分离格栅视觉诱发电位联合HD-OCT对早期原发性开角型青光眼的诊断效能研究

Diagnostic efficacy of IC-VEP and HD-OCT in early primary open-angle glaucoma

目的应用分离格栅视觉诱发电位(IC-VEP)和高清度相干光层析成像术(HD-OCT)分析、评估早期原发性开角型青光眼(POAG)功能和结构变化,为POAG的早期诊断提供依据。方法收集2017年3月至2019年4月在我院就诊的POAG患者(观察组)31例(31只眼),平均年龄(43.11±5.34)岁(24~56岁);正常对照者(对照组)30例(30只眼),平均年龄(42.88±5.15)岁(27~59岁)。所有受试者均行视野、HD-OCT及IC-VEP检测,统计分析两组受试者基线资料,评估各参数的诊断效能。结果两组受试者的性别、年龄、最佳矫正视力、屈光度、中央角膜厚度均无统计学差异(P﹥0.05),视野平均缺损比较P﹤0.01。早期POAG患者IC-VEP及HD-OCT检查的敏感性和特异性分别为83.87%和90%,80.64%和86.67%,两者敏感性及特异性比较均P﹥0.05。IC-VEP检测早期POAG的ROC曲线下面积(AUCs)为0.901,和黄斑区不同部位节细胞内丛状层(GCIPL)的AUCs比较,均无统计学差异(P>0.05),两者的一致性检测率为65.57%。结论IC-VEP联合HD-OCT对早期POAG诊断的效能较高,快捷、简便,能够提高POAG早期诊断率,降低青光眼致盲率。

Objective To analyze and assess the function and structural changes in early POAG with the IC-VEP and HD-OCT and provide evidence for diagnosis of early POAG.Methods 31 eyes of 31 patients with POAG(Observed group)and 30 eyes of 30 normal persons(Control group)were collected in our hospital from March 2017 to April 2019.The average age was(43.11±5.34)years(24~56 years)and(42.88±5.15)years(27~59 years)in the observed group and control group,respectively.The visual field,HD-OCT,and IC-VEP were performed for all subjects.The baseline data of two groups were analyzed with statistics and each parameter was evaluated for its diagnostic efficacy.Results There was no statistical difference in gender,age,best corrected visual acuity,refractive diopter,and central corneal thickness between the two groups of subjects(P﹥0.05).The statistically significant difference was found in MD between the two groups(P﹤0.01).The sensitivity and specificity of IC-VEP and HD-OCT in early POAG patients were 83.87%and 90%,80.64%and 86.67%,respectively.Also,these changes were not different.The AUCs shown by IC-VEP was 0.901 in early POAG,compared with the AUCs of GCIPL in different parts of the macula,there was no statistical difference(P﹥0.05).The detection rate of consistency was 65.57%in the two groups.Conclusions IC-VEP combined with HD-OCT has high efficacy on the diagnosis for early POAG,fast and simple,and can improve the early diagnosis rate of POAG,as well as reduce the blindness rate of glaucoma.