HRT-Ⅲ、SD-OCT、Humphrey自动视野计和视网膜电图明视负波反应在POAG诊断中的应用  

The application of HRT-Ⅲ、SD-OCT 、Humphrey VF and Photopic negative response of Electroretinogram in primary open-angle glaucoma diagnosis

作　　者：申晓丽[1] 李强[2] 赵军[1] 黄丽娜[1] 

机构地区：[1]深圳市眼科医院深圳市眼科学重点实验室暨南大学附属深圳市眼科医院,518040 [2]深圳市人民医院,518000

出　　处：《临床眼科杂志》2016年第3期222-225,共4页Journal of Clinical Ophthalmology

基　　金：广东省医学科学技术研究基金项目(A2015315);深圳市创新委基础研究项目(JCYJ20120831154554508)

摘　　要：目的探讨HRT-Ⅲ、SD-OCT、Humphrey自动视野计及视网膜电图明视负波(Ph NR)对原发性开角型青光眼(POAG)的诊断价值。方法选择我院就诊的POAG患者100例(100只眼)、正常人50例(50只眼),所有入选者均行上述4种检测。应用SPSS17.0软件对数据进行独立样本t检验和ROC曲线分析。结果 SD-OCT平均视网膜神经纤维层厚度(RNFLT)的ROC曲线下面积最大为0.974,对POAG的诊断价值最高;W-W Ph NR振幅的ROC曲线下面积为0.954,对POAG的诊断价值仅次于OCT平均RNFLT。在设定特异性≥80%和≥95%的情况下,SD-OCT平均RNFLT和W-W Ph NR振幅的敏感性分别为95%、90%、93.3%、76.7%。余检测参数的ROC曲线下面积均大于0.7,对POAG有一定的诊断价值。结论 SD-OCT平均RNFL对POAG的诊断价值最高,W-W Ph NR振幅次之。上述4种检测仪器从不同角度评估了青光眼视神经结构与功能损害的特征,有助于指导青光眼的临床诊治。Objective To explore the diagnostic values of Heidelberg Retina Tomography（ HRT-Ⅲ）,Spectraldomain optical coherence tomography（ SD-OCT）,Humphrey Automated Perimetry and Electroretinogram Photopic Negative Response（ Ph NR） in Primary Open-angle Glaucoma（ POAG） patients. Methods 100 cases（ 100 eyes） of POAG patients and 50 cases（ 50 eyes） of normal subjects were examined by HRT-Ⅲ,SD-OCT,Humphrey Automated Perimetry and Ph NR in our hospital. The results were analyzed by using SPSS 17. 0 software,single sample t-test and ROC curve analysis. Results The area under the ROC curve of SD-OCT average RNFLT is the largest（ AUC = 0. 974）,which has the highest diagnostic value to POAG; The area under the ROC curve of white-white Ph NR amplitude is 0. 954,the diagnostic value to POAG is secondly to the average RNFLT of SD-OCT. The sensitivity of the average RNFLT of SD-OCT and white- white Ph NR amplitude are 95%,90%,93. 3% and 76. 7% separately in setting specifity≥ 80% and ≥ 95%. The area under the ROC curve of the others parameters were greater than 0. 7,and have certain diagnostic values to POAG. Conclusions In POAG patients,the average retinal nerve fiber layer thickness of SD-OCT has the highest diagnostic values and white- white Ph NR amplitude has the second one. The four equipments above have assessed the optic nerve damage characteristics of the structure and function from different view angles,which helps to guide the diagnosis and treatment of glaucoma.

关 键 词：HRT-Ⅲ SD-OCT 视野 视网膜电图明视负波 原发性开角型青光眼 

分 类 号：R775[医药卫生—眼科]