蓝黄视野与自动视野检查法联合光学相干断层成像在原发性开角型青光眼诊断中的应用  

The application of Blue-on-Yellow Perimetry , Standard Automated Perimetry and Optical Coherence Tonometry in the diagnosis of Primary Open angle Glaucoma

作　　者：李劲嵘[1] 余敏斌[1] 钟华[1] 邱璇[1] 朱朱[1] 刘杏[1] 林羡钗[1] 

机构地区：[1]眼科学国家重点实验室,中山大学中山眼科中心,广州510060

出　　处：《中国实用眼科杂志》2009年第11期1229-1232,共4页Chinese Journal of Practical Ophthalmology

基　　金：基金项目：广东省科技计划项目（2002C30301）,（2005830901019）

摘　　要：目的探讨蓝黄视野检查法（BlueonYellowPerimetry，BYP）、自动视野检查法（stmdardAutomaticPerimetry，SAP）和光学相干断层成像（OpticalCoherenceTonometry，OCT）在原发性开角型青光眼诊断中的应用。方法POAG患者42例66只眼，24例双眼、18例单眼，男性30例48只眼，女性12例18只眼，左32只眼、右36只眼，年龄为19—69岁，平均（38．06±14．86）岁。应用HuMPHERY750Ⅱ-i电脑自动视野计的Sita—Standard检测程序进行SAP检查和蓝黄视野检测程序来进行BYP检查，应用STRATUSOCTTM型OCT检查视网膜神经纤维层（RNFL）平均厚度。结果SAP、BYP和OCT三种检测方法的阳性率分别为75．00％、93．75％和84．37％，三者总体的差异比较无统计学意义（P=0．118）。POAG早期SAP和BYP的平均缺损（MD）值与OCT检测的RNFL平均厚度均存在相关关系。进展期和晚期，SAP和BYP的MD值与RNFL平均厚度则均存在相关关系和线性回归关系。进展期和晚期，BYP的MD值与RNFL平均厚度的决定系数均高于SAP。早期、进展期和晚期SAP和BYP的PSD与RNFL平均厚度均不存在相关。结论BYP比SAP更能进一步反映POAG视野和视功能的损害程度。BYP、SAP和OCT联合应用可提高POAG早期诊断的敏感性。Objective To evaluate application of Blue-on-Yellow Perimetry （BYP）, Standard Automatic Perimerty （SAP） and Optical Coherence Tomography （OCT） in the diagnosis of primary open angle glaucoma （POAG） patients. Methods A total of 42 patients （ 66 eyes ） diagnosed POAG were enrolled for examination of SAP with sitatandard strategy and BYP with fastpac strategy by Humphrey 750 II -I perimetry, and the average thickness of RNFL by StratusoctTM OCT. There were 12 females （ 18 eyes） and 30 males （48 eyes）, 32 left eyes, 36 Right eyes. Mean （SD） age of the patients was 38.06 （14.86） years （range, 19-69 years）. Results The positive rate of SAP, BYP and OCT was 75.00%, 93.75% and 84.37% respectively, Chi-square test showed that the differences between the three groups were not statistically significant. The MD values, either SAP or BYP, had no correlation with the average thickness of RNFL in the early period of POAG. The correlation and linear regression was found in the moderate and advanced period of POAG between MD values and the average thickness of RNFL, either SAP or BYP. MD values of BYP showed a higher correlation index than SAP both in the moderate and the advanced period. There was no correlation between PSD values of SAP and BYP and the average thickness of RNFL in every period of POAG. Conclusions BYP is more sensitive than SAP in the diagnosis of POAG. SAP, BYP and OCT should be combined in the visual field and visual function examination to promote the diagnosis sensitivity of POAG.

关 键 词：蓝黄 视野 光学 相干 断层 原发性开角型青光眼 

分 类 号：R775.2[医药卫生—眼科] R770.4[医药卫生—临床医学]