mGCL厚度、pRNFL厚度及BMO-MRW对早期原发性闭角型青光眼的诊断价值  

Significance of macular ganglion cell layer thickness, peripapillary retinal nerve fiber layer thickness and Bruch membrane opening-minimal rim width in diagnosis of early primary angle-closure glaucoma

作　　者：赵会芳 赵春梅[2] 刘湘云[2] 郑艳瑾 洪阳 李金秋 ZHAO Huifang;ZHAO Chunmei;LIU Xiangyun;ZHENG Yanjin;HONG Yang;LI Jinqiu(Combined Department of Glaucoma and Cataract,the North China University of Science and Technology,Tangshan 063210,Hebei Province,China;Combined Department of Glaucoma and Catarat,Tangshan Eye Hospital,Tangshan 063001,Hebei Province,China)

机构地区：[1]华北理工大学,河北省唐山市063210 [2]唐山市眼科医院,河北省唐山市063001

出　　处：《眼科新进展》2022年第3期230-233,共4页Recent Advances in Ophthalmology

摘　　要：目的探讨黄斑区神经节细胞层(mGCL)厚度、盘周神经纤维层(pRNFL)厚度及Bruch膜开口-最小盘沿宽度(BMO-MRW)对早期原发性闭角型青光眼的诊断价值。方法选取2021年6月至2021年10月来我院青光眼专家门诊进行早期青光眼筛查的10例17眼早期原发性闭角型青光眼患者为观察组,同期10人18眼健康人为对照组。采用Spectralis OCT测量两组受试者mGCL厚度、pRNFL厚度及BMO-MRW。计算各参数受试者工作特征曲线下面积(AROC)。结果观察组患者颞侧、颞上、颞下、鼻侧、鼻上、鼻下及平均BMO-MRW及pRNFL厚度均低于对照组,差异均有统计学意义(均为P<0.05)。观察组患者各象限mGCL厚度均低于对照组,并且两组受试者在内环的上方、下方、颞侧、鼻侧和外环的上方、下方、颞侧、鼻侧mGCL厚度差异均有统计学意义(均为P<0.05);而两组受试者中心区mGCL厚度差异无统计学意义(P>0.05)。ROC曲线分析显示,颞下区pRNFL厚度的AROC最大值为0.920(P<0.01);BMO-MRW平均值的AROC最大值为0.864(P<0.01);内环颞侧mGCL厚度的AROC最大值为0.631(P<0.05)。结论pRNFL、mGCL及BMO-MRW在早期原发性闭角型青光眼患者中均出现局部变薄和变窄,对早期原发性闭角型青光眼具有一定的诊断价值,其中pRNFL的诊断准确性最高,BMO-MRW次之,mGCL的诊断准确性较低。Objective To investigate the value of macular ganglion cell layer(mGCL) thickness, peripapillary retinal nerve fiber layer(pRNFL) thickness and Bruch membrane opening-minimal rim width(BMO-MRW) in the diagnosis of early primary angle-closure glaucoma.Methods A total of 20 patients(35 eyes) receiving glaucoma screening in our hospital from June 2021 to October 2021 were enrolled in this study. Among them, 17 eyes(10 patients) with early primary angle-closure glaucoma were divided into the observation group and 18 healthy eyes(10 patients) into the control group. Spectralis optical coherence tomography was used to measure the mGCL thickness, pRNFL thickness and BMO-MRW of the two groups. The area under the receiver operating characteristic curve(AROC) of each parameter was calculated.Results The BMO-MRW and pRNFL thickness in the temporal, supratemporal, subtemporal, nasal, supranasal, and subnasal sides and the average BMO-MRW and pRNFL thickness in the observation group were all lower than those in the control group, and the differences were statistically significant(all P<0.05). The mGCL thickness in each quadrant in the observation group was lower than that in the control group, and there were significant differences in the superior, inferior, temporal, and nasal mGCL thickness in both inner and outer rings between the two groups(all P<0.05). The mGCL thickness showed no significant difference in the central side between the two groups(P>0.05). ROC curve showed that the highest AROC of pRNFL thickness in the subtemporal side was 0.920(P<0.01), the highest AROC of average BMO-MRW was 0.864(P<0.01), and the highest AROC of mGCL thickness in the inner temporal side was 0.631(P<0.05).Conclusion pRNFL, mGCL and BMO-MRW become thin and narrow locally in patients with early primary angle-closure glaucoma, providing a reference for the diagnosis of the early primary angle-closure glaucoma. The diagnostic accuracy based on pRNFL is the highest, followed by BMO-MRW and mGCL.

关 键 词：早期原发性闭角型青光眼 黄斑区神经节细胞层 盘周神经纤维层 Bruch膜开口-最小盘沿宽度 

分 类 号：R775.2[医药卫生—眼科]