垂体瘤患者黄斑区GCIPL和视神经乳头周围RNFL厚度分析  

The Analysis of Macular GCIPL and Peripapillary RNFL in Patients with Pituitary Adenoma

作　　者：张晟[1] 罗陈川[1] 胡艳霞[1] 苏丽苗 查文丽 庄静宜[1] ZHANG Sheng;LUO Chenchuan;HU Yanxia;SU Limiao;ZHA Wenli;ZHUANG Jingyi(Department of Ophthalmology,The First Affiliated Hospital of Xiamen University,Xiamen 361001,China)

机构地区：[1]厦门大学附属第一医院眼科,厦门361001

出　　处：《福建医科大学学报》2022年第4期351-356,共6页Journal of Fujian Medical University

摘　　要：目的分析垂体瘤患者黄斑区视网膜神经节细胞内丛状层(GCIPL)厚度和视神经乳头周围视网膜神经纤维层(pRNFL)厚度的改变情况,探讨GCIPL和pRNFL在垂体瘤引起的视交叉压迫检测中的敏感性和可靠性。方法收集2021年1—11月确诊为垂体瘤且未经治疗的患者36例(64眼),并以同年龄段正常人9例(18眼)作为对照组。所有受试者均进行黄斑区、视神经乳头光学相干断层(OCT)扫描和视野(VF)检查。采用SPSS 21.0对VF平均缺损(MD)值、模式标准差(PSD)值与GCIPL、pRNFL平均厚度进行Pearson相关性分析。结果Pearson相关性分析提示,VF异常组患者MD值与GCIPL平均厚度、最小厚度呈正相关(P<0.05),与pRNFL无相关性,而PSD值与GCIPL平均厚度呈负相关(P<0.05);VF正常+GCIPL变薄组,其MD值与GCIPL平均厚度呈负相关(P<0.05),与GCIP最小厚度及pRNFL平均厚度均无相关性;VF正常+GCIPL正常组,其MD、PSD值与GCIPL平均厚度、最小厚度及pRNFL平均厚度均无相关性。VF异常组、VF正常+GCIPL变薄组pRNFL平均厚度与GCIPL平均厚度呈正相关(P<0.05);VF正常+GCIPL正常组,pRNFL平均厚度与GCIPL平均厚度、最小厚度均无相关性。结论在垂体瘤视交叉压迫评估中,黄斑区GCIPL的敏感性、可靠性比VF和pRNFL高,能更早且更客观地反映垂体瘤对视路的压迫情况。Objective To investigate the sensitivity and reliability of ganglion cell-inner plexiform layer(GCIPL)in macular and peripapillary retinal nerve fiber layer(pRNFL)in the detection of optic chiasma compression in pituitary adenoma by comparing the changes of GCIPL and pRNFL thickness in patients with pituitary adenoma.Methods 36 patients(64 eyes)diagnosed with pituitary adenoma from 2021 January to November were enrolled in case group,and 9 normal persons(18 eyes)with the same age in control group.All subjects underwent optical coherence tomography(OCT)and visual field(VF)examination.The relationship between macular GCIPL and pRNFL thickness and VF is analyzed.Results Pearson correlation was used to analyze the results.In patients with abnormal VF,the MD was correlated with the mean GCIPL thickness and the minimum thickness of GCIP(P<0.05),but there was no correlation with the MD and pRNFL.However,the PSD value was negatively correlated with the mean GCIPL thickness(P<0.05).In GCIPL thinning patients with normal VF,the MD value was negatively correlated with the mean thickness of GCIPL(P<0.05),but had no correlation with the minimum thickness of GCIP or the mean thickness of pRNFL.In GCIPL normal patients with normal VF,there was no correlation between visual field MD and PSD values and GCIPL average pRNFL,thickness and GCIPL thickness and pRNFL average thickness.In VF abnormal patients and GCIPL thinning patients with normal VF,the average thickness of pRNFL was positively correlated with the average thickness of GCIPL(P<0.05).In the GCIPL normal patients with normal VF,the mean thickness of pRNFL had no correlation with the mean thickness and minimum thickness of GCIPL.Conclusion In the evaluation of optic chiasma compression in patients with pituitary adenoma,the sensitivity and reliability of macular GCIPL are higher than that of VF and pRNFL,which can reflect the compression of visual pathway more directly and objectively.

关 键 词：垂体瘤 神经纤维层 神经节细胞内丛状层 视野 

分 类 号：R736.4[医药卫生—肿瘤]