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张睿,孙伟峰,秦海峰,顾操,赵子畅,许冰,赵世红*.频域光学相干断层扫描检测原发性开角型青光眼视盘及黄斑参数的影响因素分析[J].Academic Journal of Second Military Medical University ,2020,41(1):43-48
频域光学相干断层扫描检测原发性开角型青光眼视盘及黄斑参数的影响因素分析    点此下载全文 Fulltext
张睿  孙伟峰  秦海峰  顾操  赵子畅  许冰  赵世红*
长海医院眼科, 上海 200433
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      目的 利用频域光学相干断层扫描(SD-OCT)检测健康对照和早中期原发性开角型青光眼(POAG)患者的视盘及黄斑参数,分析其相关影响因素。方法 选择2015年9月至2018年8月在我科就诊的早中期POAG患者40例(40眼),其中20~39岁者20例、60~79岁者20例;纳入同期在我科就诊的40名(40眼)健康对照,其中20~39岁者20名、60~79岁者20名。受试者均接受全面的眼科检查,并利用SD-OCT测量所有受试者视盘周围视网膜神经纤维层(pRNFL)厚度、黄斑区平均神经节细胞层联合内丛状层(GCL-IPL)厚度、黄斑区最薄GCL-IPL厚度和黄斑区平均整体厚度。结果 健康对照组和早中期POAG组黄斑区平均GCL-IPL厚度及最薄GCL-IPL厚度均随年龄增长而变薄,差异均有统计学意义(P<0.05,P<0.01);两组黄斑区平均整体厚度随着年龄的增长均无明显变化。在健康对照组,年龄因素对pRNFL厚度影响不大,20~39岁者与60~79岁者pRNFL厚度差异无统计学意义(P>0.05)。在早中期POAG组,20~39岁者和60~79岁者pRNFL平均厚度、上方厚度、下方厚度和颞侧厚度与健康对照组同年龄者相比均变薄,且60~79岁者上述pRNFL厚度与20~39岁者相比更薄,差异均有统计学意义(P<0.01);早中期POAG组pRNFL鼻侧厚度在20~39岁者与60~79岁者之间差异无统计学意义(P>0.05),与健康对照组同年龄者相比差异亦无统计学意义(P>0.05)。结论 SD-OCT测量的pRNFL厚度与POAG有关,可作为早期诊断POAG的检测指标。
关键词:频域光学相干断层扫描  开角型青光眼  视盘神经纤维层厚度  黄斑区神经节细胞层联合内丛状层厚度
Parameters of optic disc and macular in primary open-angle glaucoma measured by spectral domain optical coherence tomography and its influencing factors    Fulltext
ZHANG Rui  SUN Wei-feng  QIN Hai-feng  GU Cao  ZHAO Zi-chang  XU Bing  ZHAO Shi-hong*
Department of Ophthalmology, Changhai Hospital, Naval Medical University(Second Military Medical University)
, Shanghai 200433, China
*Corresponding author
Fund Project:Supported by National Natural Science Foundation of China (81970822).
      Objective To measure the parameters of optic disc and macula by spectral domain-optical coherence tomography (SD-OCT) in healthy controls and patients with mild or moderate primary open-angle glaucoma (POAG), and to analyze the related influencing factors. Methods Forty patients (40 eyes) with mild or moderate POAG who were admitted to our department from Sep. 2015 to Aug. 2018 were enrolled, including 20 patients aged 20-39 years old and 20 patients aged 60-79 years old. Contemporaneous 40 healthy controls (40 eyes) were also included (20 aged 20-39 years old and 20 aged 60-79 years old). All subjects received comprehensive ophthalmic examination. SD-OCT was used to measure the thickness of peripapillary retinal nerve fiber layer (pRNFL), the thickness of macular average ganglion cell layer combined with the inner plexiform layer (GCL-IPL), the macular minimum GCL-IPL thickness, and the average thickness of the macular cube. Results The average and minimum GCL-IPL thickness decreased significantly with age in both healthy control and POAG groups (P<0.05, P<0.01). With the increase of age, the average macular cube thickness did not change significantly in the two groups. In the healthy control group, there was no significant difference in the pRNFL thickness between 20-39 and 60-79 years old subgroups (P>0.05). The mean, superior, inferior and temporal thicknesses of pRNFL in the POAG group (both 20-39 years old and 60-79 years old subgroups) were significantly thinner than those in the healthy control group (P<0.05, P<0.01). Moreover, the thickness of pRNFL in POAG patients aged 60-79 years was significantly thinner than those in POAG patients aged 20-39 years (P<0.05, P<0.01). There was no significant difference in the nasal thickness of pRNFL between 20-39 and 60-79 years old patients in the POAG group (P>0.05). And no significant difference was found in the nasal thickness of pRNFL between POAG group and healthy control group of the same age (P>0.05). Conclusion The pRNFL thickness measured by SD-OCT is related to POAG, and it can be used as a detection index for early diagnosis of POAG.
Keywords:spectral domain optical coherence tomography  open angle glaucoma  peripapillary retinal nerve fiber layer thickness  macular ganglion cell layer combined with inner plexiform layer thickness
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