变化角膜补偿器偏振光激光扫描仪对青光眼的临床观察

Analysis of peripapillary nerve fiber layer thickness measured by Scanning Laser Polarimetry with variable corneal compensation in glaucoma

目的 评价使用变化角膜补偿器的偏振光激光扫描仪 (GDx -VCC)对青光眼患者的定量观察。方法 对青光眼患者 91人 165眼根据有无视野异常及程度分为 :青光眼视野正常组 87眼 ,早期青光眼 5 6眼及中晚期青光眼 2 2眼 ,正常人组 3 6人 3 6眼进行GDx -VCC检查。统计各组平均视神经纤维层厚度 (RNFL)、上方及下方神经纤维层厚度、平均视盘周神经纤维层厚度标准差及视神经纤维索引因素 (NFI)。对各组值进行多组比较统计处理。结果 正常人平均视神经纤维层厚度、上方及下方神经纤维层厚度与视野有异常的青光眼各组值方差分析P <0 0 0 1;与视野正常的青光眼组各对应区域的神经纤维层厚度比较P =0 0 0 9、 0 0 0 5及 0 0 64。结论 使用变化角膜补偿器的偏振光激光扫描仪测量视神经纤维层厚度对正常人与青光眼患者有区别能力 ,能更早于视野反映视神经纤维层异常。

Objective To evaluate the ability of Scanning Laser Polarimetry(SLP)with variable corneal compensation(VCC)to discriminate normal controls from patients with glaucoma.Methods A total of 36 healthy subjects and 91 patients with glaucoma was included.According to the predefined types of visual field defect,glaucomatous eyes were divided into three groups:glaucomatous eyes with normal visual field,with early visual field defects and with moderate and advanced visual visual field defects.Scanning Laser Polarimetry was performed.TSNIT average,superior average,inferior average,TSNIT standard deviation and NFI were measured.Analysis of variance(ANOVA)was used to compare different value among the groups.Results All parameters measured showed statistically significant difference between normal control and glaucoma patients with visual field defects( P <0.001).About TSNIT average and superior average,there were statistically significant differences between normal control and glaucoma patients with normal visual field( P =0.009 and P =0.005).Conclusions Assessments of nerve fiber layer thickness as determined by Scanning Laser Polarimetry with variable corneal compensation can differentiate patients with glaucoma from normal subjects.Decrease of NFL can be found before visual field defect.