光学相干断层扫描仪测量视网膜视盘周边区神经纤维层与黄斑厚度对青光眼的诊断价值  

Measurement of optic disc nerve fiber layer surrounding area and macular thickness of retinal for diagnosis value of glaucoma by OCT

作　　者：杨昌全[1] 周明敏[1] 夏朝华[1] 

机构地区：[1]中南大学湘雅医院眼科,湖南长沙410008

出　　处：《中国现代医学杂志》2011年第11期1404-1406,1409,共4页China Journal of Modern Medicine

摘　　要：目的比较视盘周边区神经纤维层(RNFL)厚度与黄斑区视网膜厚度(MRT)的光学相干断层扫描仪(OCT)不同测量部位对青光眼的诊断价值。方法 48例(71眼)青光眼患者纳入该研究,并取40例(63眼)健康体检者为正常对照组,均行OCT检查。采用ROC曲线和曲线下面积(AUC)比较RNFL厚度与黄斑厚度对青光眼的诊断价值。结果青光眼患者视盘周边区平均RNFL(t=12.950,P=0.000)与黄斑(t=8.917,P=0.000)的厚度均比正常人减少;并且RNFL与黄斑的厚度与青光眼的严重程度呈负相关,rs为0.361(t=4.516,P=0.024)。AUC比较显示RNFL周边厚度的诊断价值均要高于黄斑厚度;在RNFL周边厚度中,又以RNFL周边6点钟的厚度指标AUC最大(95%CI 0.664～-0.865)。相应诊断界值下,RNFL周边6点钟和黄斑厚度的诊断特异度、灵敏度和诊断符合率分别为85.6%、91.2%、87.1%和80.2%、88.4%、84.6%。结论视盘周边区RNFL厚度与黄斑厚度对青光眼均有较好的早期诊断价值,而又以视盘周边区下部RNFL厚度的诊断效果为最佳。【Objective】To compare optic disc nerve fiber layer surrounding area（RNFL） thickness and macular retinal thickness（MRT） by OCT for diagnosis of glaucoma.【Methods】48 patients（71 eyes） with glaucoma were included in the study,and 40 healthy（63 eyes） were also included as healthy control group.All candidates examined NFL by OCT.We used ROC curves and area under the curve（AUC） to compare the diagnosis value.【Results】The average RNFL（t =12.950,P =0.000） and macular thickness（t =8.917,P =0.000） in patients with glaucoma were thinner than that of the control group;and RNFL thickness in glaucoma nega-tive correlated with the severity of glaucoma rs was 0.361（t =4.516,P =0.024）,so as to macular thickness,rs was 0.337（t =4.249,P =0.035）.RNFL thickness has higher diagnosis effect than macular thickness by AUC comparison,and the best diagnosis effect is 6 o＇clock of RNFL thickness（95% CI 0.664~0.865）.Under the appropriate diagnostic cutoff value,the diagnostic specificity,sensitivity,diagnostic accuracy for 6 o＇clock RN-FL and macular was 85.6%,91.2%,87.1% and 80.2%,88.4%,84.6%,respectively.【Conclusion】The RNFL thickness of the optic disc and macular thickness also have a good diagnosis effect for glaucoma,but the thickness of lower area of RNFL has the best diagnosis value.

关 键 词：青光眼 光学相干断层扫描 诊断 视盘周边区 黄斑区 

分 类 号：R775[医药卫生—眼科]