Ⅱ检测视盘参数与Humphrey 750检测视野结果结合对照分析有助于原发性青光眼的早期诊断。Objective To detect relationship between topographic parameters of the optic disc from Heidelberg Retinal Tomograph （HRT-Ⅱ） and Humphrey 750 perimeter in early primary glaucoma. Methods 79 subjects were examined with HRT-Ⅱ and Humphrey 750 perimeter. These included 49 primary, glaucoma patients and 30 normal individuals. Both eyes were included in the study, optic nerve head damage per eye was corresponding to respective visual field defect independently. To compare difference of topographic parameters of optic disc among normal, chronic angle-closure glaucoma （CACG）, primary open-angle glaucoma （POAG） and normal tension glaucoma （NTG） subjects, and analysis correlation between topographic parameters of the optic disc and mean defect of visual field respectively. The topographic parameters of the optic nerve head were undergone stepwised discriminant analysis and the discriminant function was established. The sensitive diagnostic parameters of glaucoma were screened. Results The topographic parameters of optic disc, including cup area （ CA ）, disk area （ DA ）, rim area （ RA）, cup volume （ CV ）, rim volume （ RV ）, cup/disk area ratio （CDAR）, linear cup/disk ratio （LCDR）, mean cup depth （MCD）, maximum cup depth （max CD）, cup shape measure （ CSM ）, height variation contour （ HVC ）, mean RNFL thickness （ MRNFLT）, RNFL cross sectional area （ RCSA ） and mean defect （MD） values, showed significant （ P 〈0.01 ） difference between the above 4 groups. There was a linear relationships between LCDR and MD in normal eyes, DA, CA and MD in POAG group, CA, RA, CV, CDAR, HVC and MD in NTG group. The sensitive diagnostic parameters were CV and HVC. The regression equation was MD = 4. 475× CV ＋ 5. 338 × HVC - 0.480. The discriminant function was D = 2.767 ＋ 0.312 × RA ＋ 3.731 × RV ＋ 4.294 × MRNFLT - 3. 668 × CSM - 4.024 × HVC. Conclusion The examination of the topographic parameters of optic discs, together with Humphrey 750 Results is

关 键 词：青光眼 视野 视盘 

分 类 号：R775[医药卫生—眼科]