视盘损伤可能度和杯盘比与POAG视野缺损的关系

Comparison of disc damage likelihood scale and cup/disc ratio for defect of visual field in POAG

目的：利用海德堡视网膜断层扫描仪-Ⅲ（HRT-Ⅲ）对原发性开角型青光眼（primary open angle glaucoma,POAG）进行视盘损伤可能度（disc damage likelihood scale,DDLS）评分,比较DDLS评分是否比杯盘比（cup/disc ratio,C/D）值更能反映POAG视野缺损的程度.方法：共有56例56眼POAG患者纳入本研究.在双盲情况下确定C/D值.完成对受检者的OCTOPUS-900视野计（G2-TOP）和HRT-Ⅲ检查后,记录视野平均缺损值（mean defect, MD）,再根据HRT-Ⅲ的地形图对受检者的视盘进行DDLS评分.结果选用Pearson相关系数进行评价.结果：大视盘（视盘面积3.09～3.43mm2）9眼、中等大小的视盘（2.41～2.67mm2）34眼和小视盘（1.64～1.81mm2）13眼纳入分析.DDLS与MD强相关（总：Pearson r=0.916, P＜0.01;大视盘：Pearson r=0.850, P=0.0037,中视盘：Pearson r=0.934, P〈0.01;小视盘：Pearson r=0.912, P〈0.01）.C/D与MD有中等程度相关（总：Pearson r=0.676, P〈0.01;大视盘：Pearson r=0.472, P=0.199,中视盘：Pearson r=0.682, P〈0.01;小视盘：Pearson r=0.788, P=0.0014）.结论：利用HRT-Ⅲ对POAG的视盘进行DDLS分期,是比C/D更好地对POAG视神经损害程度进行分级的方法.

AIM：To score disc damage likelihood scale（DDLS）in primary open angle glaucoma（POAG）using Heidelberg retina tomography-Ⅲ（HRT-Ⅲ）and to determine if DDLS score is better than cup/disc ratio（C/D）values in reflecting the extent of visual field defects in POAG.METHODS：A total of 56 POAG patients were included in this study.It was in double-blind case to determine C/D values.After the OCTOPUS-900 perimeter（G2-TOP）and HRT-Ⅲ examination,the value of vision mean defect（MD）were recorded.According to the topographic map of HRT-Ⅲ,DDLS score of the optic disc for subjects was gained.Results were evaluated with Pearsons correlation coefficient.RESULTS：Large optic disc（optic disc area of 3.09-3.43mm2）of 9 eyes,medium-sized disc（2.41-2.67mm2）34 eyes and small optic disc（1.64-1.81mm2）13 eyes were included in the analysis.DDLS was strongly associated with MD（total：Pearson r=0.916,P〈0.01;large disc：Pearson r=0.850,P=0.0037,medium-sized optic disc：Pearson r=0.934,P〈0.01;small disc：Pearson r=0.912,P〈0.01）.C/D had moderate correlation with the MD（total：Pearson r=0.676,P〈0.01;large disc：Pearson r=0.472,P=0.199,medium-sized disc：Pearson r=0.682,P〈0.01;small disc：Pearson r=0.788,P=0.0014）.CONCLUSION：Using HRT-Ⅲ to do DDLS staging for POAG optic disc has better grade in the extent of optic nerve damage than the C/D.