本文選題：光學(xué)相干斷層掃描 + 視網(wǎng)膜神經(jīng)纖維層��； 參考：《新鄉(xiāng)醫(yī)學(xué)院》2012年碩士論文

【摘要】：背景隨著生活水平的提高及科技的進(jìn)步,青光眼已成為主要的致盲性眼病。青光眼診斷難點(diǎn)之一就是由其他視神經(jīng)疾病引起的杯盤比增大及類似青光眼樣的生理性大視杯與青光眼性大杯盤比的鑒別診斷。 目的利用光學(xué)相干斷層掃描技術(shù)(RTVue-100FD-OCT)比較青光眼性大視杯和生理性大視杯及其他視神經(jīng)疾病引起的大視杯患者RNFL (Retinal Nerve Fiber Layer,視網(wǎng)膜神經(jīng)纖維層)各部位厚度,視盤參數(shù)及黃斑區(qū)GCC (Ganglion Cell Complex,神經(jīng)節(jié)細(xì)胞復(fù)合體)厚度差異,研究OCT在區(qū)分青光眼性大視杯和非青光眼性大視杯中的作用。 方法選取青光眼性大視杯18例28眼為青光眼組,生理性大視杯17例24眼為生理性大杯組,其他視神經(jīng)疾病引起大視杯者15例20眼為視神經(jīng)疾病組。利用光學(xué)相干斷層掃描技術(shù)RNFL3.45程序,ONH (Optic Nerve Head,視神經(jīng)乳頭)程序及GCC程序的掃描記錄青光眼患者,非青光眼者RNFL各部位厚度,黃斑區(qū)GCC厚度及各視盤參數(shù)值,SPSS16.0統(tǒng)計(jì)軟件對(duì)比各組間RNFL各部位厚度,黃斑區(qū)GCC厚度及各視盤參數(shù)值有無差異。 結(jié)果OCT測(cè)量青光眼組、視神經(jīng)疾病組和生理性大視杯組RNFL全周平均RNFL厚度及顳側(cè)、上方、鼻側(cè)、下方RNFL厚度值。青光眼組和視神經(jīng)疾病組比較,平均RNFL厚度無明顯差異(P=0.3430.05),上方,下方象限,顳側(cè),鼻側(cè)象限兩組RNFL厚度均有顯著性差異(P0.05),上下方象限,青光眼組RNFL厚度明顯小于視神經(jīng)疾病組,顳鼻側(cè)象限青光眼組RNFL厚度則高于視神經(jīng)疾病組。青光眼組和視神經(jīng)疾病組與生理性大視杯組比較,各個(gè)部位RNFL厚度均有顯著性差異(P0.05)。 OCT測(cè)量三組黃斑區(qū)Average、Superior Inferior GCC厚度值,各組內(nèi)平均GCC厚度及上方、下方象限GCC厚度值間對(duì)比差異無統(tǒng)計(jì)學(xué)意義(P0.05)。三組間平均GCC厚度及上方、下方象限GCC厚度值間對(duì)比,差異有顯著統(tǒng)計(jì)學(xué)意義(P0.05)。青光眼組和視神經(jīng)疾病組比較,平均GCC厚度,上方,下方GCC厚度均有明顯差異(P0.05),即青光眼組各部位GCC厚度均較視神經(jīng)疾病組小。青光眼組和視神經(jīng)疾病組與生理性大視杯組比較,平均GCC厚度,上方,下方GCC厚度均有顯著性差異(P0.05),即青光眼組和視神經(jīng)疾病組平均GCC厚度,上方,下方GCC厚度均較生理性大視杯組降低。 視盤參數(shù)中,盤沿面積,盤沿容積,杯盤垂直徑比青光眼組與視神經(jīng)疾病組和生理性大視杯組比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05),視神經(jīng)疾病組和生理性大杯組間則差異無統(tǒng)計(jì)學(xué)意義(P0.05),杯盤水平徑比三組間兩兩比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05),余視盤參數(shù)無統(tǒng)計(jì)學(xué)意義。 結(jié)論通過OCT的檢測(cè)能發(fā)現(xiàn)青光眼患者和能引起大視杯的其他視神經(jīng)疾病患者RNFL各個(gè)部位厚度,黃斑區(qū)GCC厚度及視盤參數(shù)之間均有差別,具體結(jié)論如下： 1.青光眼疾病上、下象限RNFL極易受損,視神經(jīng)疾病引起的大視杯顳、鼻象限易受損,兩組平均RNFL厚度均降低,即平均RNFL厚度損害不是青光眼所特有的。 2.青光眼和視神經(jīng)疾病引起的大視杯患者黃斑區(qū)GCC厚度均降低,但視神經(jīng)疾病降低更明顯。 3.青光眼的盤沿面積和盤沿容積均減小,非青光眼無明顯改變。青光眼和視神經(jīng)疾病引起的大視杯組視盤容積小于生理性大視杯組。青光眼組的杯盤水平徑比小于視神經(jīng)疾病引起的大視杯組。青光眼組的杯盤垂直徑比大于非青光眼性大視杯組。
[Abstract]:Background With the improvement of living standard and the progress of science and technology , glaucoma has become the primary blindness eye disease . One of the difficulties in diagnosis of glaucoma is the differential diagnosis of the ratio of cup - to - disc ratio caused by other optic nerve diseases and the ratio of physiological macrovision cup similar to glaucoma .

Objective To compare the thickness of RNFL ( retinal nerve fiber layer ) , optic disc parameters and the thickness difference of GCC ( Ganglion Cell Complex , Ganglion Cell Complex ) in patients with glaucoma with large visual cup and optic neuropathy caused by optic coherence tomography ( RTVue - 100FD - OCT ) .

Methods 18 eyes of 18 patients with glaucoma were treated with optic coherence tomography ( RNFL 3.45 ) , ONH ( Optic Nerve Head ) program and GCC procedure . The thickness of RNFL , the thickness of GCC and the parameter values of each optic disc were recorded .

Results Compared with the optic neuropathy group , the thickness of RNFL was significantly different between the two groups ( P = 0.3430 . 05 ) . Compared with the optic nerve disease group , the thickness of RNFL in the superior , inferior and inferior quadrants was significantly lower than that in the optic nerve disease group .

The average GCC thickness , upper and lower GCC thickness were significantly different between the three groups ( P0.05 ) . The average GCC thickness , upper and lower GCC thickness were significantly different between the three groups ( P0.05 ) . The average GCC thickness , upper and lower GCC thickness were significantly different between the glaucoma group and the optic nerve disease group ( P0.05 ) .

There was no significant difference between the optic nerve disease group ( P0.05 ) , the optic nerve disease group and the physiological large cup group ( P0.05 ) .

Conclusion The detection of OCT can reveal the difference between the thickness of RNFL , GCC thickness and optic disc parameters in patients with glaucoma and other patients with optic neuropathy which can cause macrovision . The specific conclusions are as follows :

1 . In glaucoma , the RNFL in the lower quadrant is extremely vulnerable , and the temporal and nasal quadrants of the macrovision cup caused by optic neuropathy are easily damaged , and the average RNFL thickness of the two groups is reduced , that is , the average RNFL thickness damage is not characteristic of glaucoma .

2 . The GCC thickness of macular region in patients with glaucoma and optic neuropathy decreased , but optic neuropathy was more pronounced .

3 . The volume of the disc in the glaucoma group and the volume of the disc were both decreased and the non - glaucoma was not changed significantly . The volume of the optic disc of the large - view cup group caused by glaucoma and optic neuropathy was smaller than that of the physiological large - view cup group . The diameter ratio of the cup in the glaucoma group was smaller than that of the large - view cup group caused by optic nerve disease . The vertical diameter ratio of the cup in the glaucoma group was larger than that of the non - glaucoma macrovision cup group .

【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R775.2

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