原发性开角型青光眼视盘损伤可能度分级与光学相干断层扫描一致性研究  

The consistency of disc damage likelihood scale and optical coherence tomography in patients with primary open-angle glaucoma

作　　者：刘擘 李佳孟 孟素坤 付玮 李书珊 洪颖[1] 张纯[1] LIU Bo;LI Jia-Meng;MENG Su-Kun;FU Wei;LI Shu-Shan;HONG Ying;ZHANG Chun(Department of Ophthalmology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院眼科

出　　处：《眼科新进展》2019年第12期1133-1136,共4页Recent Advances in Ophthalmology

基　　金：国家自然科学基金资助(编号:81670851)~~

摘　　要：目的探究原发性开角型青光眼(primary open-angle glaucoma,POAG)患者眼底照相视盘损伤可能度(disc damage likelihood scale,DDLS)分级与光学相干断层扫描(optical coherence tomography,OCT)是否具有一致性。方法采用回顾性分析,以本院2014年1月至2018年7月确诊的同时具有眼底照相和OCT检查结果的POAG患者为研究对象,由2名医师进行DDLS分级,采集患者基本信息、DDLS分级结果,Heidelberg OCT检测视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度及同期视野平均缺损值,进行统计学分析。结果纳入患者78例(144眼),男女比例为3444,年龄15~83(56.82±17.88)岁。视盘不同方向RNFL厚度的变薄程度差异有统计学意义(P<0.001),其中视盘颞上侧与颞下侧的RNFL厚度变薄程度均显著高于其他方向(均为P<0.001)。DDLS分级与各方向RNFL厚度(P<0.05)、DDLS分级与视野缺损程度(P<0.001)、各方向RNFL厚度与视野缺损程度(P<0.001)均存在显著相关性,其中DDLS分级与整体、鼻下侧RNFL厚度的相关性最强(均为P<0.05),视野缺损程度与整体、颞上侧RNFL厚度相关性最强(均为P<0.001)。结论 POAG的两种常用结构检查方法的结果(DDLS分级、OCT测得视盘RNFL变薄情况)具有一致性,且二者与视野缺损程度均密切相关,结果具有一致性。Objective To investigate the consistency of disc damage likelihood scale(DDLS) and optical coherence tomography(OCT) in patients with primary open-angle glaucoma(POAG).Methods We retrospectively reviewed all patients with POAG who underwent examination of both fundus photography and OCT from January 2014 to July 2018 in our hospital.DDLS classification was conducted by two doctors.General information,DDLS classification,the thickness of the retinal nerve fiber layer(RNFL) detected by Heidelberg OCT and mean defect(MD) values of concurrent visual field examination were collected for statistical analysis.Results A total of 78 patients(144 eyes) were included,with a male/female ratio of 34:44,aged 15-83(56.82±17.88) years.Statistical differences were found in different areas of the optic disc(P<0.001),and both temporal superior(TS) rims and temporal inferior(TI) rims were thinner than other directions with statistically significant differences(all P<0.001).There were statistical differences in DDLS and RNFL thickness(P<0.05),DDLS and the degree of visual field defect(P<0.001),and RNFL thickness and the degree of visual field defect(P<0.001).The correlation between DDLS and the thickness of RNFL both in average and nasal inferior(NI) was the most significant(P<0.05).The degree of visual field defection has the most significant correlation with the thickness of RNFL both in average and TS(both P<0.001).Conclusion There is a significant consistency between two common structural inspection methods(DDLS classification and RNFL thinning of disc measured by OCT),and both of them have a significant association with the degree of visual field defect in POAG patients.

关 键 词：原发性开角型青光眼 光学相干断层扫描 视盘损伤可能度 

分 类 号：R775.2[医药卫生—眼科]