OCT不同扫描模式在检测视网膜神经纤维层厚度中的应用

Application of different OCT scanning patterns on detecting retinal nerve fiber layer thickness

目的比较3种OCT扫描模式检测视网膜神经纤维层（retinal nerve fiber layer,RNFL）厚度时受视盘大小的影响程度。方法按视盘面积将年龄18~30岁的156名正常人156眼分为大视盘组、中视盘组、小视盘组。应用OCT三种不同模式[RNFL厚度（3.4）扫描模式、视神经盘圆（0.98＋视盘半径）扫描模式、RNFL厚度（2.27×disc）扫描模式],分别检测3组受试者全周RNFL厚度。比较同一扫描模式不同组间所测全周RNFL厚度差别。并分析OCT三种扫描模式检测所得全周平均RN-FL厚度值与视盘面积的相关性。结果 RNFL厚度（3.4）扫描模式所测全周平均RNFL厚度不同组间比较,差异有显著统计学意义（F=23.762,P=0.000）：大视盘组所测值最大,中视盘组次之,小视盘组最小（P〈0.001）。RNFL厚度（2.27×disc）扫描模式（F=0.738,P=0.416）及视神经盘圆（0.98＋视盘半径）扫描模式（F=1.091,P=0.339）所测全周RNFL厚度在各组间比较,差异均无统计学意义。全周平均RNFL厚度值与视盘面积相关性分析,RNFL厚度（3.4）扫描模式所测值与之成正相关（r=0.506,P=0.000）;RNFL厚度扫描模式（2.27×disc）所测值与之成负相关（r=-0.290,P=0.001）;视神经盘圆扫描模式（0.98＋视盘半径）所测值与之无相关性（r=-0.005,P=0.949）。结论 RNFL厚度（3.4）扫描模式检测RNFL厚度受视盘大小影响最大,OCTRNFL厚度（2.27×disc）扫描模式及视神经盘圆（0.98＋视盘半径）扫描模式次之,临床应用需注意。

Objective To investigate the influence of optic disc on the retinal nerve fiber layer（RNFL）thickness measured by three different optical coherence tomography（OCT）scanning patterns.Methods According to the optic disc area,156 eyes of 156 healthy subjects from 18 to 30 years old were divided into 3 groups,big disc group,middle disc group and small disc group.Using 3 kinds of OCT scan protocols[RNFL thickness（3.4）,nerve head circle（0.98＋optic radius）and RNFL thickness（2.27×disc）] to measure the 360° average RNFL thickness of three groups,respectively.The differences between each two groups were compared using the same OCT scanning pattern.The correlations between 360° average RNFL thickness measured by three OCT scanning patterns and the optic disc area were analyzed.Results The 360° average RNFL thickness measured by RNFL thickness（3.4）scanning pattern among three groups had statistically significant differences（F=23.762,P=0.000）.The big optic disc group is the biggest one,the middle optic disc group is the next,the small optic disc group is the smallest one（P0.001）.The 360° average RNFL thickness measured by RNFL thickness（2.27×disc）scanning pattern and nerve head circle（0.98＋optic radius）scanning pattern among 3 groups had no statistically significant difference（F=0.738,P=0.416;F=1.091,P=0.339）.A positive correlation was observed between the 360° average RNFL thickness measured by RNFL thickness（3.4）scanning pattern and the optic disc area（r=0.506,P=0.000）.A negative correlation was observed between the 360° average RNFL thickness measured by RNFL thickness（2.27×disc）scanning pattern and the optic disc area（r=-0.290,P=0.001）.No correlation was observed between the 360° average RNFL thickness measured by nerve head circle（0.98＋optic radius）scanning pattern and the optic disc area（r=-0.005,P=0.949）.Conclusions The influence of optic disc on RNFL thickness measured by RNFL thickness（3.4）scanning pattern is the biggest one.RNFL thickness（2.27×disc）scanning pattern and nerve head circle（0.98＋optic radius）scanning pattern are following.More attention should be paid in clinical application.