分离格栅视觉诱发电位和光学相干断层扫描血管成像术在原发性开角型青光眼早期诊断中的相关性  

Correlation between isolated-check visual evoked potential and optical coherence tomography angiography in early diagnosis of primary open-angle glaucoma

作　　者：张恒丽 李树宁 闫晓伟 耿玉磊 马丽华 李凡 唐广贤 ZHANG Hengli;LI Shuning;YAN Xiaowei;GENG Yulei;MA Lihua;LI Fan;TANG Guangxian(Department of Glaucoma,Shijiazhuang People’s Hospital,the First Eye Hospital of Shijiazhuang,Shijiazhuang 050000,China;Beijing Tongren Eye Center,Beijing Tongren Hospital,Beijing Ophthalmology&Visual Science Key Lab,Capital Medical University,Beijing 100005,China)

机构地区：[1]石家庄市人民医院,石家庄市第一眼科医院青光眼科,石家庄050000 [2]北京同仁眼科中心,北京同仁医院,北京市眼科学与视觉科学重点实验室,首都医科大学,北京100005

出　　处：《眼科学报》2020年第6期405-412,共8页Eye Science

基　　金：河北省科技计划项目(17277751D)。

摘　　要：目的:分析、评估分离格栅视觉诱发电位(isolated-check visual evoked potential,IC-VEP)和光学相干断层扫描血管成像术(optical coherence tomography angiography,OCTA)在原发性开角型青光眼(primary open-angle glaucoma,POAG)早期诊断中的相关性,为提高POAG早期诊断效能和速率提供理论依据。方法:病例对照研究。回顾性分析2018年3月至2019年1月在石家庄市人民医院(石家庄市第一眼科医院)就诊的早期POAG患者31例31只眼,设为观察组,年龄(43.11±5.34)岁;正常对照者30例30只眼,设为对照组,年龄(42.88±5.15)岁。所有受试者行视野、IC-VEP及OCTA检测,统计分析两组受试者基线资料,分析信噪比(signal-to-noise,SNR)和乳头周围血管密度变化及相关性,评估诊断效能。结果:两组性别、年龄、最佳矫正视力、屈光度、中央角膜厚度差异均无统计学意义(P>0.05),视野平均缺损差异有统计学意义(P<0.001)。早期POAG患者IC-VEP及乳头周围血管密度的敏感性和特异性分别为83.87%和90%,87.1%和86.67%,组间差异均有统计学意义(P>0.05)。两组受试者的一致性检测率为67.21%。观察组和对照组SNR值分别为0.92±0.05和1.37±0.16,差异有统计学意义(t=3.15,P=0.004)。观察组乳头周围血管密度明显降低(P<0.05)。观察组SNR和乳头周围血管密度呈正相关(r=0.79,P<0.001)。结论:IC-VEP和OCTA在POAG早期的一致性变化,将进一步提高POAG早期诊断效能和速率,降低青光眼致盲率。Objective:To analyze and evaluate the correlation between the isolated-check visual evoked potential(IC-VEP)and optical coherence tomography angiography(OCTA)in early diagnosis of primary open-angle glaucoma(POAG)and provide theoretical evidence for improving the efficiency of diagnosis in early POAG.Methods:A clinical case-control study.Thirty-one eyes of 31 patients with early stage of POAG(observation group)and 30 eyes of 30 normal individuals(control group)were retrospectively collected in Shijiazhuang People’s Hospital from March 2018 to April 2019.The age was(43.11±5.34)years and(42.88±5.15)years in the observation group and control group,respectively.The visual field,IC-VEP,and OCTA were performed for all subjects.The baseline data were statistically analyzed between two groups.The correlation and the changes in signal-to-noise(SNR)and peripapillary capillary density were analyzed,and the diagnostic efficacy was evaluated.Results:There was no statistical significance in gender,age,best corrected visual acuity,refractive diopter,and central corneal thickness between two groups(all P>0.05).Statistical significance was found in MD between two groups(P<0.05).The sensitivity and specificity of IC-VEP and peripapillary capillary density in early POAG patients were 83.87%and 90%,87.1%and 86.67%,respectively.No statistical significance was observed(P>0.05).The detection rate of consistency was 67.21%between two groups.The SNR values in the observation and control groups were 0.92±0.05 and 1.37±0.16,with statistical significance between two groups(t=3.15,P=0.004).In the observation group,the peripapillary capillary density was notably decreased(P<0.05).Positive correlation was noted between SNR and peripapillary capillary density in the observation group(r=0.79,P<0.001).Conclusion:The consistent changes in the visual evoked potential and OCTA at the early stage of POAG will further improve the early diagnostic efficiency and rate of POAG and reduce the blindness rate of glaucoma.

关 键 词：原发性开角型青光眼 早期诊断 光学相干断层扫描血管成像 分离格栅视觉诱发电位 相关性 

分 类 号：R775[医药卫生—眼科]