三维OCT在开角型青光眼鉴别诊断价值

The diagnostic value of high-resolution three-dimensional OCT in early primary open-angle glaucoma

目的探讨高分辨率三维OCT在开角型青光眼中的诊断价值。方法采用CirrusHD—OCT对正常组94人188只眼和试验组46例92只眼进行视网膜神经纤维层厚度的检测，对比分析视盘形态和视网膜神经纤维层厚度改变。结果正常组各部位神经纤维层厚度与性别、眼别无相关（P〉0．05）。正常对照组各部位神经纤维纤维层厚度明显高于实验组，经过独立样本t检验得出差异有统计学意义（P〈O．05）。根据OCT结果，并根据视野、眼压等将试验组46例92只眼诊断为青光眼的24例48只眼，大视杯22例44只眼，两个亚组各部位RNFL厚度和正常对照组相比较，视网膜神经纤维层厚度均变薄，差异有统计学意义（P〈0．05）；但大视杯亚组各部RNFL厚度均高于青光眼亚组，差别有统计学意义（P〈0．05）。结论OCT可以清晰显示视网膜神经纤维层变薄的范围和区域，再配合其他检查，即可较准确、快捷鉴别原发性开角型青光眼患者，大大提高开角型青光眼的早期诊断水平，是诊断早期青光眼的不可缺少的重要检查方法之一。

Objective To evaluate the diagnostic value of of high-resolution three-dimensional OCT in early primary open-angle glaucoma. Methods The retinal nerve fiber layer thickness in the normal group of 94 cases （188 eyes） and experimental group （glaucoma suspect group） of 46 cases （92 eyes） were detected using the Cirrus HD-OCT, and the comparative analysis of optic disc and retinal nerve fiber layer thickness were taken. The OCT performance of normal and suspected glaucoma image features was compared. Results There was no relationship in different parts of nerve fiber layer thickness （RNFL） with gender and eyes （P 〈0.05）. The thickness of nerve fiber layer of normal control group was higher than experimental group, there was statistical- ly significant difference＂ （P 〈0.05） by independent sample t test. Based on the measured thickness of retinal nerve fiber layer, the image features and characteristics of OCT images, vision and intraoeular pressure,.48 eyes of 24 patients were diagnosed with glaucoma, and 44 eyes of 22 cases were diagnosed with large cup in experimental group. RNFL thickness of different parts of the two sub-group were thinning compared with the control group, the difference was statistically significant （P 〈0.05）; but large cup group showed thicker RNFL than glaucoma group, and there was the statistically significant difference （P 〈0.05）. Conclusions Cirrus HD-OCT has important diagnostic value in early primary open-angle glaucoma; also can greatly increase early diagnosis in primary open-angle glaucoma. It is an important and indistpensable cheek method