Cirrus HD OCT测量近视人群的青光眼诊断参数对比研究

Measurement of Glaucoma Diagnostic Parameters in Myopic People by Cirrus HD OCT

目的采用Cirrus HD OCT测量近视人群的青光眼诊断参数差异性及近视人群的特征。方法选取2016年1月至2017年8月,就诊于我院的18~35岁不同近视程度的患者共95例(190只眼)。记录患者性别、年龄,采集其眼轴、医学验光屈光度(等效球镜)、视盘周围视网膜神经纤维层厚度(cpRNFL)包括平均、上下方,颞鼻侧5个参数、黄斑部神经节细胞和内丛状层(GCIPL)厚度包括平均、最小、上下方、鼻颞侧6个参数。根据屈光度分为A组(-0.25~3.0D);B组(-3.25^-6.0D);C组(>-6.0D),采用单因素方差分析进行所有参数的组间比较。采用Pear-son相关性分析不同屈光度与眼轴、GCIPL厚度、cpRNFL厚度的相关性及GCIPL厚度与cpRNFL厚度之间相关性。结果各组的性别及年龄无统计学差异。但各组间平均屈光度差异有统计学意义(F=521.963,P=0.000),眼轴和屈光度之间呈显著负相关(相关系数-0.706,P=0.000)。根据屈光度分组,所有参数各组之间均有显著差异(F=3.396~16.305,P<0.05)。cpRNFL厚度除颞侧外均与屈光度呈负相关(相关系数-0.316^-0.212,P<0.05),GCLIP厚度各参数均与屈光度呈负相关(相关系数-0.205^-0.384,P<0.05)。两种参数之间除颞侧外,其余参数均具呈正相关性(相关系数0.222~0.559),GCIPL与cpRNFL厚度在近视人群中均随屈光度发生一定的改变。结论近视眼cpRNFL厚度上下方及鼻侧象限均随屈光度增大逐渐变薄,颞侧变厚。GCIPL厚度各参数均随屈光度增大逐渐变薄,二者具有很好的一致性。近视人群采用此两种方法评估青光眼损害时,均需要考虑近视程度对参数的影响。

Objective To measure the difference of the glaucoma diagnostic parameters in myopia and characteristics of myopic people by Cirrus HD-OCT. Methods 95 cases（ 190 eyes） from 18-35 years old with different degrees of myopia from January 2016 to August 2017 in our hospital were selected. Gender,age,eye axis,medical optometry diopter（ equivalent spherical lens）,thickness of retinal nerve fiber layer around optic disc（ cpRNFL） including 5 parameters of average,upper and lower,and naso-temporal side,macular ganglion cells and thickness of inner plexiform layer（ GCIPL） including 6 parameters of average,minimum,upper and lower,and naso-temporal side of patients were recorded. According to diopter,all patients were divided into group A（-0. 25 to3. 0 D）,group B（-3. 25 to-6. 0 D）,and group C（ -6. 0 D）. Univariate ANOVA was used to conduct inter-group comparison of all parameters. Pear-son correlation analysis was used to analyze the correlation between different diopters,eye axis and the thickness of GCIPL and cpRNFL,and the correlation between GCIPL thickness and cpRNFL thickness. Results There was no significant difference in gender and age among the 3 groups. However,there were significant differences in the mean diopter（ F = 521. 963,P =0. 000） among them. There was significant positive correlation between ocular axis and refractive power（ correlation coefficient =0. 706,P = 0. 000）. The groups were divided according to different degrees of refraction,and there were significant differences in all parameters among the 3 group（ F = 3. 396 ~ 16. 305,P〈0. 05）. The thickness of CpRNFL was negatively correlated with diopter except for temporal side（ correlation coefficient-0. 316 ^-0. 212,P〈0. 05）,and the thickness of GCLIP was negatively correlated with diopter（ correlation coefficient-0. 205 ^-0. 384,P〈0. 05）. Except for the temporal side,other parameters were positively correlated（ correlation coefficient 0. 222 ~ 0. 559）. With the increase of diopter,the thickness of cpRNFL and GCLIP had a certain change. Conclusion The thickness of cpRNFL and nasal quadrant in myopia gradually became thinner and thicker at temporal side with the increase of diopter,while the thickness parameters of GCIPL gradually thinned with the increase of diopter. There is good consistency between them. Therefore,the influence of myopia degree on parameters should be considered when assessing glaucoma damage by these two methods.