[关键词]
[摘要]
目的：探讨OCT检测原发性开角型青光眼(POAG)患者视网膜神经纤维层厚度(RNFL)的改变及视野缺损情况。
方法：回顾性病例系列研究。将POAG患者158例158眼作为POAG组，其中早期81眼，中期47眼，晚期30眼，选取同期体检无眼部相关疾病者50例50眼作为对照组。检测上方、下方、鼻侧、颞侧RNFL厚度及视野平均缺损值，POAG患者随诊3mo观察连续性变化。
结果：POAG组随诊前及随诊3mo上方、下方、鼻侧、颞侧RNFL厚度均低于对照组，视野平均缺损值多于对照组，差异有统计学意义(P<0.05)； 早期POAG患者各部位RNFL厚度、视野平均缺损值与对照组比较差异无统计学意义(P>0.05)，但各部位RNFL厚度高于中期、晚期POAG患者，视野平均缺损值少于中期、晚期POAG患者，差异有统计学意义(P<0.05)； POAG组随诊前和随诊3mo各部位RNFL、视野平均缺损值比较差异无统计学意义(P>0.05)。Pearson相关分析显示，上方、下方、鼻侧、颞侧RNFL厚度与视野平均缺损值均呈负相关关系(r=-0.719、-0.615、-0.681、-0.518，均P<0.05)。
结论：OCT可监测POAG患者RNFL厚度变化，且与视野平均缺损呈负相关关系，可用于POAG早期诊断。
[Key word]
[Abstract]
AIM: To investigate the application of retinal nerve fiber layer(RNFL)thickness detected by OCT in the diagnosis of primary open angle glaucoma(POAG)and its relationship with the mean defect of visual field.
METHODS: A retrospective study was carried out. Totally 158 cases(158 eyes)of patients with POAG were selected as POAG group, including 81 cases in early stage, 47 cases in middle stage and 30 cases in late stage. At the same time, 50 cases of persons without eye related diseases were selected as the control group. The upper, lower, nasal and bitamporal RNFL thickness and mean defect of visual field were detected, and the patients with POAG were followed up for 3mo.
RESULTS: The upper, lower, nasal and bitamporal RNFL in POAG group were thinner than those in the control, and the mean defect of visual field was higher than that in the control group at different time(P<0.05). There was no significant difference in RNFL thickness and mean defect of visual field between patients with early POAG and the control group(P>0.05). The RNFL thickness of various parts was higher than that in patients with middle and late POAG, and the mean defect of visual field was lower than that in patients with middle and late POAG(P<0.05). There was no significant difference in RNFL thickness of various parts and mean defect of visual field in POAG group at different time(P>0.05). Pearson correlation analysis showed that the upper, lower, nasal and bitamporal RNFL thickness was negatively correlated with the mean defect of visual field(r=-0.719, -0.615, -0.681, -0.518, P<0.05).
CONCLUSION: OCT can monitor the change of RNFL thickness in patients with POAG, and has a negative correlation with mean defect of visual field, which can be used for early diagnosis of POAG.
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