中华实验眼科杂志
中華實驗眼科雜誌
중화실험안과잡지
CHINESE JOURNAL OF EXPERIMENTAL OPHTHALMOLOGY
2011年
3期
249-253
,共5页
青光眼%傅立叶OCT%海德堡激光眼底扫描仪%视网膜神经纤维层厚度%视盘%视野
青光眼%傅立葉OCT%海德堡激光眼底掃描儀%視網膜神經纖維層厚度%視盤%視野
청광안%부립협OCT%해덕보격광안저소묘의%시망막신경섬유층후도%시반%시야
Glaucoma%Optovue RTVue OCT%Heidelberg Retina Tomograph Ⅲ confocal scanning laser ophthalmoscopy%Retinal nerve fiber layer thickness%Optical disc%Perimetry
背景 研究表明,视网膜神经纤维层(RNFL)缺损是青光眼早期损害的重要表现,如何准确地定量检测RNFL的厚度变化是青光眼早期诊断及监测青光眼病情进展的关键步骤之一.目的 对傅立叶OCT、海德堡激光眼底扫描仪(HRT-Ⅲ)测量青光眼患者的RNFL厚度以及视盘的各项参数进行分析,对二者在青光眼早期诊断中的作用进行临床评价.方法 收集可疑开角型青光眼(SOAG)患者26例40眼、原发性开角型青光眼(POAG)患者29例48眼以及正常对照组27例48眼.应用傅立叶OCT、HRT-Ⅲ、Humphrey750-ⅰ型全自动视野计对所有研究对象分别进行视盘面积,视杯面积,杯盘面积比,盘沿面积,盘沿容积,视盘上方、下方、颞侧、鼻侧象限的RNFL厚度等参数测定和视野检查,对不同受检者测得的各项参数进行分析和比较,分别与视野平均缺损值做相关分析,评价不同参数对于青光眼RNFL损伤的诊断价值.结果 傅立叶OCT和HTR-Ⅲ检测对正常对照组检查结果均证实RNFL从厚到薄依次为视盘下方、上方、颞侧、鼻侧象限,SOAG组和POAG组RNFL厚度变薄的顺序依次为视盘下方、上方、颞侧、鼻侧象限,各部位厚度改变的差异均有统计学意义(P<0.05),SOAG组和POAG组患者盘沿面积、杯盘面积比、视杯面积、盘沿容积与正常对照组比较.差异均有统计学意义(P<0.05).对3组患者的检测表明,傅立叶OCT与HTR-Ⅲ检测视盘上方象限、下方象限的测定之间存在着正相关关系(r=0.362、r=0.441、r=0.395,P<0.05);2种检查方法所测得3个组视杯容积、视杯面积、盘沿容积、杯盘面积比呈正相关(P<0.05).在POAG组中,傅立叶OCT测得视盘参数中的盘沿面积、盘沿容积、视杯容积、杯盘面积比与视野的平均缺损值间的相关系数分别为0.284、0.286、0.340、0.371(P<0.05);HRT-Ⅲ测得视盘参数中的盘沿面积、盘沿容积、杯盘面积比与视野的平均缺损值间的相关系数分别为0.339、0.859、0.422(P<0.05).结论傅立叶OCT和HRT-Ⅲ检测的视盘参数结果接近,且均与视野的平均缺损值有较好的相关性;所检测杯盘面积比、盘沿面积和视盘上方象限、下方象限的RNFL厚度的改变在青光眼早期诊断中均有重要价值.
揹景 研究錶明,視網膜神經纖維層(RNFL)缺損是青光眼早期損害的重要錶現,如何準確地定量檢測RNFL的厚度變化是青光眼早期診斷及鑑測青光眼病情進展的關鍵步驟之一.目的 對傅立葉OCT、海德堡激光眼底掃描儀(HRT-Ⅲ)測量青光眼患者的RNFL厚度以及視盤的各項參數進行分析,對二者在青光眼早期診斷中的作用進行臨床評價.方法 收集可疑開角型青光眼(SOAG)患者26例40眼、原髮性開角型青光眼(POAG)患者29例48眼以及正常對照組27例48眼.應用傅立葉OCT、HRT-Ⅲ、Humphrey750-ⅰ型全自動視野計對所有研究對象分彆進行視盤麵積,視杯麵積,杯盤麵積比,盤沿麵積,盤沿容積,視盤上方、下方、顳側、鼻側象限的RNFL厚度等參數測定和視野檢查,對不同受檢者測得的各項參數進行分析和比較,分彆與視野平均缺損值做相關分析,評價不同參數對于青光眼RNFL損傷的診斷價值.結果 傅立葉OCT和HTR-Ⅲ檢測對正常對照組檢查結果均證實RNFL從厚到薄依次為視盤下方、上方、顳側、鼻側象限,SOAG組和POAG組RNFL厚度變薄的順序依次為視盤下方、上方、顳側、鼻側象限,各部位厚度改變的差異均有統計學意義(P<0.05),SOAG組和POAG組患者盤沿麵積、杯盤麵積比、視杯麵積、盤沿容積與正常對照組比較.差異均有統計學意義(P<0.05).對3組患者的檢測錶明,傅立葉OCT與HTR-Ⅲ檢測視盤上方象限、下方象限的測定之間存在著正相關關繫(r=0.362、r=0.441、r=0.395,P<0.05);2種檢查方法所測得3箇組視杯容積、視杯麵積、盤沿容積、杯盤麵積比呈正相關(P<0.05).在POAG組中,傅立葉OCT測得視盤參數中的盤沿麵積、盤沿容積、視杯容積、杯盤麵積比與視野的平均缺損值間的相關繫數分彆為0.284、0.286、0.340、0.371(P<0.05);HRT-Ⅲ測得視盤參數中的盤沿麵積、盤沿容積、杯盤麵積比與視野的平均缺損值間的相關繫數分彆為0.339、0.859、0.422(P<0.05).結論傅立葉OCT和HRT-Ⅲ檢測的視盤參數結果接近,且均與視野的平均缺損值有較好的相關性;所檢測杯盤麵積比、盤沿麵積和視盤上方象限、下方象限的RNFL厚度的改變在青光眼早期診斷中均有重要價值.
배경 연구표명,시망막신경섬유층(RNFL)결손시청광안조기손해적중요표현,여하준학지정량검측RNFL적후도변화시청광안조기진단급감측청광안병정진전적관건보취지일.목적 대부립협OCT、해덕보격광안저소묘의(HRT-Ⅲ)측량청광안환자적RNFL후도이급시반적각항삼수진행분석,대이자재청광안조기진단중적작용진행림상평개.방법 수집가의개각형청광안(SOAG)환자26례40안、원발성개각형청광안(POAG)환자29례48안이급정상대조조27례48안.응용부립협OCT、HRT-Ⅲ、Humphrey750-ⅰ형전자동시야계대소유연구대상분별진행시반면적,시배면적,배반면적비,반연면적,반연용적,시반상방、하방、섭측、비측상한적RNFL후도등삼수측정화시야검사,대불동수검자측득적각항삼수진행분석화비교,분별여시야평균결손치주상관분석,평개불동삼수대우청광안RNFL손상적진단개치.결과 부립협OCT화HTR-Ⅲ검측대정상대조조검사결과균증실RNFL종후도박의차위시반하방、상방、섭측、비측상한,SOAG조화POAG조RNFL후도변박적순서의차위시반하방、상방、섭측、비측상한,각부위후도개변적차이균유통계학의의(P<0.05),SOAG조화POAG조환자반연면적、배반면적비、시배면적、반연용적여정상대조조비교.차이균유통계학의의(P<0.05).대3조환자적검측표명,부립협OCT여HTR-Ⅲ검측시반상방상한、하방상한적측정지간존재착정상관관계(r=0.362、r=0.441、r=0.395,P<0.05);2충검사방법소측득3개조시배용적、시배면적、반연용적、배반면적비정정상관(P<0.05).재POAG조중,부립협OCT측득시반삼수중적반연면적、반연용적、시배용적、배반면적비여시야적평균결손치간적상관계수분별위0.284、0.286、0.340、0.371(P<0.05);HRT-Ⅲ측득시반삼수중적반연면적、반연용적、배반면적비여시야적평균결손치간적상관계수분별위0.339、0.859、0.422(P<0.05).결론부립협OCT화HRT-Ⅲ검측적시반삼수결과접근,차균여시야적평균결손치유교호적상관성;소검측배반면적비、반연면적화시반상방상한、하방상한적RNFL후도적개변재청광안조기진단중균유중요개치.
Background Many studies showed that attenuation of retinal nerve fiber layer(RNFL)in early glaucoma is one of the important signs.How to accurately and quantitatively measure RNFL thickness is very important for the early diagnosis and monitoring of glaucoma.0bjective This study was to evaluate the clinical value of Optovue RTVue OCT and Heidelberg Retina Tomograph Ⅲ(HRT-Ⅲ)confocal scanning laser ophthalmoscopy in glaucomatous eyes. Methods This cross-sectional study included 40 eyes of 26 patients with suspected open-angle glaucoma(SOAG),48 eyes of 29 patients with open-angle glaucoma and 48 eyes of 27 healthy subjects.Optical nerve head(ONH) parameters and peripapillary RNFL thickness were measured in all the subjects with Optovue RTVue OCT and HRT-Ⅲ,meanwhile all the eyes received perimetry with Humphrey 750-I.Glaucoma variables obtained from Optovue RTVue OCT and HRT-Ⅲ were analyzed among the groups.Topographic Optovue RTVue OCT and HRT-Ⅲ parameters,including disc area(DA),cup area(CA),rim area(RA),rim volume(RV),cup volume(CV),cup/disc area ratio(C/DAR)as well as superior,temporal,inferior and nasal average RNFL thickness,were analyzed.The relationship of ONH parameters and RNFL thickness was analyzed using a linear correlation.The correlation between the mean defect(MD)of the visual field and the tomography parameters in glaucomatous eyes was described by bivariate Pearson correlation coefficients.Resuits The ONH parameters and RNFL thickness obtained by HRT-Ⅲ and OCT showed significant difference(P<0.05).ONH parameters such as RA,C/DAR,CA and RV were statistically changed in SOAG and the POAG patients compared with the normal subjects(q=6.47,q=7.67,P<0.05).The superior and inferior RNFL thickness parameters in three groups were positively correlated between HRT-Ⅲand OCT(r=0.362,r=0.441,r=0.395,P<0.05),Topographic Optovue RTVue OCT and HRT-Ⅲ parameters including CV,CA,RA and C/DAR fitted Pearson analysis(all P<0.05).In POAG group。The RA,RV,CV,C/DAR from Optovue RTVue OCT were correlated with MD with the significant coefficient 0.284,0.286,0.340,0.371 respectively(P<0.05),and evidently correlations also were found between RA,RV,C/DAR with MD respectively with the coefficient 0.339,0.859,0.422(P<0.05)by HRT-Ⅲ. Conclusion Both Optovue RTVue OCT and HRT-Ⅲ can difierentiate ONH analysis with a similar outcome in glaucomatous eye.The C/D value.RA,superior and inferior RNFL thickness based on Optovue RTVue OCT and HRT-Ⅲare distinguishing indexes in the diagnosis of early glaucomatous damage.
