黄斑区节细胞复合体 视乳头周围视网膜神经纤维层厚度和视野平均缺损在新生血管性青光眼临床分期 疗效及预后中的价值分析  

Value analysis of mGCC,pRNFL thickness,and MD in clinical staging,efficacy,and prognosis of neovascular glaucoma

作　　者：丁巧娟 赵杰琼 张晨曦 刘云 岳春艳 Ding Qiaojuan;Zhao Jieqiong;Zhang Chenxi;Liu Yun;Yue Chunyan(Department of Ophthalmology,Xi'an Yanliang District People's Hospital,Shaanxi 710089,China)

机构地区：[1]西安市阎良区人民医院眼科,710089

出　　处：《山西医药杂志》2023年第23期1767-1771,共5页Shanxi Medical Journal

摘　　要：目的分析黄斑区节细胞复合体(mGCC)、视乳头周围视网膜神经纤维层(pRNFL)厚度和视野平均缺损(MD)在新生血管性青光眼(NVG)临床分期、疗效及预后中的价值。方法选取80例NVG患者(80眼)作为研究对象,依据临床分期不同将其分为虹膜红变组(24例24眼)、开角型青光眼组(30例30眼)和闭角型青光眼组(26例26眼);同期选取40名健康体检者(80眼)作为对照组;所有对象均接受光学相干断层扫描技术(OCT)检查,并收集mGCC、pRNFL厚度和MD,对比各组mGCC、pRNFL厚度和MD差异;NVG患者治疗方案相同,根据术后疗效将NVG患者分为有效组(56例)和无效组(24例),对比2组mGCC、pRNFL厚度和MD差异,绘制受试者工作曲线(ROC)分析疗效预测价值;根据术后6个月虹膜及前房角新生血管复发情况将NVG患者分为复发组(8例)和健康组(48名),对比2组mGCC、pRNFL厚度和MD差异,绘制ROC曲线分析预后预测价值。结果NVG各组和对照组mGCC-a、pRNFL-a厚度和MD比较,差异均有统计学意义(P<0.05),其中mGCC-a、pRNFL-a厚度在对照组、虹膜红变组、开角型青光眼组和闭角型青光眼组依次降低,而NVG各组MD均高于对照组,但在虹膜红变组、开角型青光眼组和闭角型青光眼组依次降低。NVG患者中有效组患者mGCC-a、pRNFL-a厚度高于无效组,但MD低于无效组,差异均有统计学意义(P<0.05)。与正常组比较,复发组mGCC-a、pRNFL-a厚度降低,MD升高,差异均有统计学意义(P<0.05)。绘制ROC曲线分析发现,mGCC-a、pRNFL-a厚度和MD均可预测NVG患者疗效和预后,三者联合效果更佳。结论mGCC-a、pRNFL-a厚度和MD在NVG在一定程度上可预测患者疗效和预后,具有一定临床推广价值。Objective To analyzethevalueof macular ganglion cell complex(mGCC),peripapillary retinal nerve fiber layer(pRNFL)thickness and mean field defect(MD)in the clinical staging,curative effect and prognosis of neovascular glaucoma(NVG).Methods Eighty NVG patients(80 eyes)were selected as the study subjects and divided into three groups based on clinical staging:iris redness group(24 cases,24 eyes),open angle glaucoma group(30 cases,30 eyes),and closed angle glaucoma group(26 cases,26 eyes);During the same period,40 healthy individuals(80 eyes)were selected as the control groupi All subjects underwent optical coherence tomography(OCT)examination and collected mGCC,pRNFL thickness,and MD to compare the differences in mGCC,pRNFL thickness,and MD among the groupsi The treatment plan for NVG patients is the same.NVG patients are divided into an effective group(n=56)and an ineffective group(n=24)based on postoperative efficacy.The differences in mGCC,pRNFL thickness,and MD between the two groups are compared,and the subject working curve(ROC)is drawn to analyze the predictive value of efficacy.NVG patients were divided into a recurrent group(n=8)and a normal group(n=48)based on the recurrence of neovascularization in the iris and anterior chamber angle at 6 months after surgery.The differences in mGcC,pRNFL thickness,and MD between the two groups were compared,and ROC curves were drawn to analyze the predictivevalue of prognosis.Results There were statistically significant differences in mGCC-a,pRNFL-a thickness,and MD between the NVG groups and the control group(all P<0.05).Among them,mGCC-a,pRNFLa thickness decreased sequentially in the control group,iris redness group,open angle glaucoma group,and closed angle glaucoma group,while MD in the NVG groups was higher than that in the control group,but decreased sequentially in the iris redness group,open angle glaucoma group,and closed angle glaucoma group.The thickness of mGCC-a and pRNFL-a in the effective group of NVG patients was higher than that in the ineffective group,

关 键 词：青光眼 新生血管性 节细胞复合体 黄斑区 视网膜神经纤维层 视乳头 视野缺损 临床价值 

分 类 号：R775[医药卫生—眼科]