RTVue OCT、GDxVCC和HRT-Ⅲ视网膜神经纤维层厚度参数在青光眼诊断中的作用

Effects of retinal nerve fiber layer thickness parameter measured by RTVue OCT,GDx VCC and HRT-Ⅲ on diagnosis of glaucoma

目的探讨应用频域光学相干断层扫描(spectral-domain optical coherence tomo-graphy,SD-OCT)-RTVue OCT、偏振激光扫描(scanning laser polarimetry,SLP)-偏振光青光眼检测联合个性化角膜补偿系统(glaucoma detection with variable corneal compensation,GDxVCC)和海德堡视网膜断层扫描-Ⅲ(Heidelberg retina tomography-Ⅲ,HRT-Ⅲ)测量所得的视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度参数在青光眼诊断中的作用。方法应用RTVue OCT、GDx VCC和HRT-Ⅲ分别测量62人正常个体和72例青光眼患者总的以及各区域的RNFL厚度,比较正常个体和青光眼患者RNFL厚度。用受试者工作特性曲线下面积(area under the receiver operating characteristic curve,AUC)来评价每一个参数区分正常眼与青光眼的能力大小。结果正常个体和青光眼患者各参数测量值(总的及各区域RNFL厚度)之间比较,差异均有统计学意义(均为P<0.001)。平均RNFL厚度RTVue OCT正常个体为(109.758±9.095)μm,青光眼患者为(80.455±19.353)μm;GDx VCC正常个体为(57.013±5.132)μm,青光眼患者为(45.374±10.417)μm;HRT-Ⅲ正常个体为(295.833±69.485)μm,青光眼患者为(201.385±105.235)μm。各测量参数中,诊断效能最高的是RTVue OCT测得的平均RNFL厚度,其AUC值为0.914±0.026,最低的是颞侧TU和TL区域,其AUC分别为0.783±0.040和0.805±0.039。结论 RTVue OCT测得RNFL厚度参数具有很好的区别正常个体和青光眼患者的能力,在青光眼诊断方面是一个有用的工具。

Objective To study the effects of retinal nerve fiber layer （RNFL） thickness parameter measured by spectral-domain optical coherence tomography （ SD- OCT）-RTVue OCT, scanning laser polarimetry （SLP）-glaucoma detection with variable vorneal compensation （ GDx VCC ） and Heidelberg retina tomography- III （ HRT- III） on diagnosis of glaucoma. Methods Average and regional RNFL thickness were measured and compared by RTVue OCT, GDx VCC and HRT- III in 62 normal people and 72 glaucoma eyes. The area under the receiver operating characteristic curve （AUC） was used to assess the ability to different glaucoma eyes from normal eyes of each testing parameter. Results There were statistical differences in all measurement parameters （ all and regional RNFL thickness） between normal people and glaucoma patients （ all P〈0,001）. The average RNFL thickness of normal and glaucomatous eyes were （ 109. 758 ± 9.095 ） um and （80.455 ± 19.353 ） um by RTVue OCT, （ 57. 013 ± 5. 132） um and （45. 374 ± 10. 417 ）um by GDx VCC,and （295. 833 ± 69.485 ）um and （201. 385 ± 105. 235 ） um by HRT- III. Among all the parameters of RNFL thickness ,the highest AUG 0. 914 ± 0. 026 was average RNFL thickness by RTVue OCT, and the lowest AUC 0.783 ± 0.040,0. 805 ± 0.039 was the temple TU and TL area. Conclusions Parameters of RNFL thickness by RTVue OCT show fair discriminating ability in distinguishing normal from glaucoma eyes. RTVue OCT is a valuable tool for the diagnosis of glaucoma.