原发性开角型青光眼患者视网膜神经纤维层厚度与视野缺损相关性分析

Correlation analysis on retinal nerve fiber layer thickness and visual field defect in primary open angle glaucoma by OCT measurement

目的:探讨原发性开角型青光眼视网膜神经纤维层厚度(RNFL)OCT测量及与视野缺损(MD)相关性。方法:68例(68眼)单侧原发性开角型青光眼患者为观察组,71例(71眼)正常人群作为对照组(71眼),采用Cirrus OCT对两组患者RNFL进行测量并采用全自动视野分析仪观察患者MD情况。结果:观察组患者RNFL水平明显低于对照组,观察组患者MD绝对值高于对照组,差异均具有统计学意义(t=6.682,17.30;P<0.01);中期青光眼组、晚期青光眼组患者RNFL水平明显低于对照组,随着青光眼患者病程分期的加重,患者RNFL水平明显降低,组间差异均具有统计学意义(P<0.05)。早期青光眼组、中期青光眼组、晚期青光眼组患者MD绝对值水平均高于对照组患者,随着病程的加重,MD损伤程度明显加重,组间差异均具有统计学意义(P<0.05);观察组患者视杯面积、视杯容积、C/D、水平C/D及垂直C/D水平明显高于对照组,而观察组患者盘沿面积、盘沿容积则低于对照组,差异均具有统计学意义(P<0.05);采用Pearson相关性检验分析发现,观察组患者RNFL与MD绝对值水平呈负相关(r=-0.554,P<0.01)。结论:OCT测量RNFL、MD是原发性青光眼诊断的有效检测方法,且两者存在负相关关系。

Ob je c t iv e ：T o in v e s tig a te co rre la tio n on re t in a l nerve fibe r laye r th ick n e s s OCT me a su remen t and visual field defect in primary open angle glaucoma. Methods：Clinical data of 68 patients （68 eyes） with unilateral primary open angle glaucoma were analyzed. 71 normal people （71 eyes） were served as control group. Results：The RNFL of the observation group was significantly lower than that in the control group, the absolute value of MD was higher than control group, the differences were statistically significant （r= 6. 682, 17. 30; P 〈0. 0 0 1 ） ; R N F L in middle and late glaucoma group was significantly lower than that in the control group, the difference was statistically significant （P 〈 0. 0 5 ） . Th e level of RNFL was sign if ic an tly lower th a n tha t in th e co n tro l group. Wi th th e increase of the stage, the level of RNFL was significantly lower, and the difference was statistically significant （P〈0. 0 5 ）; the absolute value of MD in early glaucoma group？ middle late glaucoma ,severe glaucoma group were higher than control group patients, as the disease aggravated ,level of MD was significantly increased, the differences were sta-tistically significant （P〈0. 05）; cup area？ cup volume？ C/D, horizontal C/D and vertical C/D in the observation group was significantly higher than that in control group, rim area, rim volume in the observation group was lower than the control group, the differences were statistically significant （P〈0. 05） ; Us in g P e a rso n co rre la tio n te s t , th e absolute value of MD in the observation group was negatively correlated with RNFL （r= -0. 554,P〈0. 0 0 1 ） . Con- elusion：RNFL thickness,MD is an effective detection method of primary glaucoma diagnosis by OCT measurement of, and they have a negative correlation.