慢性青光眼和非青光眼视神经萎缩环视盘视网膜神经纤维层厚度和视盘参数比较  

Comparability of circumpapillary retinal nerve fiber layer thickness and optic nerve head parameters of chronic glaucoma and no-glaucoma optic atrophy

作　　者：赵桂玲[1] 庞燕华[1] 周舟[1] 叶丽[1] 吕秋荣[1] 

机构地区：[1]广东医学院附属医院眼科,广东湛江524001

出　　处：《中国实用眼科杂志》2015年第7期743-747,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的 对比慢性青光眼和非青光眼视神经萎缩的环视盘视网膜神经纤维层（pRNFL）厚度和视盘参数的差异.方法 临床病例对照研究.对2012年1月至2014年9月在广东医学院附属医院眼科的青光眼以外的各种原因导致的视神经萎缩和慢性青光眼患者进行视盘OCT 3D模式扫描,以健康青年人为对照组,对比研究慢性青光眼与非青光眼视神经萎缩及健康青年人的pRNFL厚度和视盘参数的差异.结果 慢性青光眼15例21只眼,非青光眼视神经萎缩19例24只眼,对照组49例,90只眼.pRNFL平均厚度在对照组为（105.83±9.80） μm,青光眼视神经萎缩为（58.76±8.93） μm,非青光眼视神经萎缩为（62.71±12.60） μm,与对照组相比差异有统计学意义（P＜0.01）.慢性青光眼与非青光眼视神经萎缩对比,全周平均及各象限的pRNFL厚度差异无统计学意义（P＞0.05）.慢性青光眼与对照组相比视盘面积增大,盘沿面积变小,差异有统计学意义（P＜0.01）;视杯面积增大;杯盘面积比、水平径比和垂直径比均比对照组明显增大,差异有统计学意义（P＜0.01）.非青光眼视神经萎缩与对照组相比视杯面积增大,盘沿面积变小,差异有统计学意义（P＜0.01）.慢性青光眼与非青光眼视神经萎缩相比,视杯面积更大,盘沿面积更小,杯盘面积比、水平径比和垂直径比均比后者明显增大,差异均有统计学意义（P＜0.01）.结论 慢性青光眼和非青光眼视神经萎缩pRNFL厚度与对照组相比均明显变薄,但二者之间对比无差异.与对照组相比,二者盘沿面积均变小,视杯面积均变大,杯盘比均变大.慢性青光眼与非青光眼视神经萎缩相比,视杯面积更大,盘沿面积更小.OCT检测的pRNFL厚度和视盘参数对二者的鉴别诊断无明显帮助。Objective To compare peripapillary retinal nerve fiber layer （pRNFL） thickness and optic nerve head （ONH） parameters of glaucoma and non-glaucoma optic atrophy measured by optical coherence tomography （OCT）.Methods Twenty-four eyes of 19 non-glaucoma optic atrophy aged between 17 and 68,and 21 eyes of 15 chronic glaucoma aged between 17 and 74,and 90 eyes of 49 healthy young people between 19 and 26 underwent OCT scan （3D disk mode）.Results Compared with healthy young people,the mean and every quadrant pRNFL thicknesses of non-glaucoma optic atrophy and chronic glaucoma were significantly thinner （P 〈0.01）.The Cup Area,C/D Area Ratio,Linear CDR,Vertical CDR of non-glaucoma optic atrophy and chronic glaucoma were all significantly increase （P 〈0.01） and Rim Area was significantly thinner （P 〈0.01）.Compared with non-glaucoma optic atrophy,the mean and every quadrant pRNFL thicknesses （inferior except,P =0.03） of glaucoma were not significantly different （P 〉0.05）;The cup Area,C/D Area Ratio,Linear CDR,Vertical CDR of glaucoma were all significantly bigger,And Rim Area was significantly thinner （P 〈0.01）.Conclusions Compared with healthy young people,the mean and every quadrant pRNFL thicknesses of non-glaucoma optic atrophy and chronic glaucoma are significantly thinner,but there is no significantly different between chronic glaucoma and non-glaucoma optic atrophy;rim Area of non-glaucoma optic atrophy and chronic glaucoma measured by OCT are significantly thinner,and rim Area of chronic glaucoma is much more thinner than non-glaucoma optic atrophy,pRNFL and ONH parameters measured by OCT can not provide obvious help for distinguish glaucoma and non-glaucoma optic atrophy.

关 键 词：慢性青光眼 非青光眼视神经萎缩 pRNFL厚度 视盘参数 光学相干断层成像 

分 类 号：R779.63[医药卫生—眼科]