应用海德堡视网膜断层扫描仪对高眼压症视盘结构参数的测定

The application of the HRT in detecting stereometric parameters of optic nerve head of ocular hypertension

目的应用海德堡视网膜断层扫描仪（HRT）对高眼压症患者视盘结构进行测试，观察眼压大于25mmHg和小于25mmHg的高眼压症视盘结构参数的异同。方法对27例（50只眼）高眼压症患者和27名（50只眼）正常人进行HRT检查，并将高眼压症患者分为眼压≥25mmHg（23只眼）。和眼压〈25mmHg（27只眼）两组。将获得的视盘结构参数分为三组进行比较：①高眼压症眼与正常眼②眼压≥25mmHg和〈25mmHg的高眼压症眼。③眼压25mmHg的高眼压症眼与正常眼。结果高眼压症眼与正常眼比较视盘参数中盘沿面积、盘沿体积、最大杯深、轮廓线高度变化值、神经纤维截面面积差异有显著性（P〈0.05）：眼压大于和小于25mmHg的高眼压症眼比较盘沿面积、盘沿体积、平均网膜神经纤维层厚度、神经纤维截面面积差异有显著性（P〈0．05）；眼压〈25mmHg的高眼压症眼与正常眼比较各视盘参数间差异无显著性（P〉0．05）。结论眼压〈25mmHg高眼压症的HRT视盘结构无明显变化，而眼压≥25mmHg高眼压症的HRT视盘结构参数中盘沿面积、盘沿体积、平均视网膜神经纤维层厚度及神经纤维截面面积发生了较明显改变，这四个参数可作为诊断早期青光眼的重要参考指标。

Objective By being detected stereometric parameters of optic nerve head of ocular hypertension in HRT, their differences and similarities can found between the ocular hypertension（OHT） eyes of lOP≥ 25mmHg and IOP〈25mmHg.Methods Fifty eyes of 27 patients with ocular hypertension and fifty eyes of 27 patients normal people were examined using HRT. The patients of ocular hypertension were divided into two groups of lOP≥ 25mmHg and IOP〈25mmHg. The stereometric parameters of optic nerve head were then divided into three groups, and compare the results. ①the OHT eyes and normal eyes②the OHT eyes of lOP≥ 25mmHg and IOP〈25mmHg ③the OHT eyes of IOP〈25mmHg and normal eyes. Results There were remarkable differences in optic disc parameters （RA, RV, MaxCD, HVC, RNFLcsa） between the OHT eyes and normal eyes （P〈0.05）; There were remarkable differences in optic disc parameters （RA, RV, MRNFL, RNFLcsa） between the OHT eyes of lOP≥ 25mmHg and IOP〈25mmHg （P 〈0.05 ）; There were no remarkable differences in optic disc parameters between the OHT eyes of IOP〈25mmHg and normal eyes （P 〉0.05）. Conclusions There were no obvious changes in stereometric of optic disc of the OHT eyes of IOP〈25mmHg, whreas there were obvious changes in the stereometric parameters（RA, RV, MRNFL, RNFLcsa） of the OHT eyes of lOP≥ 25mmHg. The four parameters can be regarded as the important index of early Glaucoma.