摘要【目的】探讨光学相干断层扫描仪(Optical CoherenceTomography,OCT)后极部非对称性检查对青光眼的早期诊断价值。【方法】选取2015年1月至2018年1月于本院接受治疗的可疑开角型青光眼(SOAG)患者21例31眼,原发性开角型青光眼(POAG)患者23例33眼作为研究对象,同期选取于本院检测视力且健康者30例49眼作为对照组(CON组)。比较三组受试者视野指标、视网膜神经纤维层厚度(RNFL)及后极部位视网膜厚度参数,分析POAG组和SOAG组患者视野平均缺损(visual field mean defdct,MD)与后极部位视网膜厚度非对称性间相关性。【结果】SOAG组、CON组颞侧RNFL平均厚度、RNFL平均厚度、鼻侧RNFL平均厚度、上方RNFL平均厚度及下方RNFL平均厚度均显著高于POAG组,差异有统计学意义(P<0.05),CON组下方RNFL平均厚度显著高于SOAG组,差异有统计学意义(P<0.05); SOAG组、CON组后极部位视网膜下方、上方及平均厚度均显著高于POAG组,差异有统计学意义(P<0.05),SOAG组和CON组比较,差异无统计学意义(P>0.05);CON组、POAG组及SOAG组视野MD分别是(1.43±1.03)dB、(-13.18±1.12)dB、(-1.69±1.04)dB,差异有统计学意义(P<0.05);Spearman相关分析显示,SOAG组患者D2、D3及D5与视野MD有相关性,POAG组患者各个参数与视野MD没有相关性。【结论】OCT可检测出SOAG患者后极部位视网膜厚度非对称性变化情况,对诊断前期开角型青光眼有一定帮助。
Abstract：【Objective】To explore the value of post-polar asymmetry examination of optical coherence tomography (OCT) in the early diagnosis of glaucoma. 【Methods】From January 2015 to January 2018, 21 patients (31 eyes) with suspected open angle glaucoma (SOAG) and 23 patients (33 eyes) with primary open angle glaucoma (POAG) were selected as the study subjects. At the same time, 30 patients (49 eyes) with visual acuity and healthy subjects were selected as the control group (CON group). The parameters of visual field index, retinal nerve fiber layer thickness (RNFL) and retinal thickness at the posterior pole were compared among the three groups. The correlation between mean visual field defect (MD) and asymmetry of retinal thickness at the posterior pole in POAG group and SOAG group was analyzed.【Results】The mean thickness of RNFL in temporal side, RNFL in nasal side, RNFL in upper part and RNFL in lower part of CON group were significantly higher than those in POAG group (P<0.05). The mean thickness of RNFL in lower part of the CON group was significantly higher than that in the SOAG group (P<0.05). The posterior retina thickness of the CON group was significantly higher than that of the POAG group (P<0.05). There was no significant difference between the SOAG group and the CON group (P>0.05). The visual field MD of the CON group, the POAG group and the SOAG group were (1.43±1.03) dB, (-13.18±1.12) dB, (-1.69 ±1.04) dB, respectively. Spearman correlation analysis showed that D2, D3 and D5 in the SOAG group were correlated with visual field MD, while parameters in the POAG group were not correlated with visual field MD.【Conclusion】OCT can detect the asymmetric changes of retinal thickness in the posterior pole of patients with SOAG, which is helpful for the diagnosis of early open-angle glaucoma.
龙波, 杨旭, 苟文军. OCT后极部非对称性检查对青光眼的早期诊断价值[J]. 医学临床研究, 2019, 36(7): 1305-1307.
LONG Bo, YANG Xu, GOU Wen-jun. OCT technique posterior pole asymmetry examination for early diagnosis of glaucoma. JOURNAL OF CLINICAL RESEARCH, 2019, 36(7): 1305-1307.
2019, Vol. 36 
