FD-OCT测量视盘周围视网膜神经纤维层和视神经乳头参数在青光眼早期诊断中的意义

The significance of the retinal nerve fiber layer thickness and optic nerve head measured by fourier-domain optical coherence tomography(FD-OCT) in early diagnosis of glaucoma

目的:探讨RTVue傅里叶域光学相干断层扫描成像仪(fourier-domain optical coherence tomography,FD-OCT)测量视盘周围视网膜神经纤维层(retinal nerve fiber layer,RNFL)及视神经乳头(optic nerve head,ONH)各项参数在青光眼早期诊断中的作用。方法:应用RTVue FD-OCT测量青光眼患者50例76只眼及正常人45例80只眼的视盘周围RNFL厚度及ONH各项参数,比较正常眼与各期青光眼的差异,用受试者工作特征曲线下面积(area under the receive operating characteristic curve,AUROC)评价其在青光眼早期诊断中的作用。结果:不同阶段青光眼患者各象限及平均RNFL厚度均比正常人减少,差异有统计学意义(P<0.001)。除视盘面积,其余ONH参数(视杯面积、盘沿面积、盘沿容积、视神经容积、视杯容积、杯盘比、水平杯盘比、垂直杯盘比)在正常组与青光眼组之间差异均有统计学意义(P<0.001)。正常组与青光眼组之间平均RNFL、垂直杯盘比、杯盘比和视杯面积的AUROC最大。正常组与早期组之间平均RNFL、杯盘比、视杯面积AUROC最大。结论:RTVue FD-OCT测量视盘周围RNFL厚度及ONH参数有助于青光眼早期诊断。

Objective：To evaluate the significance of the retinal nerve fiber layer（RNFL） thickness and optic nerve head（ONH） measured by RTVue fourier-domain optical coherence tomography（FD-OCT） in early diagnosis of glaucoma.Methods：The RNFL thickness and ONH were measured by FD-OCT in 50 patients with glaucoma（76 eyes） and 45 normal subjects（80 eyes）.Comparisons were made between normal and different stages of glaucoma.The area under the receiver operating characteristic curves was used to assess the effects of FD-OCT.Results：There were significant differences of RNFL thickness in various quadrants and in mean thickness between normal and glaucomatous groups（P0.001）.There were significant differences of all ONH parameters between normal and glaucomatous eyes except disc area（P0.001）.The highest ROC values were mean RNFL thickness,cup/disc vertical ratio,cup/disc area ratio and cup area between normal and all glaucomatous eyes.The highest ROC values were mean RNFL thickness,cup/disc area ratio and cup area between normal and early glaucoma.Conclusion：RTVue FD-OCT may offer comprehensive analysis for RNFL thickness and ONH,which show good diagnostic ability in distinguishing normal from glaucomatous eyes.