正常人视盘、视杯形态及盘周神经纤维层光学相干断层定量检测

Quantification of disk area,disk cup and the retinal nerve fiber layer thickness measurements obtained by optical coherence tomography on normal eyes

目的:观察光学相干断层扫描仪检测正常人视盘、视杯形态及盘周视网膜神经纤维层厚度。方法:应用CarlZeiss公司Humphrey2000型光学相干断层扫描仪检查系统对80例单侧眼病患者的80只正常对侧眼进行视盘"十字交叉"和"环形"扫描,分别测量视盘、视杯的直径,视杯深度,以及盘周视网膜神经纤维层厚度,计算杯盘比值及面积,统计各参数的平均值。结果:用视盘横纵扫描方法测量结果为:视盘纵扫直径为1.60±0.22mm,横扫直径为1.40±0.15mm,平均直径为1.50±0.22mm;视盘扫描平均面积为1.77±0.53mm2。视杯纵扫直径为0.54±0.22mm,视杯横扫直径为0.52±0.24mm,平均直径为0.54±0.23mm;视杯扫描平均面积为0.26±0.20mm2;正常人杯盘直径比纵扫为0.34±0.13,杯盘直径比横扫为0.38±0.15,平均为0.36±0.14;杯盘面积比平均为0.15±0.11。视杯深度纵扫为0.31±0.14mm,横扫为0.27±0.14mm,平均为0.29±0.14mm。用视盘周围环扫方法测量的盘周神经纤维层厚度结果:颞侧为95.57±17.63μm,上方为144.17±18.98μm,鼻侧为99.00±28.13μm,下方为155.53±18.65μm。结论:光学相干断层检测能做出视盘及视杯的定量测量和分析,得到的正常值范围可作为前部缺血性视神经病变、青光眼性视神经损害等视神经疾病临床观察的参考。

AIM： To quantitatively assess the normal reference values for optic disc, cup and per-papillary retinal nerve fiber layer （RNFL） thickness with optical coherence tomography （OCT） on normal eyes. METHODS： Eighty normal eyes in 80 normal subjects （47 males and 33 females） confirmed after routine ophthalmic examination were examined with OCT 2000, except for physiologically small disc and large disc and so on. Focusing on the horizontal and vertical planes crossing the optic disc, 360°circular scans with a diameter 3.46mm centered on the optic disc were obtained in each scanning. The diameter of disc and cup, optic nerve head disc area, cOp area, depth of cup and thickness of the RNFL were measured by manual method, The C/D ratio and the average area of disc and cup were calculated in normal control subjects. RESULTS： The morphological characteristics of optic disc, cup and the normal value range were analyzed.With OCT images, the diameters of disc in the horizontal and vertical were 1.60±0.22mm and 1.40±0.15mm, respectively, with the average of 1.50±0.22mm. The vertical diameter of cup was 0.54±0.22mm, and the horizontal diameter of cup was 0.53± 0.24mm, with the average diameter of 0.54±0.23. The C/D ratio 0.34±0.13 in the horizontal plane and 0.38±0.15 in the vertical plane. The depths of cup were 0.31±0.14mm and 0.27±0.14mm in the horizontal and vertical plane, with the average of 0.29±0.14mm. The thicknesses of nerve fiber layer of retina infra were 95.57 ±17.63μ m temporal,144.17 ±18.98μm superior, 99.00 ±28.13μ m nasal and 155.53 ± 18.65μm inferior. OONCLUSION： The measurement with OCT in clinical observation can obtain the quantification of disk area and disk disk, The reference average indexes of disc and cup can help the reorganization of the damage changes of optic disc and cup in anterior ischemic optic neuropathy （AION） and glaucomatous optic atrophy.