青光眼视网膜神经纤维层厚度变化及其与视野缺损的相关性

Correlations between retinal nerve fiber layer thickness and visual field defec of glaucoma

目的利用光学相干断层扫描(optical coherence tomography,OCT)检测早期原发性开角型青光眼和可疑青光眼患者视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度的变化,并分析其与视野缺损的相关性。方法收集来我院就诊的可疑青光眼患者35例(63眼)为A组,早期原发性开角型青光眼患者41例(72眼)为B组,对照组34例(66眼)为C组,采用OCT仪和Humphrey740i全自动视野计分别对3组受检者进行视盘周围RN-FL厚度和视野检测,比较3组患者的RNFL厚度,分析青光眼组RNFL厚度与视野缺损间的关系。结果 A组的上方、下方象限及平均RNFL厚度与C组对应象限比较,差异均有统计学意义(均为P<0.05);B组与C组比较平均及各象限RNFL厚度差异均有统计学意义(均为P<0.05);A组与B组比较上方、下方、鼻侧象限及平均RNFL厚度差异均有统计学意义(均为P<0.05)。三组受检者各象限及全周视野缺损两两比较,差异均有统计学意义(均为P<0.05)。B组平均及各象限RNFL厚度与视野缺损程度均呈负相关(均为P<0.05)。结论青光眼患者RNFL厚度变薄,并且与视野缺损程度呈负相关。

Objective To detect the changes of retinal nerve fiber layer（RNFL） thickness of primary open-angle glaucoma and suspected glaucoma by optical coherence tomography（OCT）,and analyze its correlation with visual field defect.Methods Thirty-five patients（63 eyes） with suspected glaucoma in our hospital were set as group A,41 patients（72 eyes） with early primary open-angle glaucoma as group B,and 34 control cases（66 eyes） as group C.The optical coherence tomography（Cirrus Hd-CT3000） and Humphrey Field Analyzer 740 i were used to measure the RNFL thickness at different quadrants and visual field in the three groups.RNFL thickness of three groups were compared,and its correlation with visual field defect was analyzed.Results Compared with group A,there were statistical differences in the superior,inferior quadrant and mean RNFL thickness in group C（all P〈0.05）,and there were statistical differences in the each quadrant and mean RNFL thickness between group B and group C（all P0.05）.There were statistical differences in the superior,inferior,nasal quadrant and mean RNFL thickness between group A and group B（all P〈0.05）.There were statistical differences in each quadrant and mean visual field defect among three groups（all P〈0.05）.The each quadrant and mean RNFL thickness were negative correlated with visual field defect in group B（all P〈0.05）.Conclusion RNFL thickness in patients with glaucoma is thinner,and negative correlated with visual field defect.