傅立叶光学相干断层扫描检测眼房角巩膜突可见性分析

Scleral spur visibility of anterior chamber angle measured by Fourier optic coherence tomography

目的探讨傅立叶光学相干断层扫描仪CAM模块房角测量图像中巩膜突可见性及其影响因素。方法连续选择本院眼科门诊40岁及以上患者，所有受试者均接受眼科常规项目检查，房角均分别接受RTvueOCT（Optovue Inc，USA）CAM模块和房角镜检查。分析OCT图像中巩膜突的可见性及其影响因素。结果受试者共98例（98眼），年龄（63．3±10．5）岁，其中女性62例（63．3％）。在392个OCT房角象限中，286个（73．0％）象限的巩膜突可见，在象限之间、局部球结膜是否增厚之间的巩膜突可见率差异有统计学意义（P〈0．叭）。Logistic多元逐步回归分析发现，巩膜突可见性与性别、年龄、房角镜分级均无关（P〉0．05），与局部球结膜增厚（OR：0．113，P〈0．01）、象限（上方与颞侧OR=0．210，下方与颞侧OR=0．340，P〈0．01）有关，其中上、下象限与颞侧相比存在差异（OR=0．210、0．340，P〈0．01）。巩膜突在不可见情况下，仍有80．2％的象限可分辨出房角状态。结论傅里叶OCT作为一项房角检查方法具有较好的可行性，可为判断闭角型青光眼的发病机制提供有用信息。

Objective To assess visibility of scleral spur in images of anterior chamber angle measured by the CAM model of Fourier optic coherence tomography （OCT）. Methods Subjects aged 40 years or older were selected from outpatients in our opthalmologic clinic. All participants underwent standard ocular examinations, and anterior chamber angle was measured by CAM-L model of RTVue-OCT （ Optovue Inc, USA） and gonioscopy. Visibility of scleral spur in OCT images and its related factor were analyzed. Results 98 subjects （98 eyes） aged （63.3 ± 10. 5 ）y included 62 females （63.3%） were selected in this study. There were 286 in 392 quadrants （73.0%） with visualized scleral spur, which had significant difference among local bulbar conjunctiva thickened or not （ P 〈 0. 01 ）. Logistic multiple regression showed that the visibility of scleral spur was not associated with gender, age, gonioscope grades （P 〉0.05）, but significant associated with local bulbar conjunctiva thickened （ OR = 0. 113, P 〈 0. O1 ） and quadrants （ OR of superior/temporal = 0. 210, OR of inferior/temporal = 0. 340, P 〈 0. 01 ）, of which there were different scleral spur visibility in superior and inferior quadrants compared with temporal（ OR = 0. 210, 0. 340, P 〈 0. 01 ）. Angle status was still identified in 80. 2% quadrants on condition that scleral spur was not visual- ized. Conclusions Fourier optic coherence tomography has good feasibility to detect anterior chamber angle as an alternative method, and may supply helpful information to estimate the pathogenesis of angle closure glaucoma.