视野缺损计分与OCT测量RNFL厚度的关系

Relationship between visual field defect score and retinal nerve fiber layer thickness measured by OCT

目的:探讨视野缺损计分值与视网膜神经纤维层损害的关系。方法:收集开角型青光眼患者30例30眼,分别进行OCT视网膜神经纤维层厚度及视野检查。根据视野结果进行视野缺损计分并分组。组间分析各象限视网膜神经纤维层厚度值与视野缺损计分,平均缺损(MD)的关系和相关性。结果:根据视野缺损计分将患者分为四组,上侧、下侧,平均视网膜神经纤维层厚度在组间有显著性差异(P=0.010,P<0.01,P<0.01)。四组间随视野缺损程度加重,上侧、下侧,平均视网膜神经纤维层厚度变薄。在重度缺损组视网膜神经纤维层厚度最薄。视野缺损计分与上、下、鼻、颞侧及平均视网膜神经纤维层厚度均明显负相关(r=-0.610,P=0.001;r=-0.779,P<0.01;r=-0.463,P=0.015;r=-0.500,P=0.008;r=-0.782,P<0.01),视野指数MD与上侧,下侧及平均RNFL厚度明显正相关(r=0.557,P=0.003;r=0.431,P=0.025;r=0.532,P=0.004)。结论:视野缺损计分对视野缺损的客观评估,与OCT测得的视网膜神经纤维层厚度的结果负相关,是反应青光眼视神经损伤的可靠的观察指标。

AIM ：To investigate the relationship between visual field defect scoring value and retinal nerve fiber layer（RNFL） damage. METHODS： Thirty cases （30 eyes） with open-angle glaucoma were collected and performed OCT to examine retinal nerve fiber layer thickness and visual field check respectively. In accordance with the visual field results, the visual field defect was scored, and the patients were grouped. Every quadrant＇s RNFL thickness values, visual field defect score, mean defect （ MD） relationships and correlativity were analyzed. RESULTS： According to the visual field defect scoring, the patients were divided into four groups. There were significant differences （ P = 0. 010, P 〈 0.01, P 〈 0.01 ） of the RNFL thickness on the supral side , inferior side and the average among these groups. As for the four groups, the thickness of supral side and inferior side and the average RNFL thickness became thinner along with the increasing of visual field defect. In severe defect group, RNFL thickness was the thinnest. The visual field defect score was significantly inverse correlated （ r = -0. 610, P = 0.001;r=-0.779,P〈0.01;r=-0.463,P=0.015;r= -0.500,P= 0.008;r=-0.782,P〈 0.01） to RNFL thickness of the supral side, inferior side, the nasal side, the temporal side and the average RNFL thickness. Value of MD was significantly positive correlated （ r = 0.557, P= 0.003 ; r = 0. 431, P= 0.025 ; r= 0.532, P= 0. 004） to RNFL thickness of the supral side and inferior side and the average RNFL thickness. CONCLUSION： The objective assessment of visual field defect by visual field defect scoring is negatively correlated to the results of RNFL thickness measured by OCT, and it is a reliable observation index of glaucoma retinal nerve injury.