3D OCT检测黄斑区视网膜厚度在青光眼诊断中的价值  

Macular retinal thickness measured by three dimensional optical coherence tomography for glaucoma diagnosis

作　　者：庞燕华[1] 赵桂玲[1] 柯毅[1] 谭志[1] 朱敏怡[1] 李瑞庄[1] 

机构地区：[1]广东医学院附属医院眼科,广东省湛江市524023

出　　处：《眼科新进展》2014年第5期468-470,共3页Recent Advances in Ophthalmology

摘　　要：目的应用3D光学相干断层扫描(optical coherence tomography,OCT)检测青光眼患者黄斑区视网膜厚度,并与正常人眼黄斑区视网膜厚度进行比较,以探讨其在青光眼诊断中的价值。方法选取2012年9月至2013年6月于我院就诊的青光眼患者40例(46眼)为青光眼组,另选取于我院同期健康体检的正常人50例(50眼)作为对照组,应用Topcon 3D OCT进行黄斑区视网膜厚度检测,观察正常人和青光眼患者黄斑地形图的图像特征,并分析青光眼黄斑区视网膜平均厚度与视野平均缺损值的相关性。结果对照组及青光眼组黄斑视网膜厚度地形图均表现为黄斑中心凹最薄,对照组黄斑区内环视网膜较外环厚,青光眼组内环及外环视网膜局限性或弥漫变薄。青光眼组与对照组黄斑中心凹1 mm内及黄斑中心凹视网膜厚度比较,差异均无统计学意义(t=1.39、1.64,P=0.17、0.10);青光眼组内环、外环各象限视网膜厚度、黄斑区视网膜体积及视网膜厚度均较对照组变薄或变小,差异均有统计学意义(均为P<0.05)。青光眼患者黄斑区视网膜厚度与视野缺损值呈负相关(r=-0.612,P=0.01)。结论黄斑区视网膜OCT检测将有可能是青光眼诊断、追踪的重要手段之一。Objective To measure macular retinal thickness parameters in glau- coma patients and compare them with normal subjects using three dimensional optical coherence tomography （3D OCT）, and discuss its value in glaucoma diagnosis. Meth- ods A total of 40 patients （46 eyes） with glaucoma in our hospital from September 2012 to June 2013 were chosen as glaucoma group,and 50 healthy subjects （50 eyes） in control group. OCT imaging of macular area were examined using 3D OCT. The changes of macular thickness parameters in two groups were observed,the differences of image feature of macular topographic map were compared, and the correlation between macu- lar retinal thickness and mean defect of visual field was analyzed. Results Macular retinal thickness in healthy subjects and patients with glaucoma topographic maps were the fovea at the thinnest. While inner-ring retinal thickness was much thicker than out- er-ring retina in healthy subjects, inner-ring and outer-ring retinal thickness in patients with glaucoma were localized or diffuse thinning. The inner-ring retinal thickness, outer- ring retinal thickness ,macular volume and average macular thickness in glaucoma group were thinner or smaller than those in control group, there were statistical differences（ all P 〈0.05） ,but there were no statistical difference in central macular thickness with l mm and central fovea of macula thickness between two groups （t = 1. 39,1. 54,P=0.17,0. 10）. The macular retinal thickness in glaucoma group was nega- tive correlated with mean defect of visual field （ r = - 0.512,P = 0.01 ）. Conelusion Macular images detected by 3 D OCT can be a useful method to determine glaucoma status and has a potential for tracking glaucoma progression.

关 键 词：光学相干断层扫描 黄斑 视网膜厚度 青光眼 

分 类 号：R779.66[医药卫生—眼科]