青光眼患者合并视网膜前膜影响视网膜神经纤维层厚度的测量  

Measurement of retinal nerve fiber layer thickness in patients with glaucoma complicated with epiretinal membrane

作　　者：房畅 韩亚维 徐丽丽[1] Fang Chang;Han Yawei;Xu lili(Department of Ophthalmology,Affiliated Hospital of Nantong University,Nantong 226001,China)

机构地区：[1]南通大学附属医院眼科,226001

出　　处：《临床眼科杂志》2023年第5期414-418,共5页Journal of Clinical Ophthalmology

摘　　要：目的探讨青光眼患者视网膜前膜(ERM)的发生早期对视盘周围视网膜神经纤维层(RNFL)厚度测量的影响。方法回顾性病例研究。在定期随访的青光眼患者中,连续入组新诊断为ERM的患者。在ERM发病前后,用相干光层析成像术(OCT)测量RNFL厚度,并用Humphrey视野分析仪进行视野检查。主要评估RNFL厚度的变化和视野分析仪视野指数的变化。结果共入组32例(32只眼)。在发生ERM后RNFL平均厚度增加,差异有统计学意义(P=0.007)。上方、鼻侧和颞侧象限RNFL较发生ERM之前增加,但只有颞侧象限的差异有统计学意义(P<0.001),下方象限RNFL厚度较前降低,差异无统计学意义(P=0.205)。在视野检查中视野平均缺损从-15.1 dB降至-16 dB,差异有统计学意义(P=0.024)。结论青光眼患者ERM发生后虽然视野平均缺损有所下降,但是RNFL平均厚度显著增加。当ERM发生在青光眼患者,临床医生应注意用OCT测量RNFL厚度可能低估青光眼视神经病变程度。Objective To investigate the effect of early occurrence of epiretinal membrane(ERM)on the measurement of retinal nerve fiber layer(RNFL)thickness around the optic disc in patients with glaucoma.Methods Among glaucoma patients who were followed up regularly,patients with newly diagnosed ERM were enrolled continuously.Before and after the onset of ERM,the thickness of RNFL was measured by OCT,and the visual field was examined by Humphrey visual field analyzer.The change of RNFL thickness and the change of visual field index of visual field analyzer were evaluated.Results A total of 32 cases and 32 eyes were enrolled.After the occurrence of ERM,the average thickness of RNFL increased,and the difference was statistically significant(P=0.007).The RNFL in the upper,nasal,and temporal quadrants increased compared to before the occurrence of ERM,but only the difference in the temporal quadrant was statistically significant(P<0.001).The RNFL thickness in the lower quadrant decreased compared to before,and the difference was not statistically significant(P=0.205).In visual field examination,the average visual field defect decreased from-15.1 dB to-16 dB,with a statistically significant difference(P=0.024).Conclusions Although the average visual field defect decreased after ERM onset in glaucoma patients,the average thickness of RNFL increased significantly.When ERM occurs in glaucoma patients,clinicians should note that measuring RNFL thickness with OCT may underestimate the degree of glaucoma optic neuropathy.

关 键 词：视网膜前膜 青光眼 光学相干断层扫描 视野检查 视网膜神经纤维层厚度 

分 类 号：R775[医药卫生—眼科]