实用临床医学
實用臨床醫學
실용림상의학
Practical Clinical Medicine
2015年
5期
65-68
,共4页
频域OCT%视网膜神经纤维层厚度%青光眼%诊断
頻域OCT%視網膜神經纖維層厚度%青光眼%診斷
빈역OCT%시망막신경섬유층후도%청광안%진단
optical coherence tomography%retinal nerve fiber layer thickness%glaucoma%diagnosis
目的：探讨频域光学相干断层扫描（OCT）对发现和诊断早期青光眼的应用价值。方法将84例（160眼）行眼底视乳头 OCT 检查的患者按检查结果分为3组：疑似青光眼组（SG 组，34例，68眼）、确诊青光眼早中期组（DG 早中期组，40例，72眼）和正常组（10例，20只眼）。分别对各组采集的各象限（颞侧、上方、鼻侧、下方）视神经纤维层（RNFL）厚度、平均 RNFL、视盘参数（水平及垂直杯盘比、杯／盘面积比）的数据进行比较；将 OCT 测得的各组眼的平均 RNFL 厚度值与视野平均缺损（MD）进行直线相关性分析。结果SG 组下方、上方象限及平均 RNFL厚度，DG 早中期组下方、上方、鼻侧、颞侧象限及平均 RNFL 厚度均明显低于正常组（均 P ＜0．05）；SG 组鼻侧、颞侧 RNFL 厚度与正常组比较差异均无统计学意义（均 P ＞0．05）。DG 早中期组各象限（上方、下方、鼻侧）及平均RNFL 厚度明显低于 SG 组（均 P ＜0．05）；颞侧 RNFL 厚度比较差异无统计学意义（P ＞0．05）。DG 早中期组及SG 组的水平及垂直杯盘比、杯／盘面积较正常组明显变大（均 P ＜0．05）。各组的平均 RNFL 厚度值与 MD 呈高度正相关（r＝0．703，P ＝0．00）。结论频域 OCT 能直观、精确地以图像及数据的方式显示视神经病变的微观层面，能检测出视野损害前的早期青光眼 RNFL 局限性损害，具有简便、非侵入性、重复性好、可长期随访等特点，有利于对青光眼患者的早期诊断。
目的：探討頻域光學相榦斷層掃描（OCT）對髮現和診斷早期青光眼的應用價值。方法將84例（160眼）行眼底視乳頭 OCT 檢查的患者按檢查結果分為3組：疑似青光眼組（SG 組，34例，68眼）、確診青光眼早中期組（DG 早中期組，40例，72眼）和正常組（10例，20隻眼）。分彆對各組採集的各象限（顳側、上方、鼻側、下方）視神經纖維層（RNFL）厚度、平均 RNFL、視盤參數（水平及垂直杯盤比、杯／盤麵積比）的數據進行比較；將 OCT 測得的各組眼的平均 RNFL 厚度值與視野平均缺損（MD）進行直線相關性分析。結果SG 組下方、上方象限及平均 RNFL厚度，DG 早中期組下方、上方、鼻側、顳側象限及平均 RNFL 厚度均明顯低于正常組（均 P ＜0．05）；SG 組鼻側、顳側 RNFL 厚度與正常組比較差異均無統計學意義（均 P ＞0．05）。DG 早中期組各象限（上方、下方、鼻側）及平均RNFL 厚度明顯低于 SG 組（均 P ＜0．05）；顳側 RNFL 厚度比較差異無統計學意義（P ＞0．05）。DG 早中期組及SG 組的水平及垂直杯盤比、杯／盤麵積較正常組明顯變大（均 P ＜0．05）。各組的平均 RNFL 厚度值與 MD 呈高度正相關（r＝0．703，P ＝0．00）。結論頻域 OCT 能直觀、精確地以圖像及數據的方式顯示視神經病變的微觀層麵，能檢測齣視野損害前的早期青光眼 RNFL 跼限性損害，具有簡便、非侵入性、重複性好、可長期隨訪等特點，有利于對青光眼患者的早期診斷。
목적：탐토빈역광학상간단층소묘（OCT）대발현화진단조기청광안적응용개치。방법장84례（160안）행안저시유두 OCT 검사적환자안검사결과분위3조：의사청광안조（SG 조，34례，68안）、학진청광안조중기조（DG 조중기조，40례，72안）화정상조（10례，20지안）。분별대각조채집적각상한（섭측、상방、비측、하방）시신경섬유층（RNFL）후도、평균 RNFL、시반삼수（수평급수직배반비、배／반면적비）적수거진행비교；장 OCT 측득적각조안적평균 RNFL 후도치여시야평균결손（MD）진행직선상관성분석。결과SG 조하방、상방상한급평균 RNFL후도，DG 조중기조하방、상방、비측、섭측상한급평균 RNFL 후도균명현저우정상조（균 P ＜0．05）；SG 조비측、섭측 RNFL 후도여정상조비교차이균무통계학의의（균 P ＞0．05）。DG 조중기조각상한（상방、하방、비측）급평균RNFL 후도명현저우 SG 조（균 P ＜0．05）；섭측 RNFL 후도비교차이무통계학의의（P ＞0．05）。DG 조중기조급SG 조적수평급수직배반비、배／반면적교정상조명현변대（균 P ＜0．05）。각조적평균 RNFL 후도치여 MD 정고도정상관（r＝0．703，P ＝0．00）。결론빈역 OCT 능직관、정학지이도상급수거적방식현시시신경병변적미관층면，능검측출시야손해전적조기청광안 RNFL 국한성손해，구유간편、비침입성、중복성호、가장기수방등특점，유리우대청광안환자적조기진단。
ABSTRACT:Objective To investigate the value of optical coherence tomography (OCT)in the early diagnosis of glaucoma.Methods A total of 84 patients (160 eyes)who received the OCT of optic nerve head were divided into three groups:suspected glaucoma (SG group,34 patients,68 eyes),early-to-mid stages of definite glaucoma (DG group,40 patients,72 eyes),and healthy eyes (normal group,10 patients,20 eyes).The retinal nerve fiber layer (RNFL)thickness in 4 quad-rants (temporal,superior,nasal,and inferior),average RNFL thickness and optic disc parameters (horizontal and vertical cup/disc ratios,and cup/disc area ratio)were compared among the three groups.In addition,the correlation between the average RNFL thickness and the mean visual field defect (MD)was analyzed.Results Compared with normal group,the inferior,superior and aver-age RNFL thickness decreased,but the horizontal and vertical cup/disc ratios and cup/disc area ratio increased in SG group (P <0.05).No significant differences in the nasal and temporal RNFL thickness were found between normal group and SG group (P >0.05).Furthermore,compared with normal group,the inferior,superior,nasal,temporal and average RNFL thickness decreased, but the horizontal and vertical cup/disc ratios and cup/disc area ratio increased in DG group (P <0.05).Compared with SG group,the inferior,superior,nasal and average RNFL thickness de-creased in DG group (P <0.05).No significant difference in the temporal RNFL thickness was found between DG group and SG group (P >0.05).The average RNFL thickness was positively correlated with MD (r=0.703,P =0.00).Conclusion OCT can intuitively and accurately display optic nerve lesion at the micro level by forming images and data,and find localized RNFL injury before visual field damage.Moreover,OCT is a simple,non-invasive and repeatable procedure and allows long-term follow-up in patients with glaucoma.Therefore,OCT is conducive to early diag-nosis of glaucoma.
