原发性开角型青光眼OCT评估视网膜神经纤维层厚度与视盘参数的关系  

Correlation Between Retinal Nerve Fiber Layer and Optic Neuropathy Measured by Optical Coherence Tomography in Primary Open Angle Glaucoma

作　　者：胡杨[1] 杨燕宁[1] 邢怡桥[1] 赵晓辉[1] 项奕[1] 伍志琴[1] 

机构地区：[1]武汉大学人民医院眼科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2009年第5期672-675,I0001,共5页Medical Journal of Wuhan University

摘　　要：目的:使用光学相干断层成像术(OCT)评估原发性开角型青光眼(POAG)各个病程时期的视网膜神经纤维层(RNFL)与视盘参数的差异,从而探讨青光眼RNFL厚度的变化与盘沿面积和杯盘面积比(C/D AR)之间的关系,确定OCT检测参数对青光眼病程变化的参考意义。方法:应用OCT检查技术分别对40例(60只眼)的POAG患者的RNFL及视盘进行检测。数据包括颞侧(TEMP)、上方(SUP)、鼻侧(NAS)、下方(INF)RNFL厚度以及平均RNFL厚度与盘沿面积和C/D AR。按青光眼诊断标准和视野分期法分为早期、中期和晚期3组。比较和分析3组的RNFL变化趋势以及与视盘参数的相关性。结果:青光眼早期、中期和晚期3组之间RNFL和视盘参数的比较具有显著性差异(P<0.01)。RNFL平均厚度与盘沿面积有正相关性,r=0.719,P<0.01;与C/D AR有负相关性,r=-0.712,P<0.01。结论:POAG各个时期中RNFL厚度逐渐变薄,同时盘沿面积减少和C/D AR扩大。盘沿面积占影响RNFL厚度的因素比重较大,比C/D AR更能反映RNFL的变化。青光眼的病程发展能通过RNFL的减少变化来反映。OCT的客观检查所得的各项参数也对原发性青光眼的病情发展的评估具有一定的意义。Objective： To comparatively evaluate the retinal nerve fiber layer（RNFL） thickness and optic nerve head（ONH） by optical coherence tomography（OCT） in early,advanced and late stages of primary open angle glaucoma（POAG）,and to study the correlation between the RNFL thickness and glaucomatous optic neuropathy.Methods： Forty cases（60 eyes） with POAG were examined by OCT with circular scans around ONH（diameter=3.46 mm） to observe the RNFL,with radiate scans around ONH to evaluate the rim area,and cup/disc area ratio（C/D AR）.RNFL thickness,rim area,and C/D AR were compared among the early,advanced and late POAG groups.Correlation and regression analysis was used to show the correlation between RNFL thickness and glaucomatous optic neuropathy（rim area and C/D AR） in all cases.Results： There were significant difference in RNFL average thickness among the three groups.There was a significant positive correlation between RNFL average thickness and rim area（r=0.719,P〈0.01）,and a negative correl...更多ation between RNFL average thickness and C/D AR（r=-0.712,P〈0.01）.Conclusion： OCT can quantitatively measure the RNFL thickness and show the difference of RNFL thickness among the early,advanced and late stages of POAG.The RNFL thickness gradually decreases while C/D AR increases,but rim area reduced during the deteriorating process of POAG,and rim area has more impact on the RNFL thickness than C/D AR does.

关 键 词：视网膜神经纤维层 光学相干断层成像术 盘沿面积 杯盘比 青光眼 

分 类 号：R775.2[医药卫生—眼科]