原发性开角型青光眼FD-OCT结构与视野损害的研究

Research on FD-OCT structure and perimetry of primary open angle glaucoma

目的应用频域光学相关生物扫描(FD-OCT)与视野检查,研究早期发现与随访原发性开角型青光眼的敏感指标。方法选择确诊为健康对照组25例50眼、可疑开角型青光眼组23例32眼及原发性开角型青光眼组26例39眼行FD-OCT及视野检查,测量FD-OCT各项参数及视野平均光敏感度缺损值(MD),三组组间差异比较采用单因素方差分析,三组组间两两差异比较采用q检验分析,平均视网膜神经纤维层厚度值(retinal nerval fiber layer,RNFL)与MD的关系选择Pearson相关分析。结果经单因素方差分析,除了盘沿容积、视盘深度显示三组之间差别无统计学意义,其他参数均显示三组之间的差异有显著性意义(P<0.01)。经q检验,视杯面积、盘沿面积、杯盘比、线性杯盘比、视杯容积和RNFL三组两两组间对比差异均有统计学意义(P<0.05),视盘面积和视盘宽度显示原发性开角型青光眼组与其他两组差异均有统计学意义(P<0.05)。经Pearson相关分析,三组MD与RNFL均呈负的直线相关(P=0.000)。结论 D-OCT可测量各项视盘参数及RNFL,结合视野测量的MD,是早期诊断和长期随访青光眼进展的重要敏感指标。

Objective To observe important sensitive indexes for diagnosing primary open angle glaucoma （POAG） early and supervising its course by frequency domained optical coherence tomography（ FD - OCT） and perimetry. Methods Totally 50 eyes from 25 normal age - matched controls, 32 eyes from 23 suspected open angle glaucoma and 39 eyes from 26 primary open angle glaucoma were examined with FD - OCT and perimetry. All OCT indexes and mean defect （MD） were compared during three groups and between every two groups. Results By single factor analysis of variance, except rim volume and cup depth, other parameters showed significant differences during three groups. By q test, cup area, rim area, cup/disc ratio, linear cup/disc ratio, cup volume and RNFL thickness showed significant differences between every two groups. And disc area, disc width showed significant differences between POAG and every other group. By correlation analysis, there was negative correlation between MD and RNFL of each group. Conclusion Disc structure parameters, RNFL and MD detected by FD - OCT or perimetry are sensitive parameters that can be used to diagnose glaucoma early and supervise for a long time.