【摘要】：目的采用光學(xué)相干斷層掃描(optical coherence tomography,OCT)觀察視盤水腫患者視盤周圍區(qū)域厚度參數(shù)的改變,為視盤水腫的臨床評(píng)估尋找新方法。方法選取2012年10月至2015年10月在我院門診就診和住院的視盤水腫患者36例(36眼)作為研究對(duì)象,同時(shí)選取在我院體檢的無(wú)眼科疾病的正常人51人(51眼)作為對(duì)照組。所有研究對(duì)象均檢測(cè)視力、裂隙燈、眼底及眼底照相,全部研究眼均行OCT掃描檢測(cè)視盤周圍視網(wǎng)膜神經(jīng)纖維厚度(circumpapillary retinal nerve fiber layer thickness,cpRNFLT)及視盤周圍視網(wǎng)膜總厚度(circumpapillary total retinal thickness,cp TRT)。結(jié)果本研究選取的36例視盤水腫患者中輕度5例,中度15例,重度16例。OCT掃描后,連續(xù)檢查3次均不能獲得滿意圖像或計(jì)算機(jī)無(wú)法正確分析者將被剔除,最后有25例視盤水腫患者(輕度5例,中度14例,重度6例)符合分析cpRNFLT的要求;30例視盤水腫患者(輕度5例,中度15例,重度10例)符合分析cp TRT的要求;對(duì)照組有50人符合條件納入研究。兩組受試者年齡以及性別構(gòu)成差異均無(wú)統(tǒng)計(jì)學(xué)意義(均為P0.05)。OCT視網(wǎng)膜斷面圖顯示視盤水腫組cpRNFLT及cp TRT光帶明顯增寬,神經(jīng)纖維層下無(wú)反射區(qū)寬度增加;視盤水腫組患者的平均及各象限cpRNFLT明顯增厚,cpRNFLT以上方增厚最明顯,其次是下方,然后是鼻側(cè)和顳側(cè),與對(duì)照組相比差異均有統(tǒng)計(jì)學(xué)意義(均為P0.001)。OCT檢查結(jié)果顯示,視盤水腫組患者平均及各象限cp TRT明顯增厚,cp TRT以下方增厚最明顯,其次是上方,然后是鼻側(cè)和顳側(cè),與對(duì)照組相比差異亦均有統(tǒng)計(jì)學(xué)意義(均為P0.001)。結(jié)論視盤水腫患者視盤周圍區(qū)域厚度參數(shù)均較正常人明顯增厚,這些參數(shù)可作為視盤水腫診斷以及研究的參考指標(biāo)。
[Abstract]:Objective to explore a new method for clinical evaluation of optic disc edema by using optical coherence tomography Oct (Oct) to observe the changes of the thickness parameters around optic disc in patients with optic disc edema. Methods from October 2012 to October 2015, 36 patients (36 eyes) with optic disc edema were selected from outpatients and inpatients in our hospital, and 51 normal subjects (51 eyes) without ophthalmic diseases were selected as control group. All subjects were examined for visual acuity, slit lamp, fundus and fundus photography. All eyes were examined by OCT scanning for the thickness of retinal nerve fibers around the disc (circumpapillary retinal nerve fiber layer thicknesscpRNFLT) and the total retinal thickness around the disc (circumpapillary total retinal thicknesscp TRT). Results among the 36 cases of optic disk edema, 5 cases were mild, 15 cases were moderate, 16 cases were severe. After Oct scan, those who could not obtain satisfactory images for 3 times or who could not be correctly analyzed by computer would be eliminated. Finally, 25 cases of optic disc edema (mild 5 cases, moderate 14 cases, severe 6 cases) met the requirements of cpRNFLT analysis. 30 cases of optic disc edema (mild 5 cases, moderate 15 cases, severe 10 cases) met the requirements of analysis of CP TRT. 50 subjects in the control group were eligible for inclusion in the study. There was no significant difference in age and sex composition between the two groups (P0.05). Oct retinogram showed that the cpRNFLT and CP TRT optical bands were significantly widened and the width of the non-reflex area under the nerve fiber layer was increased in the optic disc edema group. In the optic disc edema group, the average and quadrant cpRNFLT thickening was the most obvious, followed by the inferior side, then the nasal side and the temporal side. The difference was statistically significant compared with the control group (all P0.001). Oct showed that the thickness of cpRNFLT was higher than that of the control group. In the optic disc edema group, the mean and each quadrant cp TRT thickened most significantly under cp TRT, followed by the upper side, then the nasal side and the temporal side, and the difference was also statistically significant compared with the control group (P0. 001). Conclusion the thickness parameters of the perioptic area in the patients with optic disc edema are significantly thicker than those in the normal group. These parameters can be used as a reference index for the diagnosis and study of optic disc edema.
【作者單位】： 廣東醫(yī)科大學(xué)附屬醫(yī)院眼科;
【分類號(hào)】：R774

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