频域OCT检测RNFL厚度在原发性青光眼早期诊断中的意义  

Significance of RNFL thickness measured by SD-OCT in the early diagnosis of primary glaucoma

作　　者：刘宇[1] 唐瑜[1] 周萍[1] 李静敏[1] 

机构地区：[1]大连医科大学附属第二医院眼科,大连116027

出　　处：《中国实用眼科杂志》2012年第9期1083-1088,共6页Chinese Journal of Practical Ophthalmology

摘　　要：目的应用频域光学相干断层成像技术（opticalcoherencetomography，OCT）检测CACG和POAG患者的视网膜神经纤维层（retinalnervefiberlayer，RNFL）厚度，探讨其与视野平均缺损（meandefect，MD）的相关性，并揭示早期原发性青光眼RNFL厚度的特征性改变，从而客观评价频域OCT在原发性青光眼早期诊断中的临床应用价值。方法分别采用zeissCirrusHD—OCT4000型和ZeissHumphrey750型全自动视野计对正常组20例（40只眼）和分成早期、中期、晚期的原发性青光眼组30例（52只服）进行检测，将各个青光眼组中心30。视野内的MD和OCT检测的RNFL厚度进行比较，并做相关性分析。绩果青光眼组RNFL厚度及视野MD程度与正常对照组差异均有统计学意义，其中正常人RNFL厚度为（112．91±9．36）μm，早期青光眼组为（94．43±7．67）μm，中期青光眼组为（80．82±10．36）μm，晚期青光眼组为（67．86±8．01）μm；正常人视野MD为（-0．88±1．53）dB，早期青光眼组为（-4．26±1．83）dB，中期青光眼组为（-7．43±2．64）dB，晚期青光眼组为（-17．06±5．85）dB。青光眼组RNFL与视野MD具有负相关，其中早期青光眼组相关系数为-0．537；中期青光眼组为-0．615；晚期青光眼组为-0．804。早期青光眼组各象限RNFL厚度为：上方（116．32±11．65）μm；下方（105．58±9．73）μm；鼻侧（75．40±10．91）μm；颞侧（70．28±13．08）μm。B组各象限RNFL厚度分别为：上方（140．15±8．79）μm；下方（137．29±10．07）μm；鼻侧（90．20±14．19）μm；颞侧（88．43±10．85）μm。经独立样本t检验A1组与B组上方及下方RNFL厚度差异有统计学意义（P〈0．05），而鼻侧及颞侧差异无统计学意义（P〉0．05）。结论（1）频域OCT检测各期原发性青光眼患者的RNFL平均厚度随病程进展逐渐变薄。（2）频域OCT检测原发性青光眼患者的RNFL平均厚度与视�Objective To measure RNFL thickness by Frequency-domain optical coherence tomog- raphy （OCT） in patients with different stages of primary glaucoma （CACG and POAG）, to evaluate the correlation between RNFL thickness and visual field mean defect （MD）, to detect RNFL thick- ness change of early stage primary glaucoma, and to discuss the clinical significance in the early diagnosis of primary glaucoma objectively. Methods Ninety-two subjects of 40 normal and 52 with different stages of primary glaucoma were enrolled in this study. RNFL thickness was measured by Zeiss Cirru HD-OCT, and visual field was tested by Zeiss Humphrey-750. The association between visual field MD and RNFL thickness was evaluated with Pearson correlation coefficients. Results In the normal group, mean RNFL thickness was 112.91±9.36μm; the early period glaucoma group 94.43±7.67μm; the middle period glaucoma group 80.82±10.36μm; the later period glaucoma group 67.86±8.01 μm. Visual field MD in each group was -0.88 - 1.53dB, -4.26 ± 1.83dB, -7.43± 2.64dB and -17.06±5.85dB. The differences in mean RNFL thickness and visual field MD between normal and each stage glaucoma group were significant （P 〈0.05） by independent sample t-test. In each stages of glaucoma group,mean RNFL thickness and visual field MD （early period： r =-0.537,middle period： r =-0.615,later period： r=-0.804） correlated significantly （P 〈0.05）. In the early period glauco- ma group,super/or RNFL thickness was 116.32±11.65μm,inferior RNFL thickness 105.58±9.73Bm,nasal RNFL thickness 75.40±10.911am,and temporal RNFL thickness 70.28±13.08μm. In group B,superior RNFL thickness was 140.15±8.79μm,inferior RNFL thickness 137.29±10.07Bm,nasal RNFL thick- ness 90.20±14.19μm,and temporal RNFL thickness 88.43±10.851am. The difference of superior and inferior RNFL thickness between group A1 and group B had statistical significance tested by independent sample t-test, P 〈0.05; nasal and temporal RNFL thickness between group A1 and group

关 键 词：光学相干断层成像 视神经纤维层 平均缺损 早期诊断原发性青光眼 

分 类 号：R775.2[医药卫生—眼科]