方法：应用SD-OCT对36例POAG患者和24例正常人监测RNFL厚度。受试者行视盘OCT、眼底照相及视野检查，每6mo一次，随访2a，至少有4次可信的OCT检查结果。根据视野及眼底照相结果将POAG患者划分为进展组和非进展组。分析各组RNFL厚度变化差异，同视野参数变化值做相关性分析。

结果：平均随访2.1±0.3a。17例被确定为POAG进展组。POAG进展组平均RNFL厚度损失速率明显高于POAG非进展组(2.46μm/a vs 1.21μm/a，P<0.001)。下方RNFL厚度变化同视野平均偏差(mean deviation，MD)变化相关性最佳(r=0.423，P=0.03)。

结论：应用SD-OCT纵向监测RNFL厚度，POAG进展者RNFL厚度丢失速率明显增高，下方RNFL厚度参数变化可能在监测中意义较大。

METHODS:A total of 60 eyes, comprising 36 glaucomatous eyes with primary open angle glaucoma(POAG)and 24 healthy controls, were included in the study over a 2-year period. All eyes underwent at least 4 serial RNFL measurements performed by Cirrus OCT every half a year over a period of 2a. Visual field(VF)testing was performed by using the Swedish interactive threshold algorithm(SITA)Standard 30-2 program of the Humphrey field analyzer within the same week as the optic disc/RNFL photography. By masked comparative analysis of VF test results and optic disc/RNFL photographs, the eyes were classified into non-progressive and progressive glaucoma cases. Longitudinal loss of RNFL thickness was compared.

RESULTS: The mean follow-up time was 2.1±0.3a. Seventeen from 36 subjects were identified as progressors. Mean rates of change in average RNFL thickness were significantly higher for progressors compared with nonprogressors(2.46μm/a vs.1.21μm/a; P<0.001). Inferior quadrant RNFL thickness were significantly correlated with MD reduction in glaucoma eyes with progression(r=0.423, P=0.03).

CONCLUSION:Longitudinal measurements of RNFL thickness using SD-OCT show a pronounced reduction in patients with progression compared with patients without progression. Inferior RNFL thickness parameters might be more important in discriminating eyes with progressive glaucomatous optic nerve damage.