生理性大视杯视盘形态结构参数的研究

Study on morphosis parameter of the optic disc of physiologic large cup

目的观察生理性大视杯视盘的结构参数特征。方法海德堡断层扫描仪对100只生理性大视杯眼和74只正常视杯眼的视盘进行断层扫描，对比分析两组之间视盘面积、视杯面积、杯盘面积比、盘沿面积、视杯容积、盘沿容积、平均杯深、最大杯深、杯形测量、轮廓线高度变化、平均视网膜神经纤维层厚度、视网膜神经纤维层横截面积等视盘结构参数差异，分析生理性大视杯眼视盘上方、下方、鼻侧、颞侧4个象限的特征。结果生理性大视杯眼视盘面积、视杯面积、杯盘面积比、视杯容积、平均视杯深度、杯形测量、最大视杯深度测量值均显著大于正常视杯眼；轮廓线高度变化、平均视网膜神经纤维层厚度、视网膜神经纤维层横截面积测量值显著小于正常视杯眼。盘沿面积鼻侧大于上方，盘沿容积颞侧显著小；视网膜神经纤维层横截面积测量值按上、下、鼻、颞侧递减。结论生理性大视杯视盘结构参数特征表现为视盘面积显著大于正常视杯眼，盘沿面积鼻侧大于上方；平均视网膜神经纤维层厚度较正常视杯眼薄。

Objective To observe the characteristics of morphosis parameter of the optic disc of physiologic large cup. Methods 100 eyes with physiologic large cup and 74 eyes with normal cup were examined by Heidelberg Retina Tomograph （HRT）. The differences of morphosis parameters between two groups were analyzed comparatively on disc area （DA）, cup volume （CV）, cup/disc area ratio （C/DR）, rim area （RA）, cup volume （CV）, rim volume （RV）, mean cup depth （MeCD）, maximum cup depth （MxCD）, cup shape measure （CSM）, height variation contour （HVC）, mean retinal nerve fiber layer thickness （mRNFLt）, and retinal nerve fiber layer cross-section area （RNFLcsa）. The characteristics of the inferior, superior, nasal, and temporal quadrants of the physiologic large cups were analyzed. Results DA, CA, C/DR, CV, MeCD, CSM （P=0.00, respectively）and MxCD （P=0.04）were significantly larger in eyes with physiologic large cup than in eyes with normal cup. RA, RV, HVC, mRNFLt, RNFLcsa （P=0.00, respectively） were significantly smaller in eyes with physiologic large cup than in eyes with normal cup. The temporal quadrant of RV of the physiologic large cup is the narrowest. RNFLcsa decreased as the following order： superior, inferior, nasal, and temporal （P 〈 0. 05 ）. Conclusions Morphosis parameter of the optic discs of physiologic large cup has its own representation on characteristics. Compared to normal cups, physiologic large cups had larger discs but smaller mRNFLt. The nasal quadrant of DA was larger than the inferior quadrant.