频域光学在伽玛刀治疗前后视功能评价中的初步观察

Preliminary observation of visual function evaluation of SDOCT in the treatment of gamma knife

目的通过相干断层扫描(spectral-domain optical coherence tomography,SDOCT)测量retinal nerve fiber layer RNFL,厚度来观察伽玛刀治疗前后视功能的改变。方法适合伽玛刀治疗的患者,经过眼科筛查,在伽玛刀治疗前后行SDOCT检查,记录RNFL厚度改变,并行分组:第一组为肿瘤远离鞍区组;第二组为鞍区肿瘤,视器未接触组;第三组为鞍区肿瘤且视器有接触组。共入选36例患者,共72只眼。女性23例,男性13例,平均年龄47.59岁。结果所有患者治疗前后RNFL厚度及各个象限厚度无统计学差异(P>0.05);3组前后数据统计分析无统计学差异(P>0.05)。第一组患者治疗前象限在正常背景,治疗后无变化;第二组患者治疗前有2例象限异常,为手术后患者,治疗后象限背景无改变;第三组患者治疗前有10例患者有象限异常,治疗后有3例患者出现象限背景改变。结论 SDOCT可以作为伽玛刀治疗鞍区肿瘤患者视功能评价的指标之一。对于视器附近的肿瘤进行伽玛刀治疗是安全的。但是,肿瘤对视器有压迫的患者,包括曾经有较长时间压迫的患者,伽玛刀治疗时剂量给予需谨慎。本组资料样本较少,仍需要更大样本检验。

Objective The change of visual function of the gamma knife was observed by SDOCTRNFL thickness. Methods My department is suitable for gamma knife treatment of pa- tients,after the screening of department of ophthalmology. SDOCT test was performed before and after gamma knife treatment,and the change of RNFL thickness was recorded. All patients were divided into three group. Results After statistical analysis indicated that the RNFL thickness and the thickness of each quadrant was no significant difference in all patients before and after treat- ment （P〉0.05） . Conclusion SDOCT can be used as one of the indicators for the evaluation of the visual function of the patients with tumors in the saddle area. Gamma knife is safe for tumors near the optic device. Gamma knife treatment doses were given to the need to be cautious in the patients with tumor of optic compression,including once with a long time of oppression.