视网膜色素变性患眼环视盘神经纤维层厚度及视盘参数改变观察

The circumpapillary retinal nerve fiber layer thickness and optic disc parameters in retinitis pigmentosa eyes

目的观察分析视网膜色素变性（RP）患眼环视盘神经纤维层（CP—RNFL）厚度及视盘参数改变情况。方法前瞻性桩床病例对照研究。临床确诊的RP患者25例42只眼（RP组）以及与之年龄相匹配的正常健康者42名84只眼（对照组）纳入研究。所有受检眼均行光相干断层扫描（0CT）检查。42只眼中，能完成视盘3D模式扫描37只眼，因软件系统无法识别视盘参数仅能完成环扫模式5只眼。应用系统自带软件分析计算视盘周围全周CP—RNFL平均厚度及鼻侧、上方、颞侧、下方各象限的CP—RNFI。厚度以及视盘面积、视杯面积、盘沿面积、杯盘面积比、杯盘水平直径比、杯盘垂直直径比、视杯体积及盘沿体积等视盘参数。结果RP组患眼全周CP—RNFL平均厚度及鼻侧、颞侧cP—RNFL厚度较对照组增厚，差异有统计学意义（t=2．27、3．73、6．44，P=0．03、0．00、0．00）。两组受检眼之间上方、下方CP～RNFL厚度比较，差异无统计学意义（t=-1．49、-1．19，P=0．14、0．24）。RP组患眼视盘面积、视杯面积、杯盘面积比、杯盘水平直径比、杯盘垂直直径比及视杯体积均较对照组受检眼增大，差异有统计学意义（t=6．00、4．80、1．75、4．65、4．10、5．10，P〈0．05）；两组受检眼之间盘沿面积及体积比较，差异无统计学意义（t=1．75、0．40，P=0．08、0．59）。结论与正常对照者比较，RP患眼全周CP—RNFI．平均厚度及鼻侧、颞侧CP—RNFL厚度增厚，视盘面积、视杯面积、杯盘面积比、杯盘水平直径比、杯盘垂直直径比及视杯体积增大。

Objective To observe the changes of circumpapillary retinal nerve fiber layer （CP RNFL） thickness and optic disk parameters in retinitis pigmentosa （RP） eyes. Methods Prospective clinical casecontrol study. A total of 25 patients （42 eyes） with RP were in the RP group, and 42 age matched healthy subjects （84 eyes） in the control group. All subjects underwent optical coherence tornography （OCT） examination, in which 37 eyes with 3D optic disk scanning and 5 eyes with circle optic disk scanning. The parameters included average thickness of entire CP-RNFL, thickness of nasal, superior, temporal and inferior quadrant of CP-RNFL, disc area, disc cup area, rim area, cup/disc （C/D） area ratio, C/D horizontal diameter ratio, C/D vertical diameter ratio, disc cup volume and disc rim volume. Results The average thickness and the thickness of temporal and nasal quadrants of CP-RNFL in RP group were significantly thicker than the control group （t=2.27, 3.73, 6.44; P^0. 027, 0.00, 0.00） ,while the thickness of inferior and superior areas were the same as control group（t~ --1.49,--1.19; P=0.14, 0.24）. The disc area, disc cup area, C/D area ratio, C/D horizontal diameter ratio, C/D vertical diameter ratio, disc cup volume in RP group were significantly bigger than control group （P〈 0. 05 ）, while rim area and rim volume were not significant differences （t= 1.75, 0. 40; P=0.08, 0.59）. Conclusion In comparison with the healthy subjects, the average thickness and temporal and nasal areas of CP-RNFL in RP eyes were thicker,and the disc area, disc cup area, C/D area ratio, C/D horizontal diameter ratio, C/D vertical diameter ratio, disc cup volume in RP eyes were bigger. coherence