GDx和眼底立体照相检测青光眼视网膜神经纤维层缺损的对比研究  

Comparative study between GDx and fundus stereophotograph of glaucoma patients on damage of retinal nerve fiber layer

作　　者：陈建华[1] 石琦[2] 徐亮[3] 杨桦[3] 马英楠[3] 

机构地区：[1]北京老年医院,北京100095 [2]四川大学华西医学院基法学院 [3]首都医科大学附属北京同仁医院,北京市眼科研究所

出　　处：《中国中医眼科杂志》2012年第2期99-103,共5页China Journal of Chinese Ophthalmology

摘　　要：目的评价用眼底立体照相和GDx对青光眼患者视网膜神经纤维层（retinal nerve fibre layer,RNFL）缺损检测的一致性。方法采用眼底立体照相技术和GDx检测青光眼患者97例（191只眼）,年龄19~76岁,平均年龄（53.39±14.67）岁;其中男44例（88只眼）,女53例（103只眼）;视野平均缺损在-2.0~23dB。所有患者视野检查的可靠参数≤15%。按视野的平均缺损（mean defect,MD）将患者分为早期青光眼改变者124只眼[MD：（1.37±5.44）dB];中晚期青光眼67只眼[MD：（11.16±5.67dB）]。然后将GDx的各象限的概率图按各概率的频数加权平均计算对其概率进行分级,与眼底立体照相的各象限RNFL分级进行一致性分析。采用方差分析、Spearman’s相关分析进行统计处理,以P〈0.05认为差异具有统计学意义。结果 GDx的上方平均值（SA）和下方平均值（IA）概率图分级与眼底立体像上方和下方RNFL分级的Spearman’s相关系数分别为0.79和0.78,两种方法四个象限的总RNFL分级相关系数为0.77,Κappa值=0.80。结论 GDx的RNFL分级与眼底立体照相RNFL分级相关性和一致性均很高,GDx可为临床青光眼的诊断提供可靠和定量的RNFL数据。OBJECTIVE To evaluate the glaucoma damage on grading of retinal nerve fiber layer images by GDx and photograph.METHODS Ninety-seven glaucoma patients（171 eyes） aged 19 to 76（mean： 53.39±14.67） were measured by GDx and fundus stereophotography.There were 44 males and 53 females.Divided into two groups of early glaucoma（MD of visual field 6dB,mean MD： 1.37±15.44dB,124 eyes） and moderation or advanced glaucoma（MD6dB,mean MD： 11.16±5.67dB,63 eyes） according to the mean defect（MD） of visual field（range-2.0 to 23dB）,analyses with t-test,ANOVA（analysis of variance）,Spearman＇s correlation compare the grading of RNFL parameters agreement between GDx images and fundus stereophotograph by using Κappa value and Spearman correlation.RESULTS There was correlation between the RNFL grading of GDx and fundus stereophotograph,both globally and regionally.The SA and IA RNFL grading with GDx decreased with decreasing superior and inferior RNFL grading of RNFL with photograph,r=0.79 and r=0.78,respectively.There were significant correlations among these parameters.Spearman＇s correlation coefficient r=0.77,Κappa value=0.80.CONCLUSIONS The superior and inferior RNFL grading between GDx images and fundus stereophotograph had the strongest correlation.GDx may provide clinically relevant and quantitative information in monitoring glaucomatous changes.

关 键 词：青光眼 GDX 眼底立体照像 RNFL 

分 类 号：R775.1[医药卫生—眼科]