三维光学相干断层扫描测量视网膜神经节细胞复合体厚度对原发性开角型青光眼诊断的意义  

Diagnostic performance of macular ganglion cell complex by three-dimension optical coherence tomography in primary open angle glaucoma

作　　者：李莉[1] 李敏[1] 

机构地区：[1]广西壮族自治区人民医院眼科,广西壮族自治区南宁市530021

出　　处：《眼科新进展》2016年第3期271-274,共4页Recent Advances in Ophthalmology

摘　　要：目的应用三维光学相干断层扫描(optical coherence tomography,OCT)测量原发性开角型青光眼(primary open angle glaucoma,POAG)患者的黄斑区各部位神经节细胞复合体(macular ganglion cell complex,m GCC)厚度,评价其在POAG诊断中的意义。方法选取早期POAG患者30例(30眼),中晚期POAG患者30例(30眼),以正常人30例(30眼)作为对照,应用Topcon 3D OCT-2000测量并记录所有受试者的视盘周围各部位视网膜神经纤维层(peripapillary retinal never fiber layer,pRNFL)和m GCC[包括黄斑区视网膜神经纤维层(macular retinal never fiber layer,mRNFL)、黄斑区神经节细胞层+内丛状层(ganglion cell layer with the inner plexiform layer,GCIP)、神经节细胞复合体(ganglion cell complex,GCC)]厚度,并对所有数据进行统计分析,应用受试者工作特征曲线下面积(area under the receiver operating characteristic curve,AUROC)评价各参数对POAG的诊断效力。结果早期、中晚期POAG患者各部位的pRNFL厚度及m GCC厚度值随着青光眼的严重程度逐渐变薄。早期POAG患者与正常人相比,除了mRNFL厚度和部分pRNFL厚度(鼻侧和颞侧)参数差异无统计学意义(均为P>0.05)外,其余的各项参数间差异均有统计学意义(均为P<0.05)。中晚期POAG患者与正常人相比、早期POAG患者与中晚期POAG患者相比,各项参数间差异均有统计学意义(均为P<0.05)。早期POAG患者mRNFL、GCIP、GCC、pRNFL平均值的AUROC值分别为0.641、0.731、0.724、0.775;中晚期为0.931、0.830、0.915、0.947。早期POAG患者mRNFL、GCIP、GCC最小值的AUROC值分别为0.674、0.746、0.732,中晚期为0.942、0.841、0.928,均高于其平均值的AUROC值。除了鼻侧及颞侧pRNFL厚度参数外,其余各项参数均能有效地诊断POAG,差异均有统计学意义(均为P<0.05)。结论 mGCC厚度参数与pRNFL厚度参数对POAG的诊断效力相当,可作为POAG诊断的一个新指标。Objective To measure the thickness of macular ganglion cell complex（mGCC） of primary open angle glaucoma（PO AG） by three-dimension optical coherence tomography（3D OCT）,and evaluate its diagnosibility for POAG.Methods Thirty patients（30eyes） with early POAG and 30 patients（30eyes） with moderates-severe POAG were recruited as early POAG group and moderate-to-severe POAG group,30 healthy people（30eyes）were chosen as control.The thickness of peripapillary retinal never fiber layer（pRNFL） and mGCC,including macular retinal never fiber layer（mRNFL）,ganglion cell layer with the inner plexiform layer（GCIP） and ganglion cell complex（GCC）,were measured by 3D OCT（Topcon 3D OCT-2000 ver8.0）,and the parameters were analyzed statistically.The ability of each parameter to discriminate PO AG was assessed by area under receiver operating characteristic curve（AUROC）.Results The thicknesses of pRNFL and mGCC at all parts gradually decreased as glaucoma degree aggravating.There were significant differences in the thicknesses of pRNFL and mGCC at all part between normal group and early POAG group except for all part mRNFL and nasal,temporal parameters（all P 〈 0.05）.All the parameters showed significant differences between moderate-to-severe POAG group and normal group and between the early POAG group and moderates-severe POAG group（all P0.05）.The AUROC of mRNFL,GCIP,GCC,pRNFL in average of early POAG group were 0.641,0.731,0.724,0.775,respectively,in mo derate-to-severe POAG group were 0.931,0.830,0.915,0.947,respectively.The AUROC of mRNFL,GCIP,GCC in minimum of early POAG group were 0.674,0.746,0.732,respectively,in moderate-to-severe POAG group were 0.942,0.841,0.928,respectively,which were higher than the average.All parts of pRNFL and mGCC parameters showed significantly positive diagnostic value for POAG（all P 〈 0.05）,except for the nasal and temporal pRNFL.Conclusion As a new diagnostic parameter for POAG,mGCC shows similar diagnostic potential compared with pRNFL

关 键 词：光学相干断层扫描 视网膜神经节细胞复合体 原发性开角型青光眼 

分 类 号：R775.2[医药卫生—眼科]