OCT测量黄斑区神经节细胞复合体厚度在早期原发性开角型青光眼诊断中的作用

Effect of macular ganglion cell complex thickness measured by optical coherence tomography in diagnosis of early primary open-angle glaucoma

目的利用光学相干断层扫描技术(optical coherence tomography,OCT)比较正常人和早期原发性开角型青光眼(primary open-angle glaucoma,POAG)患者黄斑区神经节细胞复合体(ganglion cell complex,GCC)厚度的差异,评价其对早期POAG的诊断价值。方法选取早期POAG患者46例(46眼)为早期POAG组,正常人50人(50眼)为正常组,利用RT-Vue-100FD-OCT GCC程序记录2组黄斑区平均、上方及下方GCC厚度,分析2组黄斑区不同区域GCC厚度差异,确定OCT测量黄斑区GCC厚度值对早期POAG的最佳诊断指标。结果正常组黄斑区平均、上方及下方GCC厚度值分别为(104.76±5.96)μm、(104.89±6.73)μm、(104.61±6.37)μm,各区域厚度值间对比差异无统计学意义(P>0.05);早期POAG组黄斑区平均、上方及下方GCC厚度值分别为(88.81±7.50)μm、(89.04±8.84)μm、(89.07±7.92)μm,各区域GCC厚度值比较差异无统计学意义(P>0.05);早期POAG组黄斑区不同区域GCC厚度值较正常组明显变薄,2组间比较差异均有显著统计学意义(均为P<0.01)。正常人和早期POAG之间黄斑区平均、上方、下方GCC厚度的受试者工作特征曲线下面积分别为0.899、0.894、0.903。结论 OCT测量黄斑区GCC厚度可作为早期POAG的一种辅助诊断方法。

Objective To compare the difference of macular ganglion cell complex（GCC） thickness between normal and early primary open-angle glaucoma（POAG） measured by optical coherence tomography（OCT）,and analyze the diagnostic value of these on early POAG.Methods Fifty normal cases（50 eyes） and 46 early POAG cases（46 eyes） were respectively enrolled and set as normal group and POAG group.The thickness of macular GCC in average,superior and inferior was recorded by RTVue-100 FD-OCT,and the difference of GCC thickness in different area was compared to determine the best diagnostic index of early POAG.Results The thickness of macular GCC in average,superior and inferior in normal group were（104.76±5.96）μm,（104.89±6.73）μm and（104.61± 6.37）μm,respectively,there was no statistical difference among those numerical data（P〉0.05）.The thickness of GCC in average,superior and inferior in POAG group were（88.81±7.50）μm,（89.04±8.84）μm and（89.07±7.92）μm,respectively,there was no statistical difference among those numerical data（P〉0.05）.The thicknesses of GCC in POAG group were less than that in normal group,there were significant differences（all P〈0.01）.The area under the receiver operator characteristic curve of GCC in average,superior and inferior between normal and early POAG were 0.899,0.894,0.903,respectively.Conclusion The measurement of GCC thickness by OCT is an assisted diagnostic method for early POAG.