CAJ | 학술논문

目的观察视野前青光眼(PPG)患者视盘参数和黄斑神经节细胞复合体(GCC)结构的变化.方法检查确诊的PPG患者18例18只眼(PPG组)、原发性开角型青光眼(POAG)患者22例22只眼(POAG组)、生理性大视杯者20例20只眼(生理性大杯组)纳入研究.随机选取同期健康自愿者为正常组.采用傅里叶域光相干断层扫描对所有受检者的视盘和黄斑区进行扫描,测量视盘平均、上方、下方、颞上、颞下、鼻上、鼻下、颞侧偏上、颞侧偏下、鼻侧偏上、鼻侧偏下象限的神经纤维层厚度(RNFL),视盘盘沿容积(RV)、视盘容积(NHV)、视盘面积(ODA)、盘沿面积(RA)、视杯容积(CV)、杯盘面积比(CDAR)、垂直杯盘比(VCDR)、水平杯盘比(HCDR)及视杯面积(CA)等参数以及黄斑GCC、上方GCC、下方CGG厚度和局部丢失体积(FLV)、整体丢失体积(GLV)值.比较各组间上述参数的差异.结果 PPG组较正常组颞上、颞下、颞侧偏上、颞侧偏下、上方、下方及平均RNFL厚度减少,差异有统计学意义(P＜0.05).PPG组鼻侧偏上的RNFL厚度较POAG组RNFL厚度增加,差异有统计学意义(P＜0.05).PPG组患眼RNFL厚度与POAG组相比,颞上、颞下、颞侧偏上、上方、下方、平均RNFL厚度减少,差异有统计学意义(P＜0.05).PPG组RV、NHV、ODA、RA较正常对照组均减少,差异有统计学意义(P＜0.05);CV、CDAR、VCDR、HCDR、CA较正常对照组均增大,差异有统计学意义(P＜0.05).PPG组各视盘参数与POAG组比较,差异均无统计学意义(P＞0.05).PPG组与生理性大视杯组比较,RV、NHV、ODA、RA均减少,CV、CDAR、HCDR、VCDR及CA均增加.CDAR、VCDR、RA差异有统计学意义(P＜0.05).PPG组与正常组比较,平均黄斑GCC、下方GCC、上方GCC厚度均降低,GLV、FLV值均增大,差异均有统计学意义(P＜0.05).PPG与平均黄斑GCC、下方GCC、上方GCC厚度与POAG组比较,差异均无统计学意义(P＞0.05).PPG组与生理性大视杯组比较,黄斑平均GCC、上方GCC、下方GCC均变薄,GLV、FLV值均增大,差异均有统计学意义(P＜0.05).结论 PPG患者RA、NHA、ODA、RV、黄斑GCC值较正常人、生理性大视杯者减小;与POAG者无明显差异. 目的觀察視野前青光眼(PPG)患者視盤參數和黃斑神經節細胞複閤體(GCC)結構的變化.方法檢查確診的PPG患者18例18隻眼(PPG組)、原髮性開角型青光眼(POAG)患者22例22隻眼(POAG組)、生理性大視杯者20例20隻眼(生理性大杯組)納入研究.隨機選取同期健康自願者為正常組.採用傅裏葉域光相榦斷層掃描對所有受檢者的視盤和黃斑區進行掃描,測量視盤平均、上方、下方、顳上、顳下、鼻上、鼻下、顳側偏上、顳側偏下、鼻側偏上、鼻側偏下象限的神經纖維層厚度(RNFL),視盤盤沿容積(RV)、視盤容積(NHV)、視盤麵積(ODA)、盤沿麵積(RA)、視杯容積(CV)、杯盤麵積比(CDAR)、垂直杯盤比(VCDR)、水平杯盤比(HCDR)及視杯麵積(CA)等參數以及黃斑GCC、上方GCC、下方CGG厚度和跼部丟失體積(FLV)、整體丟失體積(GLV)值.比較各組間上述參數的差異.結果 PPG組較正常組顳上、顳下、顳側偏上、顳側偏下、上方、下方及平均RNFL厚度減少,差異有統計學意義(P＜0.05).PPG組鼻側偏上的RNFL厚度較POAG組RNFL厚度增加,差異有統計學意義(P＜0.05).PPG組患眼RNFL厚度與POAG組相比,顳上、顳下、顳側偏上、上方、下方、平均RNFL厚度減少,差異有統計學意義(P＜0.05).PPG組RV、NHV、ODA、RA較正常對照組均減少,差異有統計學意義(P＜0.05);CV、CDAR、VCDR、HCDR、CA較正常對照組均增大,差異有統計學意義(P＜0.05).PPG組各視盤參數與POAG組比較,差異均無統計學意義(P＞0.05).PPG組與生理性大視杯組比較,RV、NHV、ODA、RA均減少,CV、CDAR、HCDR、VCDR及CA均增加.CDAR、VCDR、RA差異有統計學意義(P＜0.05).PPG組與正常組比較,平均黃斑GCC、下方GCC、上方GCC厚度均降低,GLV、FLV值均增大,差異均有統計學意義(P＜0.05).PPG與平均黃斑GCC、下方GCC、上方GCC厚度與POAG組比較,差異均無統計學意義(P＞0.05).PPG組與生理性大視杯組比較,黃斑平均GCC、上方GCC、下方GCC均變薄,GLV、FLV值均增大,差異均有統計學意義(P＜0.05).結論 PPG患者RA、NHA、ODA、RV、黃斑GCC值較正常人、生理性大視杯者減小;與POAG者無明顯差異.
목적 관찰시야전청광안(PPG)환자시반삼수화황반신경절세포복합체(GCC)결구적변화.방법 검사학진적PPG환자18례18지안(PPG조)、원발성개각형청광안(POAG)환자22례22지안(POAG조)、생이성대시배자20례20지안(생이성대배조)납입연구.수궤선취동기건강자원자위정상조.채용부리협역광상간단층소묘대소유수검자적시반화황반구진행소묘,측량시반평균、상방、하방、섭상、섭하、비상、비하、섭측편상、섭측편하、비측편상、비측편하상한적신경섬유층후도(RNFL),시반반연용적(RV)、시반용적(NHV)、시반면적(ODA)、반연면적(RA)、시배용적(CV)、배반면적비(CDAR)、수직배반비(VCDR)、수평배반비(HCDR)급시배면적(CA)등삼수이급황반GCC、상방GCC、하방CGG후도화국부주실체적(FLV)、정체주실체적(GLV)치.비교각조간상술삼수적차이.결과 PPG조교정상조섭상、섭하、섭측편상、섭측편하、상방、하방급평균RNFL후도감소,차이유통계학의의(P＜0.05).PPG조비측편상적RNFL후도교POAG조RNFL후도증가,차이유통계학의의(P＜0.05).PPG조환안RNFL후도여POAG조상비,섭상、섭하、섭측편상、상방、하방、평균RNFL후도감소,차이유통계학의의(P＜0.05).PPG조RV、NHV、ODA、RA교정상대조조균감소,차이유통계학의의(P＜0.05);CV、CDAR、VCDR、HCDR、CA교정상대조조균증대,차이유통계학의의(P＜0.05).PPG조각시반삼수여POAG조비교,차이균무통계학의의(P＞0.05).PPG조여생이성대시배조비교,RV、NHV、ODA、RA균감소,CV、CDAR、HCDR、VCDR급CA균증가.CDAR、VCDR、RA차이유통계학의의(P＜0.05).PPG조여정상조비교,평균황반GCC、하방GCC、상방GCC후도균강저,GLV、FLV치균증대,차이균유통계학의의(P＜0.05).PPG여평균황반GCC、하방GCC、상방GCC후도여POAG조비교,차이균무통계학의의(P＞0.05).PPG조여생이성대시배조비교,황반평균GCC、상방GCC、하방GCC균변박,GLV、FLV치균증대,차이균유통계학의의(P＜0.05).결론 PPG환자RA、NHA、ODA、RV、황반GCC치교정상인、생이성대시배자감소;여POAG자무명현차이.
Objective To observe the changes of glaucoma optic nerve head (ONH) parameters and macular ganglion cell complex (GCC) structure in preperimetric glaucoma (PPG) patients.Methods Eighteen PPG patients (18 eyes,PPG group),22 primary open-angle glaucoma (POAG) patients (22 eyes,POAG group),and 20 patients (20 eyes) with physiologic large optic cup (physiological big optic cup group) were included in this study.Seventeen healthy volunteers (17 eyes) were the normal control.The optic nerve head and macular was scanned by fourier-domain optic coherence tomography (FD-OCT) for all subjects.The following 15 parameters,including nerve fiber layer thickness (RNFL),the optic disk rim volume (RV),optic nerve head volume (NHV),optic disc area (ODA),rim area (RA),cup volume (CV),cup/disc area ratio (CDAR),vertical cup/disc ratio (VCDR),horizontal cup/disc ratio (HCDR) and optic cup area (CA),macular GCC,superior GCC,inferior GCC thickness,focal loss of volume (FLV) and global loss of volume (GLV),were measured at 10 different quadrants.The relationship between macular GCC thickness or optic disc RNFL thickness and RA was analyzed by simple linear regression analysis.Results The RNFL thickness of PPG patients was (99.29±19.93) μm (superior quadrant),(97.29±22.86) μm (inferior),(114.61±15.64) μm (superior temporal,ST),(119.22±26.19) μm (inferior temporal,IT),(116.11±39.32) μm (superior nasal,SN),(111.33±37.65) μm (inferior nasal,IN),(77.56±17.22) μm (temporal upper,TU),(76.78±10.34) μm (temporal lower,TL),(88.94± 42.54) μm (nasal upper,NU),and (82.33±43.83) μm (nasal lower,NL) respectively,which was thinner than normal control group and physiologic large cup group,but thicker than POAG patients.Compared to normal controls and physiologic large cup patients,PPG patients also had 4 parameters reduced (RV,NHV,ODA and RA),and 5 parameters increased (CV,CDAR,VCDR,HCDR and CA),the differences are statistically significant (P＜0.05).However,these parameters were similar to POAG patients (P＞ 0.05).For macular GCC parameters,PPG patients also had 3 parameters reduced (average GCC,superior and inferior GCC thickness),and 2 parameters increased (GLV and FLV) compared to normal control group and physiologic large cup patients (P＜0.05).However,these parameters were similar to POAG patients (P＞0.05).Simple linear regression analysis showed that,with the GCC macular thinning,reducing the number of ganglion cells reduced,optic disc RNFL thickness became thinner (regression coefficient=1.25,P=0.00) and RV reduced (regression coefficient =0.037,P =0.00).Conclusions PPG patients and normal control had a similar distribution of optic disc RNFL.Five parameters (RV,NHV,ODA,RA,macular GCC thickness) were less than normal control and physiological big optic cup group,but had no significant differences compared with POAG group.