光学相干断层成像术测量视网膜神经纤维层厚度在青光眼早期诊断中的意义

Significance of retinal nerve fiber layer thickness measured by optical coherence tomography in the early diagnosis of glaucoma

目的:探讨光学相干断层成像术(optical coherence tomography,OCT)测量视网膜神经纤维层厚度(retinal nerve fiber layer,RNFL)在青光眼早期诊断中的意义。方法:应用OCT测量正常人62例101眼和青光眼患者41例64眼的RNFL厚度,将正常人和青光眼患者的各象限和平均RNFL厚度进行比较;并比较各期青光眼的RNFL厚度;计算平均RNFL厚度和视野平均缺损的相关性,计算OCT测量平均RNFL厚度的敏感性和特异性。结果:青光眼患者和早期青光眼患者的各象限和平均RNFL厚度均比正常人减少,差异有统计学意义(P<0.05)。随着青光眼病程的发展,RNFL厚度逐渐下降。平均RNFL厚度和视野平均缺损呈高度正相关(r=0.722,P=0.000),OCT测量平均RNFL厚度的敏感性为85.9%,特异性为97.0%。结论:OCT测量RNFL厚度为青光眼早期诊断提供了一种新的手段。

AIM： To evaluate the significance of the retinal nerve fiber layer （RNFL） thickness measured by optical coherence tomography（OCT） in the early diagnosis of glaucoma. METHODS： The thickness of RNFL was measured by OCT in 41 patients with glaucoma （64 eyes） and 62 normal subjects （101 eyes）. Comparisons were made with regard to the RNFL thickness of quadrants and in means between normal and glaucomatous group, and the thickness at different stages of glaucoma. The correlation between mean RNFL thickness and mean defect of visual field, and the sensitivity and specificity of mean RNFL thickness measured by OCT were calculated. RESULTS： There was significant difference of RNFL thickness in various quadrants and in means between normal and glaucomatous group （P 〈0.05）. With the course of glaucoma proceeding, RNFL thickness decreased. The mean RNFL thickness was highly positively correlated with mean defect of visual field （r =0.722, P = 0.000）. The sensitivity and specificity of mean RNFL thickness measured by OCT were 85.9% and 97.0% respectively. CONCLUSION： RNFL thickness measured by OCT provides a new method for early diagnosis of glaucoma.