OCT与RTA在青光眼诊断上的比较研究  

The comparative analysis between Optical Coherence Tomography (OCT) and Retinal Thickness Analyzer (RTA)in diagnosis of glaucoma

作　　者：葛坚[1] 杨智宽[1] 王梅[1] 骆荣江[1] 

机构地区：[1]中山医科大学中山眼科中心,510060

出　　处：《中国眼耳鼻喉科杂志》2000年第4期77-80,共4页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：国家自然科学基金;广东省自然科学基金

摘　　要：目的:对光学相干眼断层成像(OCT)与视网膜厚度分析仪(RTA)在青光眼诊断上的价值进行比较分析。方法:分别用RTA对116只正常眼及35只青光眼患者眼,用OCT对169只正常眼及132只青光眼患者眼进行了检测(正常人及青光眼患者均采用相同的标准),电子计算机分析后得到视网膜厚度值和视网膜神经纤维层(RNFL)厚度值。结果:RTA检查得到的正常人后极部视网膜厚度值为171.83±118.5μm,OCT得到的正常人视网膜神经纤维层厚度值为110.29±10.03μm;青光眼患者的平均视网膜厚度为154.21±25.54μm,早、中、晚期青光眼患者的平均视网膜神经纤维层厚度值分别为99.41±15.24μm、77.49±22.66μm及47.59±21.13μm;青光眼患者用RTA和OCT检查都可表现为局限性或弥漫性变薄;它们对青光眼患者进行诊断的特异性RTA为75.9%,OCT为80.3%;敏感性RTA为80.8%,OCT为79.5%。结论:RTA和OCT都可以对青光眼患者进行诊断,其特异性和敏感性相近,都有20%以上的假阳性发生;RTA检查较视野检查更敏感,OCT检查与视野也高度相关;由于RTA和OCT检查的部位是以黄斑中心窝为中心的后极部和乳头黄斑周围的范围,除对黄斑疾病的诊断有独到之处外,对青光眼早期视神经纤维层的微细变化能及早发现。并能以二维图像(或三维图像)形象化表达,特别是它们具有操作简单,重复性强,无损等特点,为动态定量观察视网膜与黄斑变化提供了一个可比性很强的方法。To compare the diagnostic value between OCT and RTA for glaucoma. Methods: The thicknesses of retinal layer of 116 normal eyes and 35 glaucomatous eyes were detected with RTA; those of another 169 normal eyes and 132 glaucomatous eyes with OCT, The same criteria for normal eye and glaucomatous eye were used in the two measurements, the retinal thickness value (RT) and retina nerve fiber layer (RNFL) were achieved by RTA and OCT separately through computer analysis. Results: The RT value of normal eyes is 171.83 ± 18. 5dm detected by RTA,and 110.29± 10.03μm of RNFL by OCT; in glaucoma patients, the RT value is 154.21 ± 25.54μm, and RNFL value is as follows:99.41 ± 15.24μm in the early stage , 77.49 ± 22.66μm in the progressive stage and 47.59 ± 21.13μm in the late stages of glaucoma,The differences are significant between glaucomatous and normal eyes.There are local and diffuse damage in glaucomatous patients detected by OCT and RTA. The specificity for diagnosis is 75. 9% with RTA and 80. 3% with OCT, whereas the sensitivity is 80.8% with RTA and 79.5% with OCT. Conclusion: Both OCT and RTA can be used in the diagnosis of glaucomatous patients, and the specificity and sensitivity are similar with 20% false positivity. RTA detection is more sensitive than perimetry; the RNFL value detected by OCT is highly related to visual field detection. Because they all can present the change of posterior pole around the fovea, RTA and OCT can be used to show macular disease and to detect the minimal change ofRNFL in glaucomatous patients early. Especially they have the advantages of easy operation, highly reproductivi-ty and noninvasion. They are very useful to distinguish glaucomatous from normal eyes.

关 键 词：光学相干眼断层成像 视网膜厚度分析仪 青光眼 视网膜 

分 类 号：R775[医药卫生—眼科]