OCT快速和重复扫描法在青光眼诊断中的可重复性研究

Reproducibility studies on OCT rapid and repeated scanning method for the diagnosis of glaucoma

目的:评价应用光学相干断层成像术(OCT)快速和重复法测量视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度在诊断青光眼中的可重复性意义。方法:应用Stratus OCT测量38例正常人和42例原发性开角型青光眼患者的RNFL厚度,分别应用快速和重复扫描两种方案来测量正常人和原发性开角型青光眼患者RNFL厚度,通过统计各组视盘区域中颞区、上区、下区和鼻区共四个象限的总体平均RNFL厚度的组内相关系数和变异性系数来进行重复性评估。结果:在正常人和原发性开角型青光眼患者中,总体平均RNFL厚度和颞侧、上方、鼻侧、下方RNFL厚度,两组均未显示出差异;而重复扫描方案较之快速扫描在视盘周围测出的平均RNFL厚度具有更高的ICC和更低的CV值,在颞区存在统计学差异(P=0.042),在颞区、鼻区、上区和下区中得出的RNFL厚度的ICC(CV值)如下:快速扫描分别为0.918(7.2%),0.831(6.82%),0.856(5.12%),0.911(7.19%);而重复扫描的分别为0.927(3.21%),0.962(5.01%),0.909(6.02)%,0.869(4.67%),0.918(6.89%)。结论:OCT测量RNFL厚度中应用快速和重复扫描在正常人和原发性开角型青光眼中均具有可重复性的价值,而重复扫描方案在评估RNFL厚度方面更为精确。

AIM： To evaluate the application ofoptical coherence tomography （ OCT） and retinal nerve fiber layer thickness （ RNFL） measured by rapid and repeated methods in the diagnosis of glaucoma repeated significance. METHODS： Stratus OCT were measured in 38 normal subjects and 42 patients with the primary RNFL thickness of open angle glaucoma patients. Rapid and repeated scanning was applied respectively to measure the RNFL thickness of patients with normal and primary open angle glaucoma. The average RNFL thickness＆#39;s related coefficient and various coefficient of the temporal, upper, lower and nasal region made reproducibility assessment. RESULTS：In normal and primary open angle glaucoma patients, the overall average RNFL thickness and lateral temporal, above, nasal, below RNFL thickness, in which two groups did not show differences; repeated scanning average RNFL thickness was measured in fast scanning scheme around the optic disc, and had higher ICC and lower value of CV, there were significant differences in the temporal region （ P=0.042 ）.The temporal, nasal, upper and lower area of the retinal nerve fiber layer thickness of the ICC （ CV ） values were as follows： fast scan was 0.918 （7.2%）, 0.831 （6.82%）, 0.856 （5.12%）, 0.911 （7.19%）; repeated scans were 0.927 （3.21%）, 0.962 （5.01%）, 0.909 （6.02%）, 0.869 （4.67%）, 0.918 （6.89%）. CONCLUSION： In normal subjects and patients with primary open angle glaucoma, the application of rapid and repeated scanning in measurement of RNFL with OCT thickness has repeated significance, but repeated scanning scheme in the assessment of RNFL thickness is more accurate.