原发性开角型青光眼的中医分型与RNFL厚度改变及视野损害关系

Relationship between the thickness change of retinal nerve fiber layer and visual field damage in the primary open angle glaucoma for the syndrome differentiation of TCM

目的:探讨原发性开角型青光眼(青风内障)中医辨证分型与视网膜神经纤维层厚度的改变及视野损害之间关系的临床研究。方法:对72例144眼原发性开角型青光眼患者,采用光学相干断层成像术对144眼作围绕视盘3.4mm的环形扫描,记录各个象限视网膜神经纤维层厚度,并采用进口Humphry视野分析仪作中30°全定量视野检测检查,同时根据中医理论对患者作中医辨证分型,观察二者之间的关系。结果:中医的证型与视网膜神经纤维层厚度改变类型有统计学意义,中医证型与视野损害的类型有统计学意义(P<0.05)。结论:视神经损害较严重多见于青风内障的虚证,视神经损害早期多见于实证,因此视神经损害的程度在一定的程度上给予中医辨证治疗一定的指导作用。

AIM- To investigate the relationship between the thickness change of retinal nerve fiber layer and visual field damage in the primary open angle glaucoma ~ bluish glaucoma） for the syndrome differentiation of TCM. METHODS. Seventy-two patients （144 eyes） of primary open angle glaucoma underwent optical coherence tomo- graphy for a 3. 4mm ring around the optic disc. Each quadrant retinal nerve fiber layer thickness was recorded, and imported Humphry vision analyzer was used for quantification in the whole field of vision 30~ test checks. Traditional Chinese medicine was applied on the patients with TCM theory. The relationship between the two was observed. ~ RESULTS： TCM syndrome and retinal nerve fiber layer thickness changes had statistical significance, TCM syndro- me type and the type of visual field damage was statistically significant （ P〈 0.05）. ~ CONCLUSION ： The optic nerve damage is more common in the deficiency within the blue wind, optic nerve damage were seen in the early period. Therefore, the extent of optic nerve damage to a certain extent gives a certain dearee of guidance in TCM treatment.