mGCC对原发性青光眼的诊断价值及其与pRNFL和视野的相关性

Diagnostic value of mGCC in primary glaucoma and its correlation with pRNFL and visual fields

目的:分析黄斑区节细胞复合体(macular ganglion cell complex,mGCC)对原发性青光眼的诊断价值,探讨mGCC与视乳头周围视网膜神经纤维层(peripapillary retinal nerve fiber layer,pRNFL)及视野的相关性,以期为原发性青光眼的诊治提供科学参考依据。方法:选取2015-01/2016-12在我院接受诊治的原发性青光眼患者67例80眼为观察组,另纳入同期我院健康体检者40例80眼为对照组。采用光学断层扫描仪(OCT)测量并比较两组受检者mGCC、pRNFL厚度,分析mGCC对原发性青光眼的诊断价值,探讨mGCC与pRNFL及视野平均缺损(MD)的相关性。结果:观察组患者上方、下方及平均mGCC厚度显著低于对照组,差异均有统计学意义(P<0. 05)。观察组患者上方、下方及平均pRNFL厚度均显著低于对照组,差异有统计学意义(P<0. 05)。观察组患者MD显著高于对照组,差异有统计学意义(P<0. 05)。Pearson相关性分析显示,观察组患者mGCC与pRNFL呈显著正相关关系(r=0. 58,P<0. 01),与MD呈显著负相关关系(r=-0. 69,P<0. 01)。ROC曲线分析显示,以86. 39μm为截点值,mGCC诊断原发性青光眼的敏感性为82. 5%,特异性为76. 25%。结论:mGCC对原发性青光眼具有一定的诊断价值,且与pRNFL呈正相关关系,与MD呈负相关关系。

AIM： To analyze the diagnostic value of macular ganglion cell complex（ mGCC） in primary glaucoma and explore the correlation between mGCC and peripapillary retinal nerve fiber layer（ pRNFL） and visual field,in order to provide scientific reference for the diagnosis and treatment of primary glaucoma.METHODS： Eighty eyes in 67 primary glaucoma patients admitted to our hospital from January 2015 to December2016 were included in the observation group. Another 80 eyes in 40 healthy subjects in our hospital were included in the control group during the same period. The mGCC and pRNFL thicknesses of two groups were measured with an optical coherence tomography（ OCT）. The thickness of mGCC and pRNFL and visual field were compared between the two groups. The diagnostic value of mGCC for primary glaucoma was analyzed. Thecorrelation between mGCC and pRNFL and visual field mean defect was detected.RESULTS： The superior,inferior and average mGCC thickness in the observation group was significantly lower than that in the control group（ P〈0. 05）. The superior,inferior and average pRNFL thickness in the observation group were significantly lower than those in the control group,the difference was statistically significant（ P〈0. 05）. The visual field mean defect in the observation group was significantly higher than that in the control group,the difference was statistically significant（ P〈0. 05）.Pearson correlation analysis showed that there was a significant positive correlation between mGCC and pRNFL（ r = 0. 58,P 〈0. 01） and there was a significant negative correlation between mGCC and the average visual field defect（ r =-0.69,P〈0.01） in the observation group. ROC curve analysis showed that the intercept point value of mGCC in the diagnosis of primary glaucoma was86. 39μm. The sensitivity was 82.5% and the specificity was76.25%. CONCLUSION： The mGCC has a certain diagnostic value for primary glaucoma. There is positive correlation between mGCC and pRNFL and negative correlation between that and visual field mean defect.