黄斑区神经节细胞复合体厚度参数在近视眼的青光眼早期诊断中应用评价  

The analyze of macular ganglion cell complex thickness in early diagnosis of glaucoma in myopic patients

作　　者：张寒峭[1] 方圆[1] 乔荣华[1] 朱赛楠[2] 姚旭阳[1] 

机构地区：[1]北京大学第一医院视觉损伤与修复教育部重点实验室,100034 [2]北京大学第一医院医学统计室,100034

出　　处：《中国斜视与小儿眼科杂志》2016年第4期1-5,共5页Chinese Journal of Strabismus & Pediatric Ophthalmology

摘　　要：目的分析频域相干光断层扫描仪(FD-OCT)测量近视者黄斑区神经节细胞复合体(GCC)厚度参数的特点,探讨根据GCC参数对近视人群进行青光眼早期诊断时可能出现的问题。方法横断面研究。选取近视眼130眼、早期青光眼47眼、正视眼82眼,行验光、FD-OCT("GCC"模式)检查,将近视眼分为低度(L组)、中度(M组)、高度(H组)三组。分析比较近视各组与正视眼组和青光眼组的GGC平均厚度(GCC-a)及上半部(GCC-s)和下半部厚度(GCC-i)是否存在差异并评估GCC厚度参数在近视各组区分近视眼和早期青光眼的能力。结果与正视眼组比较,近视组较正视眼组薄(P<0.01)。与青光眼组比较,L组和M组的GCC较青光眼组厚(P<0.01)。GCC-a的丢失概率构成比在近视各组与正视组间差异均有统计学意义(x^2=91.942,P<0.001)。高度近视组GCC-a的AUC仅为0.554,明显低于低度近视组(AUC=0.727)及中度近视组(AUC=0.701)。GCC-s、GCC-i在不同近视组的AUC值与GCC-a基本一致。结论近视者黄斑区GCC厚度较正视眼薄,应用FD-OCT测得的GCC厚度指标对近视者进行青光眼早期诊断时,诊断效能较差,尤其高度近视。Objective To analyze the characteristic parameters of macular ganglion cell complex（GCC） thickness measured by frequency domain optical coherence tomography（FD-OCT） in myopic patients and to detect the potential problems of glaucoma screening or early diagnosis in myopia according to the relevant indicators of GCC.Methods Cross sectional study.Select myopia patients（130 eyes）,early glaucoma patients（47 eyes） and emmetropia（82 eyes） for optometry and FD-OCT（ ＂GCC＂ mode） checking.Those myopia cases were further divided into low myopia（L group）,moderate myopia（M group） and high myopia（H group）.One-way ANOVA comparing GCC-a,GCC-s and GCC-i between myopia groups and emmetropia group,myopia groups and glaucoma group was utilized to analyze whether there are differences of the three indexes.The loss probability of GCC-a in myopic groups and emmetropia group were compared with the chi-square test We analyzed the ability of GCC parameters to distinguish between myopia and early glaucoma.Results Comparing the myopia groups and emmetropia group,the GCC was thinner in myopic groups than in emmetropia group（P〈0.01）.Comparing the myopic groups and glaucoma group,the GCC was thicker in low and moderate myopic groups than in glaucoma group（P〈0.01）.The proportion differences of GCC-a thickness loss probability between myopic group and emmetropia group were statistically significant（P〈0.001）.In GCC-a ROC curve analysis of high myopia,AUC=0554,which was lower than AUC in low myopic group（AUC=0.727） and in moderate myopia group（AUC=0.701）.Conclusion The macular GCC of myopia is thinner than that of the emmetropia When the GCC parameters are used for the early diagnosis of glaucoma in myopia,the diagnostic efficacy is poor,especially in high myopia.

关 键 词：近视眼 相干光断层扫描仪 黄斑区神经节细胞复合体 早期青光眼诊断 

分 类 号：R775.1[医药卫生—眼科]