我国正常人共焦激光扫描视神经乳头地形图分析

AN ANALYSIS OF CONFOCAL LASER SCANNING OPTIC NERVE HEAD TOPOGRAPHY OF NORMAL CHINESE SUBJECTS

目的 运用共焦激光扫描检眼镜(LCSO)测定国人(汉族)视神经乳头(ONH)地形图参数的正常值范围,为临床上青光眼的早期诊断及随访提供依据。方法 用HRT(Heidel-berg Retina Tomograph)技术,检测我国(汉族)74只正常眼ONH地形图参数,经统计学处理,制定各参数的均数(Mean)、标准差(SD)、第5、50、95百分位数(P5、P50、P95)值。并分析ONH参数与种族、性别相关的差异;与年龄、眼别相关的差异作了探讨。结果 国人(汉族)ONH参数的正常值(Meen±SD)为视盘面积(DA)2.34±0.46;视杯面积(CA)0.48±0.28;杯盘面积比(CDR)0.2±0.1;盘沿面积(RA)0.18±0.38;视杯体积(CV)0.1±0.1;盘沿体积(RV)0.5±0.19;平均杯深(MeCD)0.18±0.08;最大杯深(MxCD)0.57±0.21;杯形测量(CSM)-0.25±0.06;曲线高度变化(HVC)0.41±0.12;平均视网膜神经纤维层厚度(mRNFLt)0.27±0.08;视网膜神经纤维层交叉段面积(RNFLcsa)1.47±0.48;标准化参考平面高度(RH)0.29±0.11。各参数P5、P50、P95值分别为DA1、59、2.35、3.05;CA0.11、0.41、0.89;CDR0.06、0.19、0.36;RA1.28、1.82、2.49;CV 0.002、0.06、0.29;RV0.25、0.45、0.84;MeCD 0.05、0.18、0.34;MxCD 0.21、0.59、0.95;CSM-0.35、-0.25、-0.14;HVC 0.23、0.4、0.62;mRNFLt0.14、0.27、0.42;

Purpose:To measure optic nerve head (ONH) topographic parameters of normal Chinese subjects (Han race) with confocal laser scanning ophthalmoscope (CLSO). It will provide evidences for clinic in early diagnosis of glaucoma and follow-up. Methods:We measured ONH parameters of 74 eyes from normal Chinese subjects of Han race with Heidelberg Retina Tomograph (HRT). By means of statistical analysis, we calculated the mean, SD, the 5th, 50th, 95th percentile of each parameter and analysed the race, gender related differences and discussed the age-related differences,and asymmetry between fellow eyes in normal ONH. Results; The ONH parameters of normal Chinese subjects (Han race) (mean±SD): Disc area (DA) 2. 34±0. 46; cup area (CA) 0. 48± 0. 28; cup/disc area ratio (CDR) 0. 2±0.1; rim area (RA) 0. 18±0.38; cup volume (CV) 0. 1±0. 1; rim volume (RV) 0. 5±0. 19; mean cup depth (MeCD) 0.18±0. 08; maximum cup depth (MxCD) 0. 57±0. 21; cup shape measure (CSM) -0.25±0.06; height variation contour (HVC) 0. 41±0. 12; mean retinal nerve fiber layer thickness (mRNFLt)0. 27±0. 08;RNFL cross-section area (RNFLcsa)1. 47±0.48; reference height (std) (RH) 0. 29±0. 11. The P5, P50, P95 of each parameter: DA1.59, 2. 35, 3. 05; CA0.11,0. 41, 0. 89; CDR0. 06, 0.19, 0. 36; RA1. 28, 1. 82, 2. 49; CV 0.002, 0.06, 0.29; RV0. 25, 0.45, 0.84; MeCD 0.05, 0.18, 0.34; MxCD 0.21, 0.59, 0.95; CSM -0.35, -0.25,-0.14; HVC 0. 23, 0.4, 0.62; mRNFLt0. 14, 0.27, 0.42; RNFLcsa 0. 75, 1. 42, 2. 2; RH 0. 08, 0. 3, 0. 44.The racerelated differences of ONH parameters are statistically significant (P<0. 001). The gender-, age-related differences and asymmetry between fellow eyes of ONH parameters can be neglected because they are much less than interindividual variability. Conclusion: In evaluation of ONH parameters, racial differences must be considred while gender-,age-related differences and asymmetry between fellow eyes can be neglected. Now CLSO is a safe, rapid, reproducible and accurate mehod for the three-dimensional assessment of ONH in quantitation.