[关键词]
[摘要]
目的：分析光学相干断层扫描技术(OCT)测量黄斑区神经节细胞复合体(mGCC)、视盘周围视网膜神经纤维层(pRNFL)、黄斑区视网膜神经纤维层(mRNFL)和黄斑区神经节细胞层+内丛状层(GCIP)厚度对早期原发性开角型青光眼(POAG)的诊断价值。
方法：采用病例对照研究设计，收集2019-01/2020-01于我院收治的早期POAG患者82例82眼，选择同期健康志愿者40例40眼(左右眼各20眼)为对照组，所有受检者均检查裸眼视力(UCVA)及最佳矫正视力(BCVA)及等效球镜度数，比较两组受检者上方、下方、鼻侧、颞侧及平均的pRNFL厚度及上、下方、平均的mGCC、黄斑区视网膜神经纤维层(mRNFL)、黄斑区神经节细胞层+内丛状层(GCIP)厚度，采用Spearman分析各指标平均厚度之间的相关性，采用ROC曲线分析mGCC、pRNFL、mRNFL和GCIP厚度参数诊断早期POAG的价值。
结果：早期POAG组患者上方、鼻侧、下方、颞侧、平均pRNFL厚度和上方、下方及平均mGCC、mRNFL、GCIP厚度均低于对照组(均P<0.05)。平均pRNFL厚度与平均mGCC厚度、平均mRNFL厚度及平均GCIP厚度正相关(rs=0.582、0.632、0.456，均P<0.05)； 平均mGCC厚度与平均mRNFL厚度及平均GCIP厚度正相关(rs=0.583、0.851，均P<0.05)； 平均mRNFL厚度与平均GCIP厚度正相关(rs=0.528，均P<0.01)。ROC曲线分析得出不同部位mGCC厚度及平均值AUC值均在0.8以上，其诊断效能最高。
结论：OCT测量mGCC诊断早期POAG具有一定价值。
[Key word]
[Abstract]
AIM:To analyze the diagnostic value of optical coherence tomography(OCT)for early primary open angle glaucoma(POAG)by measuring the thickness of macular ganglion cell complex(mGCC), peripapillary retinal nerve fiber layer(pRNFL), macular retinal nerve fiber layer(mRNFL)and retinal ganglion cell layer+inner plexiform layer(GCIP)in the macular region.
METHODS:A case-control study design was used to collect 82 patients(82 eyes)with early POAG who admitted to our hospital from January 2019 to January 2020. There were 40 healthy volunteers(40 eyes)in the same period selected as the control group(20 eyes for left and right eyes, respectively). All subjects underwent tests of uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA)and equivalent spherical power. The upper, lower, nasal, temporal and average pRNFL thickness, the upper, lower and average mGCC, mRNFL and GCIP thickness in the macular region were analyzed. Spearman was used to analyze the correlation among the average thickness of eachindices, and ROC curve was used to analyze the value of mGCC, pRNFL, mRNF and GCIP thickness parameters in diagnosing early POAG.
RESULTS:In the early POAG group, the thickness of upper, nasal, lower, temporal, average pRNFL and the thickness of upper, lower and average mGCC, mRNFL and GCIP were lower than those in the control group(all P<0.05). Average thickness of pRNFL was positively correlated with average thickness of mGCC, average mRNFL and average GCIP(rs=0.582, 0.632, 0.456, all P<0.05); average thickness of mGCC was positively correlated with average thickness of mRNFL and average GCIP(rs=0.583, 0.851, all P<0.05); Average thickness of mRNFL was positively correlated with average thickness of GCIP(rs=0.528, all P<0.01). ROC curve analysis shows that the AUC value of mGCC thickness and average value in early diagnosis of POAG were all above 0.8, and the diagnostic efficiency was the highest.
CONCLUSION: OCT measurement of mGCC has certain value in diagnosing early POAG.
[中图分类号]
[基金项目]
河北省卫生健康委员会2018年河北省医学研究重点课题计划(No.20181245)
