频域OCT检测原发性开角型青光眼视网膜神经节复合体厚度的研究

目的探讨原发性开角型青光眼（POAG）人群黄斑区视网膜神经节复合体（GCC）厚度的分布。方法采用前瞻性病例对照研究。利用频域光学相干断层扫描（OCT）测量早期原发性开角型青光眼患者40例40眼、中晚期原发性开角型青光眼患者40例40眼及正常对照组50例50眼的黄斑区整体平均视网膜神经节复合体厚度（GCC—Avg）、上方平均视网膜神经节复合体厚度（GCC—Sup）和下方平均视网膜神经节复合体厚度（GCC-Inf）及相应区域视盘旁视网膜神经纤维层（RNFL）厚度，比较各组与正常对照组间上述3个GCC参数的差异，分析黄斑区GCC厚度和视盘旁RNFL厚度的相关性。结果正常对照组与各期青光眼组平均RNFL厚度值的差异均有统计学意义（P=0）。正常对照纽与各期青光眼组Gcc—Avg、GCC—sup和GCC—Inf厚度值的差异均有统计学意义（P=0）。早期POAG患者的GCC-Avg、GCC-sup、GCC-Inf值均比正常对照组减少，差异有统计学意义（P〈0．01）。中晚期POAG患者的Gcc-Avg、GCC-sup、GCC-Inf值明显低于早期POAG组，差异有统计学意义（P〈0．01）。GCC-Avg厚度与RNFL—Avg厚度呈明显正相关（P〈0．1）。结论频域OcT能够定量测量并区分青光眼患者与正常人群的黄斑区GCC厚度，GCC厚度随青光眼病情的进展而逐渐变薄，并与视盘旁RNFL厚度有较好的相关性。

Objective To explore the macular GCC thickness change in primary open-angle glaucoma （ POAG ） patient with SD-OCT. Methods A serial case-controlled study was designed. 40 eyes of early stage POAG patients, 40 eyes of advanced and late stage POAG patients and 50 normal eyes of age-matched and refract power-matched normal subjects were enrolled in the study. Average macular GCC thickness （ GCC-Avg ） , superior GCC thickness （ GCC-Sup ） and inferior GCC thickness （GCC-Inf） were measured by SD-OCT and compared among early stage POAG patients, advanced and late stage POAG patients and normal controls. The correlation between GCC thickness with RNFL thickness was evaluated and analyzed. Results There was significant difference in RNFL-Avg thickness, GCC-Avg thickness, GCC-Sup thickness and GCC-Inf thickness among the advanced and late stage POAG group, early POAG group and normal control group （ P〈0.01 ） . GCC-Avg thickness, GCC-Sup thickness and GCC-Inf thickness in the early POAG group were decreased than that of the normal control group （P〈0.01） . GCC-Avg thickness, GCC-Sup thickness and GCC-Inf thickness in the advanced and late stage POAG group were decreased than that of the early POAG group （ P〈0.01 ） .The positive correlations were seen between GCC-Avg thickness and RNFL-Avg thickness respectively （ P〈0.01 ） . Conclusion SD-OCT can quantitatively measure and differentiate the GCC thickness in POAG patients.The thickness gradually decreases with the development of POAG.There exists a well correlation between GCC thinning and RNFL thinning.