早期开角型青光眼OCT最佳诊断参数的研究

The best parameters in retinal nerve fiber layer thickness measured by optical coherence tomography in the early stage of glaucoma

目的探讨光学相干断层扫描(opticalcoherencetomography,OCT)在早期开角型青光眼(primaryopenangle glaucoma,POAG)神经纤维层(retinalnervefiberlayer,RNFL)检查中的最佳诊断参数。方法纳入200409-200507大坪医院野战外科研究所眼科被临床诊断为早期POAG患者119眼和易与OCT结果混淆的对照组148眼。采用Stratus OCT3000成像仪,RNFLT3.4程序检测。采用SPSS11.0的统计分析及建立受试者工作曲线(ROC)曲线。结果ROC曲线下面积最大并与机会对角线有显著性差异(α<0.05)的9个参数,分别是钟点位的7、6、11及上、下象限和自定义的Imax、Savg、Iavg和Avg.thick;误诊率大于10%的参数是钟点位1、2、3、4,和象限的鼻侧及自定义的Smax/Imax、Smax/Tavg、Imax/Tavg。结论本研究提示OCT最佳诊断参数是钟点位6、7、11,上、下象限和自定义参数Imax、Savg、Iavg和Avg.thick。

Objective To determine the characteristics and the best parameters of the retinal nerve fiber layer （RNFL） thickness measured by optical coherence tomography （OCT） in the early diagnosis of primary open angle glaucoma （POAG）. Methods The thickness of RNFL was quantified by OCT （Carl Zeiss Meditec, Stratus OCT3000 version 3, RNFL3.4） in 71 POAGs（ 119 eyes） and 76 controls（ 148 eyes）. Resulks The 9 OCT parameters with the largest AUCs and asymptatic significance less than 0.05 in ROC curve in the early diagnosis of primary open angle glaucoma （POAG） were thickness of 6, 7, 11 o＇clock position, inferior, superior, average thickness, inferior maximum, superior average, inferior average. Conclusion In early stage of glaucoma, the thickness of RNFL measured by OCT provides a new index for the diagnosis of glaucoma. The best parameters seem to 6, 7, 11 o＇clock position, inferior, superior, average thickess, inferior maximum, superior average, inferior average.