白内障对OCT视网膜神经纤维层厚度测量影响的初步分析  

Influence induced by cataract to retinal nerve fiber layer thickness measurement by optical coherence tomography

作　　者：张琪[1] 廖琼[1] 白莲[1] 

机构地区：[1]第三军医大学新桥医院眼科,重庆400037

出　　处：《临床眼科杂志》2014年第2期97-102,共6页Journal of Clinical Ophthalmology

摘　　要：目的探讨白内障混浊程度对相干光断层扫描(OCT)进行视网膜神经纤维层(RNFL)厚度测量的影响。方法根据Emery晶状体核硬度分级标准,将核型年龄相关性白内障患者分为Ⅱ级核、Ⅲ级核、Ⅳ级核组,每组入选20只眼,分析白内障术前术后RNFL厚度测量值的差异与晶状体密度值的相关性。结果晶状体密度值每两组之间差异具有统计学意义(P<0.05)。随着晶状体核混浊程度加重,晶状体密度值逐渐增加。各组间术后RNFL厚度测量值在上象限、下象限及全周平均值分别对比均无统计学意义(P>0.05)。Ⅱ级核组无论上象限、下象限还是全周平均RNFL厚度测量值,手术前后分别对比均无明显差异(P>0.05)。Ⅲ级核组上象限、下象限、全周平均RNFL厚度测量值术前术后分别对比具有差异性(P<0.05),其晶状体密度值与差异值均具有线性正相关(上象限r=0.654,P<0.05,下象限r=0.636,P<0.05,全周平均值r=0.661,P<0.05)。Ⅳ级核组手术前后上象限、全周平均RNFL厚度测量值具有显著性差异(P<0.01),下象限RNFL厚度测量值同样具有差异性(P<0.05)。晶状体密度值与RNFL术前术后差异值在下象限、全周平均值具有显著线性正相关(下象限r=0.811,P<0.01,全周平均值r=0.777,P<0.01),在上象限具有相关性(r=0.713,P<0.05)。结论当晶状体核混浊达到Ⅲ级以上程度时,OCT测量RNFL厚度结果可能出现误差,不能准确反映RNFL真实厚度。Objective To investigate the influence induced by cataract to retinal nerve fiber layer （ RNFL） thick-ness measurement by optical coherence tomography .Methods Totally 45 cases （60 eyes） of age-related cataract with nu-clear opacity were divided into 3 groups （ grade II^IV, according to Emery grading system ） .The correlation between the lens density and the difference between RNFL thickness measurement pre and post -phaco was analyzed .Results The lens density values increased with nuclear opacity （ P 〈0.05）.No difference was found in between pre-and post-phaco RNFL thickness, either in superior quadrant, inferior quadrant, or overall mean （ P 〉0.05） in grade II group.But there was difference between pre-and post-phaco RNFL thickness , either in superior quadrant , inferior quadrant , or overall mean （ P〈0.05） in grade III group.And the lens density values were positive correlated with the differences （superior quadrantr, r =0.654, P 〈0.05;inferior quadrant, r =0.636, P 〈0.05;overall mean, r =0.661, P 〈0.05）.Furthermore, Sig-nificant differences were found between pre-and post-phaco RNFL thickness in grade IV group either in superior quadrant or overall mean （ P 〈0.01） and in inferior quadrant （ P 〈0.05）.The lens density values were correlated with these differ-ences in superior quadrant （ r =0.713, P 〈0.05）, inferior quadrant （ r =0.811, P 〈0.01）, and overall mean （ r =0.777, P 〈0.01）.Conclusion Error may appear in RNFL thickness measurements by OCT when nuclear opacity was a -bove III grade , in which case it could not reflect the real RNFL thickness .

关 键 词：白内障 相干光断层扫描 视网膜神经纤维层 

分 类 号：R776.1[医药卫生—眼科]