帕金森病患者视网膜黄斑区形态及视盘周围神经纤维层厚度的频域光相干断层扫描观察

Macular morphology and circumpapillary retinal nerve fiber layer thickness in Parkinson＇s disease evaluated by spectral-domain optical coherence tomography

目的 观察帕金森病（PD）患者视网膜黄斑区形态及视盘周围神经纤维层（RNFL）厚度。 方法 37例PD患者74只眼（PD组）及同期年龄、性别与之匹配的32名健康体检者64只眼（对照组）纳入研究。采用频域光相干断层扫描（SD-OCT）技术对两组受检眼黄斑区行 5 线扫描和512×128黄斑体积扫描；采用视盘容积200×200扫描模式对视盘进行扫描。对比观察两组受检眼黄斑区视网膜厚度、黄斑中心凹视网膜厚度（CFT）、黄斑体积及视盘旁、上方、下方、鼻侧、颞侧RNFL厚度。采用Pearson相关性分析法分析PD患眼SD-OCT测量指标与其年龄、病程、Hoehn-Yahr及统一PD评定量表（UPDRS）Ⅲ评分之间的相关性。 结果 SD-OCT检查结果显示，PD组患眼黄斑区视网膜厚度及黄斑体积较对照组受检眼明显减小，差异有统计学意义（t=？2.546、？3.410，P=0.012、0.001）；两组受检眼之间CFT比较，差异无统计学意义（t=？0.463，P=0.644）。两组受检眼之间视盘旁（t=？1.645，P=0.102）、上方（t=？0.775，P=0.439）、下方（t=？1.844，P=0.067）、鼻侧（t=？0.344，P=0.732）、颞侧（t=？0.541，P=0.590）RNFL厚度比较，差异均无统计学意义。相关性分析结果显示，PD组患眼黄斑区视网膜厚度、黄斑体积、CFT及视盘旁、上方、下方、鼻侧、颞侧RNFL厚度与其年龄、病程、Hoehn-Yahr及UPDRSⅢ评分均无相关性（P＞0.05）。 结论 PD患者黄斑区视网膜厚度变薄，黄斑体积变小；CFT及视盘周围RNFL厚度无明显变化。

Objective To observe the macular morphology and circumpapillary retinal nerve fiber layer thickness （RNFL） in Parkinson＇s disease （PD） evaluated by spectral-domain optical coherence tomography （SD-OCT）. Methods A total of 37 patients （74 eyes） with PD were in the PD group, 32 age- and sex-matched healthy subjects （64 eyes） in the control group. All subjects underwent SD-OCT examination with 5 line scanning, macular cube 512×128 scanning and optic disc volume 200×200 scanning. The retinal thickness, central foveal thickness （CFT）, macular volume and thickness of circumpapillary, superior, inferior, nasal, and temporal of RNFL between two groups were comparatively analyzed. The relationship between SD-OCT parameters and age, disease duration, scores of Hoehn-Yahr and unified PD rating scale （UPDRS） Ⅲ in PD patients was analyzed by Pearson correlation analysis. Results Both of the retinal thickness and macular volume in PD group were significantly reduced than those in control group （t= ？2.546, ？3.410;P=0.012, 0.001）. There was no difference of CFT （t= ？0.463,P=0.644） and the thickness of circumpapillary （t= ？1.645,P=0.102）, superior （t= ？0.775,P=0.439）, inferior （t=？1.844,P=0.067）, nasal （t= ？0.344,P=0.732） and temporal （t= ？0.541,P=0.590） of RNFL between two groups. The retinal thickness, macular volume, CFT and the thickness of circumpapillary, superior, inferior, nasal, temporal of RNFL had no relationship with age, disease duration and scores of Hoehn-Yahr and UPDRS Ⅲ in PD patients （P〉0.05）. Conclusions In PD patients, the retinal thickness and macular volume are decreased, however, the circumpapillary RNFL have no obvious alterations.