正常眼与原发性开角型青光眼的OCT视盘参数分析的对比研究

Comparing glaucomatous optic neuropathy in primary open angle by optical coherence tomography

目的使用OCT评估正常眼与原发性开角型青光眼(primary open angle glaucoma,POAG)视盘(opticnerve head,ONH)的差异。方法选择具有青光眼性视神经损害或RNFL缺损、相应的视野缺损的开角型青光眼60例(60只眼),另选择正常眼60例(60只眼)作为正常对照组。对二组患者进行详细的眼科检查,并使用光学相干断层扫描仪(optical coherence tomography,OCT)测定视盘形态。OCT检查采用视盘扫描模式,评估数据包括视盘面积、视杯面积、盘沿面积、垂直盘沿面积(vertical integrated rim area,VIRA)、水平盘沿容积、平均杯盘比、水平和垂直杯盘比以及视杯容积。比较二组视盘参数,并比较平均误差(mean deviation,MD)和校正模型标准变异(correc-ted pattern standard deviation CPSD)与青光眼组的视盘参数有无相关。结果原发性开角型青和正常组之间视盘参数的比较具有显著性差异。正常眼、POAG比较分别为:视盘面积(211+/-0.5,2.62+/-0.4)mm2,(P<0.01),视杯面积(0.65+/-0.5,1.79+/-0.6)mm2,(P<0.01),盘沿面积(1.44+/-0.4,0.89+/-0.4)mm2,(P<0.01),VIRA(1.53+/-0.4,1.11+/-0.3)mm2,(P<0.01),盘沿容积(0.42+/-0.1,0.26+/-0.1)mm3,(P<0.061),杯盘比(0.31+/-0.2,0.62+/-0.2),(P<0.01)。结论OCT在开角型青光眼的早期诊断中具有重要价值。

Objective To comparatively evaluate the optic nerve head （ONH） using Optical Coherence Tomography （OCT） in normal subjects, primary open angle glaucoma （POAG） patients. Methods A total of 60 normal eyes （60 subjects） and 60.glaucomatous eyes （60 patients） , were evaluated in this cross-sectional observational study. The ONH was imaged on OCT using the optic disc scan. Disc area, cup area, rim area, vertical integrated tim area （VIRA）, rim volume （horizontal imegrated rim volume） , average cup/disc ratio, horizontal and vertical cup/disc ratios, and cup volume ,cup depth were evaluated. These ONH parameters were compared between normal subjects and eyes with early POAG. Correlation of mean deviation and corrected pattern standard deviation on full threshold 30-2 perimetry, with measured ONH parameters was carried out in POAG group. Results There was a significant difference in disc area （211 ＋/- 0.5, 2.62 ＋/- 0.4）mm^2,（P 〈 0. 01） , cup area （ 0. 65 ＋/- 0.5, 1.79 ＋/- 0.6）mm^2,（P 〈 0. 01） , rim area （1. 44 ＋/- 0.4, 0.89 ＋/- 0.4）mm^2,（P 〈 0.01）, VIRA （1.53 ＋/- 0.4, 1.11 ＋/- 0.3）mm^2,（P 〈 0.01）, rim volume （0.42 ＋/- 0.1, 0.26 ＋/- 0.1）mm^3,（P 〈 0.01） and cup/disc ratio （0.31 ＋/- 0.2, 0.62 ＋/- 0. 2）, （ P 〈 0.01 ） in normal vs POAG eyes. Conclusion OCT may serve as a useful diagnostic modality in distinguishing a normal optic disc from a glaucomatous one, even in the early stages of glaucoma.