PERG联合OCTA技术在开角型青光眼诊断中的应用研究  

Application of PERG Combined with OCTA in the Diagnosis of Open Angle Glaucoma

作　　者：顾修凤 郭建新 Gu Xiufeng;Guo Jianxin(Graduate School of Xuzhou Medical University,2016,Jiangsu 221004,China)

机构地区：[1]徐州医科大学研究生学院,221004 [2]徐州医科大学附属医院眼科,221002

出　　处：《医学研究杂志》2020年第6期142-147,共6页Journal of Medical Research

摘　　要：目的对图形视网膜电图(pattern electroretinogram,PERG)与光学相干断层扫描血管成像(optical coherence tomography angiography,OCTA)技术在青光眼中的应用进行研究,为早期发现、诊断青光眼,评估预后提供帮助。方法采用横断面的研究方法对同一时间段内的51例开角型青光眼患者和年龄、性别相匹配的25例正常对照者均行OCTA、PERG及眼科常规检查,检测视盘区上方、下方、鼻侧、颞侧4个不同方位的视盘神经纤维层放射状盘周毛细血管密度(radial peripapillary capillaries density,RPCD)和视盘周围视网膜神经纤维层厚度(retinal nerve fiber layer thickness,RNFLT),检测PERG中N95波幅及潜伏期大小。根据受试者工作特征曲线下面积(area under receiver operating characteristic curve,AUC)评估各参数的诊断能力,采用Pearson相关分析RPCD、RNFLT、N95波幅之间的相关性。结果正常对照组与早、中、晚期青光眼组比较,中、晚期的RPCD值在各个方位上比较,差异均有统计学意义(P<0.05),其中平均RPCD、下方RPCD在各组间比较,差异有统计学意义(P<0.05),随着青光眼分期的进展,盘周毛细血管密度逐渐降低。N95波幅及潜伏期在对照组与早期青光眼组间比较,差异有统计学意义(P<0.05),青光眼组患者N95波幅较对照组低,潜伏期较对照组延长。在早期青光眼组,RPCD参数中平均RPCD具有最高的AUC值为0.942,RNFLT参数中平均RNFLT具有最高的AUC值为0.975,N95波参数中N95波幅具有最高的AUC值为0.864,三者联合诊断的AUC值最高为0.996。结论OCTA、PERG是青光眼监测的重要手段,可作为青光眼早期诊断的辅助检查方式,OCTA、PERG、OCT等联合检查可有效地帮助临床医生掌握患者病情及评估患者预后,具有重要的临床价值。Objective To study the application of pattern electroretinogram(PERG)and optical coherence tomography angiography(OCTA)technology in glaucoma,to provide early detection and diagnosis of glaucoma and to evaluate the prognosis.Methods The study was a cross-sectional study.OCTA,PERG,and routine ophthalmological examinations were performed on 51 open-angle glaucoma patients and 25 normal controls with age and gender matching during the same period of time.The 4 different Radial peripapillary capillaries density(RPCD)and retinal nerve fiber layer thickness(RNFLT)around the optic disc nerve fiber layer in the azimuth optic disc of upper,lower,nasal,and temporal sides of the optic disc were detected for N95 amplitude and latency in PERG.The diagnostic ability of each parameter was evaluated according to the area under receiver operating characteristic curve(AUC),and the correlation between RPCD,RNFLT,and N95 amplitudes was analyzed using Pearson correlation.Results Compared with the early,middle and late glaucoma groups,the difference between the middle and late RPCD values in the normal control group was statistically significant in all directions(P<0.05).The difference between the average RPCD and the lower RPCD between the groups was statistically significant(P<0.05).With the progress of glaucoma stage,the density of capillaries around the disc gradually decreased.The difference of N95 amplitude and latency between the control group and the early glaucoma group was statistically significant(P<0.05).The N95 amplitude of the glaucoma group was lower than that of the control group,and the latency was longer than that of the control group.In the early glaucoma group,the average RPCD in the RPCD parameter has the highest AUC value of 0.942,the average RNFLT in the RNFLT parameter has the highest AUC value of 0.975,and the N95 amplitude in the N95 wave parameter has the highest AUC value of 0.864.The highest AUC value of the three combined diagnosis is 0.996.Conclusion OCTA and PERG are important methods for glaucoma monit

关 键 词：青光眼 图形视网膜电图 光学相干断层血管扫描成像 视盘神经纤维层放射状盘周毛细血管密度 

分 类 号：R775.2[医药卫生—眼科]