HRT联合视野检查在高海拔地区开角型青光眼早期诊断中的应用  

Application in early Diagnosis of HRT Combined with Visual Field Examination for Open-angle Glaucoma in High-altitude Areas

作　　者：陈冰 樊苗苗 郭倩 季瑛 CHEN Bing;FAN Miaomiao;GUO Qian;JIYing(The First People's Hospital of Xining,Qinghai Province,810000)

机构地区：[1]青海省西宁市第一人民医院,810000

出　　处：《高原医学杂志》2023年第4期13-17,共5页Journal of High Altitude Medicine

基　　金：青海省卫生健康委指导性课题(项目编号:2019-wjzdx-102)。

摘　　要：目的:对高海拔地区疑似开角型青光眼患者和健康对照者通过海德堡视网膜断层扫描仪(HRT)联合视野检查,随访6个月,通过视盘参数分析其进展,为高海拔地区原发性开角型青光眼患者早期诊断提供依据,以提高原发性开角型青光眼患者早期诊断率。方法:收集2019年1月—2022年12月来我院眼科就诊且长期居住在青海地区的疑似原发性开角型青光眼患者127例,按检查结果分为高眼压症组(51例)、早期开角型青光眼组(36例)、健康对照组(40例),每3个月复查一次,随访6个月,通过HRT检测视盘参数,结合眼压、视野变化,分析其病情进展。结果:基线0月时,早期开角型青光眼组与健康对照组比较,视盘参数除视盘面积(DA)外,其余参数差异均有统计学意义(P<0.05);高眼压症组与健康对照组比较,视盘参数除DA、平均视杯深度(MCD)外,其余参数差异均具有统计学意义(P<0.05)。高眼压症组在随访3月时视盘参数盘沿面积(RA)、视杯形态测量(CSM)、平均视网膜神经纤维层厚度(mRNFLT)、平均视网膜神经纤维层横截面积(RNFLA)与基线0月比较,差异均有统计学意义(P<0.05),视盘参数视杯容积(CV)、盘沿容积(RV)、视杯/视盘面积比值(C/D AR)、MCD、视乳头轮廓线高度变化值(HVC)在随访6月时出现明显变化(P<0.05)。早期开角型青光眼组视盘参数视杯面积(CA)、RA、RV、C/D AR、MCD、最大视杯深度(MxCD)、CSM、mRNFLT、RNFLA在随访3月时与基线0月比较,差异均有统计学意义(P<0.05),视盘参数CV、HVC在随访6月时出现明显变化(P<0.05)。结论:HRT联合视野检查可提高高海拔地区原发性开角型青光眼的早期诊断率,对随访中监测开角型青光眼的病情变化具有重要意义。Objective: To investigate the progression of suspected open-angle glaucoma patients and healthy controls in high altitude areas using Heidelberg Retina Tomograph(HRT) combined with visual field tests over a 6 month follow up period. The analysis of optic disc parameters aims to provide a basis for early diagnosis of primary open-angle glaucoma(POAG) in high-altitude areas and to improve the early diagnosis rate of POAG patients. Methods: Collect 127 suspected POAG who visited our hospital from January 2019to December 2022 and resided in Qinghai for a long time, and divided into three groups based on examination resultsm, high intraocular pressure group(51 cases), early POAG group(36 cases), and healthy control group(40 cases). Each group was followed up every 3 months for a total of 6 months. Optic disc parameters were measured using HRT, and changes in intraocular pressure and visual field were analyzed to assess disease progression. Results: At baseline(0 months), compared with the healthy control group, all parameters of the early POAG group except for disc area(DA) showed statistically significant differences(P < 0.05);compared with the healthy control group, all parameters of the high intraocular pressure group except for DA and mean cup depth(MCD) showed statistically significant differences(P < 0.05). In the high intraocular pressure group, at the 3 month follow up, the optic disc parameters of rim area(RA), cup shape measure(CSM), mean retinal nerve fiber layer thickness(mRNFLT), and mean retinal nerve fiber layer cross sectional area(RNFLA)showed statistically significant differences compared to baseline(P < 0.05), and optic disc parameters of cup volume(CV), rim volume(RV), cup to disc area ratio(C/D AR), MCD, and optic disc contour line height variation value(HVC) showed significant changes at the 6 month follow up(P < 0.05). In the early POAG group, optic disc parameters of disc area(CA), RA, RV, C/D AR, MCD, maximum cup depth(MxCD), CSM,mRNFLT, and RNFLA showed statistically significant differences a

关 键 词：高海拔地区 原发性开角型青光眼 海德堡视网膜断层扫描仪 视盘参数 

分 类 号：R775.1[医药卫生—眼科] R339.54[医药卫生—临床医学]