应用HRT观察原发性开角型青光眼盘沿面积变化情况及其与视野缺损的对应关系

Variation of optic rim area and the consistency between the locations of obvious smaller rim area and obvious damaged visual field in POAG were observed by HRT

目的对原发性开角型青光眼(POAG)患者和正常人盘沿面积进行比较,观察POAG盘沿面积变化特点,探讨POAG盘沿面积变化与视野缺损的对应关系。方法利用海德堡视网膜断层扫描仪(HRT-Ⅱ)和Octo-pus101视野G2程序对29例(50只眼)POAG患者和27例(50只眼)正常人进行检测,将HRT检测的两组盘沿面积划分为6个区域进行比较,并将出现视野缺损的POAG患者盘沿面积减少最大区域与视野缺损较重部位进行一致性比较。结果POAG患者和正常人各区域及总体盘沿面积间差异均有显著性(P<0.001),其中,以颞下区盘沿面积变窄最为明显,依次为颞上区、鼻下区、鼻上区,鼻侧区与颞侧区无明显差异。出现视野改变的POAG患眼盘沿面积变窄最明显区域与视野缺损较重部位一致性比较符合率为93.3%。结论开角型青光眼盘沿面积较正常人明显变窄,颞下区最明显,盘沿面积改变与视野缺损有较好的一致性。HRT盘沿面积检测是POAG诊断的重要手段之一。

Objective To compare the area of optic rim in primary open angle glaucoma （POAG） and normal people, and to observe the variation of optic rim area, and to investigate the consistency between the locations of obvious smaller rim area and obvious damaged visual field in POAG. Methods Fifty eyes of 29 patients with POAG and fifty eyes of 27 normal people were examined using HRT and visual field. The two groups optic rim area were divided into six loca- tions, then compared them. The consistency between the locations of obvious smaller rim area and obvious damaged visual field in POAG were compared. Results There were remarkable difference between POAG and normal people in six locations and globe of optic rim area（ P 〈0.001 ）. The most obvious locations is tmp/inf, and then tmp/sup, nsl/inf, nsl/ sup. There were no difference between nasal and temporal locations. The much-affeeted locations of rim areas were consistent with the much-damaged position of visual field, and the rate was 93.3%. Conclusion The rim area in POAG was smaller than normal people, and the most obvious locations is tmp/inf. The much-affected locations of rim areas were consistent with the much-damaged position of visual field. To detect optic rim area by HRT is one of important means in diagnosing POAG.