SS-OCT检测PACG患者视网膜神经纤维层厚度及视盘参数的价值

Application of optic disc parameters and RNFL thickness by swept source optical coherence tomography in patients with PACG

目的:探讨扫频源光学相干层析成像(SS-OCT)技术检测视网膜神经纤维层(RNFL)厚度及视盘参数在原发性闭角型青光眼(PACG)疗效评价中的应用价值。方法:选择接受周边虹膜切开术、小梁切除术治疗的PACG患者60例68眼,根据术后2mo后的眼压情况将患者分为控制组(<21mmHg,39例45眼)和未控制组(≥21mmHg,21例23眼)。采用SS-OCT检测两组患者治疗前和治疗后6mo RNFL厚度及视盘参数,评价治疗效果。结果:治疗后,两组患者眼压均明显降低,且控制组明显低于未控制组(P<0.05)。治疗后,控制组患者各RNFL厚度均较治疗前无明显差异(P>0.05),而未控制组则明显变薄,与控制组比较差异均有统计学意义(P<0.05)。治疗后,未控制组患者视盘面积(DA)明显增大,盘沿面积(RA)、盘沿容积(RV)明显减小(P<0.05),控制组患者各视盘参数均明显优于未控制组(P<0.05)。眼压与视盘参数DA呈正相关,与RA呈负相关(r=0.415、-0.399,均P<0.05)。结论:SS-OCT可准确反映PACG患者眼压控制后RNFL厚度与视盘参数的变化,对于PACG病情追踪及疗效评估具有一定的临床价值。

·AIM:To explore the application value of optic disc parameters and retinal nerve fiber layer(RNFL)thickness by swept source optical coherence tomography(SS-OCT)in the efficacy evaluation of primary angle-closure glaucoma(PACG).·METHODS:Totally 60 PACG patients(68 eyes)who was treated with peripheral iridotomy and trabeculectomy was selected.According to the intraocular pressure during postoperative follow-up,all the patients were divided into controlled group(<21mmHg,39 cases 45 eyes),uncontrolled group(≥21mmHg,21 cases 23 eyes).The SS-OCT was used to detect the RNFL thickness and optic disc parameters before and after treatment in both groups,and the therapeutic effect was evaluated.·RESULTS:The intraocular pressure in both groups were significantly reduced after treatment,and the controlled group was significantly lower than that in uncontrolled group(P<0.05).After treatment,the RNFL thickness in controlled group had not obvious difference compared with that before treatment(P>0.05),but it was obviously thinned in uncontrolled group compared with before treatment and control group(P<0.05).After treatment,disc area(DA)in uncontrolled group was increased obviously,and rim area(RA),rim volume(RV)was significantly reduced(P<0.05),and the optic disc parameters in controlled group were obviously better than those in uncontrolled group(P<0.05).Intraocular pressure was positively correlated with optic disc parameter DA,and negatively correlated with RA(r=0.415,-0.399;P<0.05).·CONCLUSION:SS-OCT can accurately reflect the change of optic disc parameters and RNFL thickness after intraocular pressure controlled in PACG patients.It has a certain clinical value in follow-up and efficacy evaluation for PACG.