海德堡相干光断层成像在高眼压症及可疑、视野前、早期原发性开角型青光眼检查中的比较  

Comparison of heidelberg optical coherence tomography for the discrimination of normal,ocular hypertension,primary open-angle glaucoma suspect,pre-perimetric and early perimetric primary open-angle glaucoma eyes

作　　者：李晓宇[1] 王铮[1] 胡蕾[1] 戴虹[1] 

机构地区：[1]北京医院眼科,北京100730

出　　处：《中国医刊》2015年第5期66-70,共5页Chinese Journal of Medicine

基　　金：卫生部北京医院青年课题(bj-2012-84)

摘　　要：目的比较海德堡相干光断层成像(heidelberg optical coherence tomography,HRA-OCT)在检查正常眼、高眼压症、可疑原发性开角型青光眼(primary open-angle glaucoma,POAG)、视野前POAG及早期POAG中的能力。方法对57例正常人、37例高眼压症、53例可疑POAG、33例视野前POAG及55例早期POAG患者行HRA-OCT检查,比较上述人群HRA-OCT各参数,并对视野前POAG及早期POAG与正常人的各参数绘制受试者操作特征曲线(receiver operating characteristic curve,ROC),通过计算ROC曲线下面积(area under the receiver operating characteristic curves,AUC),寻找HRA-OCT对视野前POAG及早期POAG的最佳诊断指标。结果高眼压症及可疑POAG者与正常人HRA-OCT各参数比较差异无显著性(P>0.05)。早期及视野前POAG HRA-OCT各参数与高眼压症、可疑青光眼者及正常人差异有显著性(P<0.05)。早期及视野前POAG患者HRA-OCT各参数比较差异无显著性(P>0.05)。HRA-OCT各参数除鼻侧视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度(P>0.05)外,其他参数对视野前青光眼均有诊断意义(P<0.05),66.7%(6/9)的参数AUC>0.800。HRA-OCT各参数对早期POAG均有诊断意义(P<0.05),77.8%(7/9)的参数AUC>0.800。结论高眼压症及可疑POAG者RNFL厚度与正常人无明显差异;视野前POAG患者的RNFL损害与早期POAG患者相当;HRA-OCT可较好地反映视野前POAG及早期POAG患者RNFL损害,在视野前POAG及早期POAG的诊断中准确度较高。Objective To compare the abilities of Heidelberg Optical Coherence Tomography （ HRA-OCT） to discrimi-nate healthy eyes, ocular hypertension （ OH） eyes, primary open-angle glaucoma （ POAG） suspect eyes and eyes with pre-perimetric and early perimetric POAG . Method 57 healthy subjects, 37 OH, 72 POAG suspects, 37 patients with pre-perimetric POAG and 55 patients with early perimetric POAG were included. All individuals underwent imaging with HRA-OCT. ANOVA and Kruskal-Wallis test were used to compare all of the parameters from HRA-OCT among pre-perimetric and early perimetric POAG, POAG suspects, OH and normal eyes. Receiver operating characteristic curves （ ROC） were calculated for all of the parameters to seek the best discriminant of HRA-OCT between pre-peri-metric POAG and normal eyes and also between early perimetric POAG and healthy eyes. Result No Statistically sig-nificant difference was found between OH, POAG suspects and normal controls in all of the parameters of HRA-OCT （P〉0. 05）;Statistically significant difference was found between pre-perimetric POAG and OH, POAG suspects and normal controls in all of the parameters, as well as early perimetric POAG （P〈0. 05）. No Statistically significant difference was found between pre-perimetric and early perimetric POAG in all of the parameters of HRA-OCT （ P〉0. 05）;Most of the HRA-OCT parameters were capable of pre-perimetic POAG diagnosis except for the nasal RNFL thickness （p=0. 095）. 66. 7% of the AUC from HRA-OCT parameters were larger than 0. 800. All of the HRA-OCT parameters were capable of early perimetic POAG diagnosis （P〈0. 05）. 77. 8% of the AUC from HRA-OCT parame-ters were larger than 0. 800. Conclusion The RNFL thickness of OH and POAG suspects was as same as normal eyes;The RNFL thickness of pre-perimetic POAG got as thin as early perimetic POAG;HRA-OCT has the ability to identify the changes of RNFL thickness in pre-perimetic and early perimetric POAG; HRA-OCT discriminate well between normal eyes and

关 键 词：海德堡相干光断层成像 高眼压症 原发性开角型青光眼 

分 类 号：R775.1[医药卫生—眼科]