频域OCT检测青光眼视乳头及黄斑区容积改变的初步研究  

Study of macular neurosensory retinal volume and peripapillary retinal nerve fiber layer volume for diagnosing glaucoma using frequency-domain optical coherence tomography

作　　者：钱勇[1] 刘菊[1] 段文静[1] 祃红燕[1] 赵淼焱[1] 张丽筠[1] 卢颖[1] 

机构地区：[1]首都医科大学教学医院北京电力医院,北京100073

出　　处：《临床眼科杂志》2011年第3期200-203,共4页Journal of Clinical Ophthalmology

基　　金：华北电网有限公司局级课题(项目编号8AE000310003);丰台区卫生科研项目(2010年)资助

摘　　要：目的通过比较青光眼和正常人视乳头旁神经纤维层容积及黄斑区神经上皮层容积的差异,分析青光眼患者视乳头和黄斑立体结构特征,探讨频域光学相干断层成像术(ED-OCT)对青光眼的诊断价值。方法采用FD-OCT对33例青光眼患者和33例正常人行视乳头及黄斑区视网膜三维立体扫描,比较青光眼患者和正常人视乳头旁和黄斑区立体结构参数差异;采用直线回归分析各参数与视野平均缺损值的相关性;计算各参数诊断青光眼的受试者工作特征曲线下面积及灵敏度、特异度。结果青光眼组和正常对照组黄斑区容积比较除黄斑中心凹直径1 mm范围内的容积差异无统计学意义外,其余8个区域差异均有统计学意义;视乳头旁神经纤维层容积(mm3)比较颞(青光眼组0.29±0.02,对照组0.32±0.04)、上(青光眼组0.49±0.28,对照组0.55±0.06)、鼻(青光眼组0.34±0.17,对照组0.35±0.05)、下(青光眼组0.47±0.29,对照组0.56±0.06)四个区域差异均有统计学意义。各参数与视野平均缺损的相关性均有统计学意义,相关系数最高的是黄斑区内环下象限的视网膜神经上皮层容积(r=0.58,P<0.01);受试者工作特征曲线分析结果显示黄斑区外环下象限视网膜神经上皮层容积(AROC 0.79;敏感度82%)与视乳头旁下象限神经纤维层容积(AROC 0.81;敏感度81%)具有最大面积及最佳敏感度。结论 FD-OCT检测黄斑区及视乳头旁神经纤维层立体结构特征和容积等参数的改变,有助于临床青光眼的诊断。Objective To evaluate the diagnostic ability of macular neurosensory retinal volume and peripapillary retinal nerve fiber layer（RNFL） volume for glaucoma using frequency-domain optical coherence tomography（FD-OCT）.Methods 33 glaucoma patients and 33 normal participants underwent macular and peripapillary RNFL scans by FD-OCT.Find the difference of the macular and peripapillary RNFL between glaucoma and normal participants.Calculate areas under receiver operating characteristics curve（AROC） and sensitivity and specificity.Correlation of visual field defects with OCT data was evaluated by linear regression analysis.Results There are significant differences between glaucoma and normal participants for all parameters except fovea in macular scan,and in peripapillary RNFL： temporal quadrant（glaucoma 0.29±0.02,normal 0.32±0.04）、superior quadrant（glaucoma 0.49±0.28,normal 0.55±0.06）、nasal quadrant（glaucoma 0.34±0.17,normal 0.35±0.05）、inferior quadrant（glaucoma 0.47±0.29,normal 0.56±0.06）.The highest correlation with mean deviation are found in inferior inner macular volume（r=0.58,P0.01）.The biggest area under AROC and best sensitivity and specificity are inferior outer macular volume（AROC：0.79;sensitivity：82%） and inferior quadrant in RNFL volume（AROC：0.81;sensitivity：81%）.Conclusion Macular and RNFL parameters had good discriminating value for the diagnosis of glaucoma by FD-OCT.

关 键 词：光学相干断层成像 青光眼 视网膜神经纤维层 黄斑 容积 

分 类 号：R775[医药卫生—眼科]