应用海德堡视网膜断层扫描仪(HRTⅢ)分析视乳头参数与近视性屈光度、年龄、性别的关系

Analysis of the relationship between optic disc parameter indexes and myopia diopter, age and sex using heidelberg retina tomogragh (HRTⅢ)

目的:研究视乳头参数与近视性屈光度、年龄和性别因素的关系及对原发性开角型青光眼早期诊断的影响。方法:应用海德堡视网膜断层扫描仪HRTⅢ的青光眼模块对89例单纯性近视患者进行视乳头检测,获得一系列视乳头参数。结果:①盘沿体积(rim volume,RV)、轮廓线高度变异(height variation contour,HVC)、平均神经纤维层厚度(mean RNFL thickness,mRNFLT)、神经纤维层横截面积(RNFL cross section area,RCSA)与屈光度呈正相关(P<0.05),相关系数分别为:0.3778、0.3217、0.3466、0.3663。②视乳头各参数与年龄无相关性。③轻度近视组中视乳头面积(discarea,DA)、盘沿面积(rimarea,RA)、RV、RCSA,中度近视组中mRNFLT、RCSA,高度近视组中HVC分别与性别因素明显相关。结论:①近视性屈光度及性别因素影响HRTⅢ的视乳头参数检测值,年龄因素的影响须进一步研究分析。②参考平面的设定使近视眼的mRNFLT的检测值较实际值偏大,影响伴有近视眼的原发性开角型青光眼的早期诊断。③需建立适用于不同近视性屈光度及性别的数据库,设定更适应视乳头形状变化的参考平面,进一步提高检测的有效性。

Objective： To investigate the relationship between optic disc parameter indexes and myopia diopter, age and sex, and analyze their effect on the early diagnosis of primary open angle glaucoma. Methods： Glaucoma module of HRTⅢ was used to examine the optic disc parameter indexes of 89 patients with myopia and obtained a series of optic disc parameter indexes. Results： （1）Rim volume （RV）, height variation contour （HVC）, mean RNFL thickness （mRNFLT） and RNFL cross section area （RCSA） had significant relationship with diopter （P〈0.05）, and the correlation coefficients were 0.337 8, 0.321 7, 0.346 6, 0.366 3 respectively. （2）There was no relationship between each optic disc parameter index and age. （3）Disc area （DA）, rim area （RA）, RV and RCSA in the group of light diopter, mRNFLT and RCSA in the medium diopter group and HVC in the group of higher diopter had obvious relationships with sex. Conclusion： （1）The factors of myopia diopter and sex influence the optic disc parameter indexes. The effect of age needs further research. （2）The definition of the refere nee plane makes the observed value of mRNFLT be larger than the real value, this may cause the wrong early diagnosis of primary open angle glaucoma patients with myopia simultaneously. （3）It is necessary to establish a reference database with the consideration on myopia diopter and sex, and set a more reasonable reference plane to improve the accuracy of diagnosis.