【摘要】：目的： 為了評價Humphrey視野青光眼進展指標(GPA)和OCT在鑒別和診斷青光眼進展中的一致性,并確定在青光眼結構性損傷中最敏感的OCT參數(shù)。 方法： 該研究總共有142例病人,142只眼,由(蔡氏光學儀器上海國際貿易有限公司)標準自動視野(SAP)的視野獲得圖像,平均隨訪時間是2.8年。引導進展分析軟件(Carl Zeiss Meditec, Inc.,Shanghai)判斷青光眼進展,隨機系數(shù)模型和接受者操作特征曲線(ROC)用于評估觀察期間OCT參數(shù)和GPA進展度之間的關系。 結果： 142只眼中,運用標準自動視野進展指標分析-SAP-GPA,有19只眼(13%)觀察期間表現(xiàn)為進展(歸類為進展組)；OCT中三個參數(shù)可用于區(qū)分進展組和非進展組：視神經(jīng)纖維層(RNFL)平均厚度,視神經(jīng)纖維層(RNFL)下方厚度以及垂直切面盤沿面積(Rim Area-VCS)。與非進展組相比,進展組視神經(jīng)纖維層(RNFL)平均厚度的改變率要顯著偏高(-3.43μm vs.-0.720μm/y；P0.05),其中靈敏度為67.5%,特異度為94.7%。進展組視神經(jīng)纖維層下方厚度以及盤沿面積(VCS)也明顯高于非進展組,其靈敏度分別為60.2%和53.7%,特異度為73.7%,73.7% 結論： STRATUS OCT能夠顯著檢測出由SAP-GPA分析顯示的所有青光眼進展的病例,具有高特異度和中等靈敏度。在區(qū)分進展組和非進展組時,平均厚度參數(shù)(尤其是平均厚度)比視盤(ONH)參數(shù)更具有顯著意義。因此OCT是檢測青光眼進展的重要技術。
[Abstract]:Objective: to evaluate the consistency of Humphrey visual field glaucoma progression indexes (GPA) and OCT) in differentiating and diagnosing glaucoma progression and to determine the most sensitive OCT parameters in glaucoma structural injury. Methods: a total of 142 patients with 142 eyes were enrolled in this study. The images were obtained from the standard automatic visual field (SAP) of Cai's Optical instrument Shanghai International Trade Co., Ltd. The average follow-up time was 2.8 years. Random coefficient model and receiver operating characteristic curve (ROC) were used to evaluate the relationship between OCT parameters and GPA progression during observation. Results: in 142 eyes, 19 eyes (13%) of SAP-GPA, showed progress during observation (classified as progression group) by using standard automatic visual field index analysis. The three parameters of OCT can be used to distinguish the average thickness of optic nerve fiber layer (RNFL), the thickness of optic nerve fiber layer (RNFL) under (RNFL) and the area of vertical section disc (Rim Area-VCS) between progressive group and non-progressive group. Compared with the non-progressive group, the average thickness of (RNFL) in the optic fiber layer in the progressive group was significantly higher (-3.43 渭 m vs.-0.720 渭 m / y P 0.05), the sensitivity was 67.5 and the specificity was 94.7%. The thickness of the optic fiber layer and the area of the disc edge in the progressive group were also significantly higher than those in the non-progressive group, the sensitivity was 60.2% and 53.7%, and the specificity was 73.7%, respectively. Conclusion: STRATUS OCT can significantly detect all cases of glaucoma progression shown by SAP-GPA analysis with high specificity and moderate sensitivity. The average thickness parameters (especially the average thickness) are more significant than the (ONH) parameters of the disc in differentiating the progressive group from the non-progressive group. Therefore, OCT is an important technique for detecting the progress of glaucoma.
【學位授予單位】：華中科技大學
【學位級別】：博士
【學位授予年份】：2012
【分類號】：R775

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