光学相干断层扫描在近视合并青光眼诊断中的应用  

Application of optical coherence tomography examination in the diagnosis of myopia combined with glaucoma

作　　者：卫水娟 杨继红[1] Wei Shuijuan;Yang Jihong(Shanxi Eye Hospital,Taiyuan 030002,China)

机构地区：[1]山西省眼科医院,太原030002

出　　处：《中华眼外伤职业眼病杂志》2024年第12期902-910,共9页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨光学相干断层扫描(OCT)在屈光手术前可疑近视合并青光眼者诊断中的应用价值。方法横断面对照研究。纳入山西省眼科医院2021年1月至2022年12月门诊屈光手术前可疑近视合并青光眼者共24例(47只眼),根据术前视野检查及视盘评估后分为单纯近视组(14例,27只眼)和近视合并青光眼组(10例,20只眼)。应用频域光学相干断层扫描(SD-OCT)测量所有患者的Bruch膜开口-最小盘沿宽度(BMO-MRW)、视网膜神经纤维层(RNFL)厚度;应用RTVue傅立叶域光学相干断层扫描仪(FD-OCT)测量视盘参数。比较两组BMO-MRW、RNFL厚度和视盘参数,包括杯盘面积比、垂直杯盘比、水平杯盘比、视杯体积及盘沿面积,并计算分析受试者工作特征曲线(ROC)和曲线下面积(AUC)。结果近视合并青光眼组各象限BMO-MRW鼻侧(270.30±68.12)μm、鼻上(287.10±75.76)μm、鼻下(298.60±74.34)μm、颞侧(202.95±52.81)μm、颞上(248.00±76.28)μm、颞下(274.25±60.66)μm及全周(256.90±53.33)μm均低于近视组[(337.96±59.08)、(376.15±61.73)、(385.30±67.04)、(245.07±44.03)、(336.89±49.54)、(354.59±58.28)、(323.30±48.75)μm],差异均有统计学意义(t=3.64、4.44、4.19、2.98、4.63、4.59、4.84,均P<0.05)。近视合并青光眼组RNFL厚度除颞侧象限[(79.95±15.03)比(87.16±12.32)μm]外(t=1.81,P>0.05),其余象限鼻侧(69.30±17.66)μm、鼻上(110.55±25.84)μm、鼻下(98.90±28.89)μm、颞上(132.95±27.56)μm、颞下(134.20±24.90)μm及全周(94.15±11.25)μm均低于单纯近视组[(79.59±11.42)、(149.00±26.01)、(125.51±22.21)、(152.93±25.85)、(176.85±20.89)、(113.22±7.89)μm],差异均有统计学意义(t=2.42、5.02、3.57、2.55、6.38、6.83,均P<0.05)。近视合并青光眼组杯盘面积比(0.53±0.20)、垂直杯盘比(0.69±0.21)、盘沿面积(0.89±0.35)及视杯体积(0.44±0.23)与单纯近视组(0.39±0.13、0.57±0.12、1.36±0.22、0.28±0.15)相比差异均有统计学意义(t=3.02、2.67、5.40、2Objective To investigate the application value of optical coherence tomography(OCT)in the diagnosis for suspected myopia glaucoma before refractive surgery.Methods This was a cross-sectional control study.A total of 24 patients(47 eyes)suspected of myopia with glaucoma before refractive surgery in Shanxi Eye Hospital from Jan.2021 to Dec.2022 were collected.Based on preoperative examination,visual field,and optic disc evaluation,all cases were categorized into two groups:the simple myopia group,consisting of 14 cases(27 eyes),and the myopia and glaucoma group,consisting of 10 cases(20 eyes).Bruch’s membrane opening-minimum rim width(BMO-MRW)and retinal nerve fiber layer(RNFL)thickness were measured by spectral domain OCT(SD-OCT),and optic disc parameters were measured by RTVue Fourier domain OCT(FD-OCT)for all patients.BMO-MRW,RNFL thickness,and optic disc parameters,including cup-to-disc area ratio,vertical cup-to-disc ratio,horizontal cup-to-disc ratio,cup volume,and rim area,were compared between the two groups.Receiver operating characteristic curve(ROC)and the underneath area(AUC)were calculated and analyzed.Results Nasal[(270.30±68.12)μm],superonasal[(287.10±75.76)μm],inferonasal[(298.60±74.34)μm],temporal[(202.95±52.81)μm],superotemporal[(248.00±76.28)μm],inferotemporal[(274.25±60.66)μm]sectors,and global[(256.90±53.33)μm]BMO-MRW values in the myopia and glaucoma group were lower than those in the simple myopia group[(337.96±59.08),(376.15±61.73),(385.30±67.04),(245.07±44.03),(336.89±49.54),(354.59±58.28),(323.30±48.75)μm],and the differences were statistically significant(t=3.64,4.44,4.19,2.98,4.63,4.59,4.84;all P<0.05).Except for the temporal sector[(79.95±15.03)vs(87.16±12.32)μm](t=1.81,P>0.05),the RNFL thickness in the rest sectors of the myopia and glaucoma group were lower than those of the simple myopia group,including nasal(69.30±17.66)μm,superonasal(110.55±25.84)μm,inferonasal(98.90±28.89)μm,superotemporal(132.95±27.56)μm,inferotemporal(134.20±24.90),and global(

关 键 词：近视 青光眼 体层摄影术 光学相干 视盘 

分 类 号：R73[医药卫生—肿瘤]