青光眼FD-OCT結(jié)構(gòu)損害與視野功能損害關(guān)系研究
發(fā)布時(shí)間：2019-05-22 20:51
【摘要】：目的 應(yīng)用頻域-相干光斷層掃描(frequence domain optical coherence tomography, FD-OCT)與標(biāo)準(zhǔn)自動(dòng)視野檢查法(standard automated perimetry, SAP)分別測(cè)量的視盤參數(shù)及六分區(qū)視網(wǎng)膜神經(jīng)纖維層(retinal nerve fiber layer, RNFL)厚度與相對(duì)應(yīng)六分區(qū)視野指標(biāo),研究早期發(fā)現(xiàn)與隨訪青光眼的敏感指標(biāo),分析聊城人群青光眼引起眼底結(jié)構(gòu)損害與功能損害的關(guān)系及直線模型適用性。 研究方法 (1)選擇2009年2月-2010年1月來(lái)我院確診為原發(fā)性開(kāi)角型青光眼患者14例19眼,可疑開(kāi)角型青光眼23例40眼,健康對(duì)照組15例29眼。分別用FD-OCT視盤固視3D掃描模式與Humphrey 720中心24-2標(biāo)準(zhǔn)閾值模式作為SAP檢查入選對(duì)象視盤參數(shù)及六分區(qū)視網(wǎng)膜神經(jīng)纖維層厚度(R值)與相對(duì)應(yīng)六分區(qū)視野線性光敏感度值(T值)及視野光敏感度缺損值(D值)。(2)FD-OCT測(cè)量并分析視盤參數(shù)視盤面積(DA),視杯面積(CA),盤沿面積(RA),視杯容積(CV),盤沿容積(RV),杯盤比(CDR),線性杯盤比(LCDR),視盤深度(DH),視盤寬度(DW),記錄并保存所有數(shù)據(jù)：六分區(qū)平均R值分別記為視盤顳側(cè)(R1),顳上(R2),鼻上(R3),鼻側(cè)(R4),鼻下(R5),顳下(R6),記錄并保存所有數(shù)據(jù)；與R值對(duì)應(yīng)SAP六分區(qū)T值/D值分別記為乳頭黃斑區(qū)(T1/D1),下方弓狀易損區(qū)(T2/D2),下方區(qū)(T3/D3),顳區(qū)(T4/D4),上方區(qū)(T5/D5),上方弓狀易損區(qū)(T6/D6),記錄并保存所有數(shù)據(jù)。(3)用SPSS13.0統(tǒng)計(jì)軟件分析收集數(shù)據(jù)資料,視盤參數(shù)、六分區(qū)R值、六分區(qū)T值組間差異分析選擇單因素方差分析,組間兩兩差異分析選擇q檢驗(yàn)；各視盤參數(shù)與六分區(qū)R值及T值兩兩關(guān)系用Pearson相關(guān)分析。視盤參數(shù)和六分區(qū)R值與相對(duì)應(yīng)六分區(qū)D值關(guān)系用Spearman秩相關(guān)分析。(4)六分區(qū)R值對(duì)應(yīng)到六分區(qū)T值,建立直線模型如下：R=soT+b。R是區(qū)域R值,T是與R值對(duì)應(yīng)區(qū)域T值,so是健康人群軸索厚度組成R值部分,b是所有敏感度和軸索丟失時(shí)剩余厚度。(5)根據(jù)研究結(jié)果分析早期診斷和長(zhǎng)期隨訪青光眼發(fā)生發(fā)展的敏感指標(biāo),分析FD-OCT測(cè)量結(jié)構(gòu)指標(biāo)和SAP測(cè)量功能指標(biāo)在聊城人群中的直線模型適用性。 結(jié)果 (1)原發(fā)性開(kāi)角型青光眼組,可疑青光眼組與健康對(duì)照組三組視盤參數(shù)除RV,DH顯示三組之間差別無(wú)統(tǒng)計(jì)學(xué)意義之外,所有視盤參數(shù)組間差異有統(tǒng)計(jì)學(xué)意義(P0.01)；其中CA,RA,CV,CDR,LCDR三組研究對(duì)象兩兩組間對(duì)比差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)六分區(qū)平均R值都顯示組間差異有統(tǒng)計(jì)學(xué)意義(P0.01),其中R1在三組研究對(duì)象兩兩組間對(duì)比差異有統(tǒng)計(jì)學(xué)意義(P0.05)：R2-R6在原發(fā)性開(kāi)角型青光眼組分別與可疑青光眼組及健康對(duì)照組差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(3)六分區(qū)平均T值都顯示組間差異有統(tǒng)計(jì)學(xué)意義(P0.01),其中T1,T5在兩兩組間差異有統(tǒng)計(jì)學(xué)意義(P0.05)；T2-T4,T6在原發(fā)性開(kāi)角型青光眼組分別與可疑青光眼組及健康對(duì)照組差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(4)CA,RA,CDR,LCDR分別與六分區(qū)R值(R1-R6),六分區(qū)T值/D值(T1-T6,D1-D6)不同程度相關(guān)(P0.05),其余視盤參數(shù)與六分區(qū)R值,T值,D值之間無(wú)明顯相關(guān)性；六分區(qū)各R值與相對(duì)應(yīng)T值/D值呈中高度正相關(guān)(P0.001)其中R1-T1,R2-T2,R6-T6,R1-D1,R2-D2, R6-D6表現(xiàn)出高度正相關(guān),相關(guān)系數(shù)分別為0.812,0.858,0.751,0.742,0.746,0.725(P0.001)。(5)建立直線模型：視盤顳下區(qū)R6=100.59T6+50.30(T61)；R6=150.89 (T6≥1);顳上區(qū)R2=92.60T2+46.30(T21)；R2=138.90(T2≥1)；顳側(cè)區(qū)R1=54.80 T1+33.03(T11);R1=87.83(T1≥1)。 結(jié)論 (1)FD-OCT測(cè)量視盤參數(shù)視杯面積CA,盤沿面積RA,杯盤比CDR,線性杯盤比LCDR是早期診斷和長(zhǎng)期隨訪青光眼進(jìn)展的重要敏感指標(biāo)。(2)FD-OCT測(cè)量的六分區(qū)的視網(wǎng)膜神經(jīng)纖維層厚度改變有利于早期發(fā)現(xiàn)青光眼引起的局限區(qū)域性神經(jīng)節(jié)細(xì)胞損傷與改變。(3)SAP測(cè)量并計(jì)算的乳頭黃斑區(qū),下方弓狀纖維易損區(qū)和上方弓狀纖維易損區(qū)光敏感度改變利于早期發(fā)現(xiàn)青光眼引起的局限性視功能損傷與改變。(4)結(jié)構(gòu)-功能相關(guān)性：視盤顳側(cè)R1-乳頭黃斑束T1/D1、顳上R2-下方弓狀纖維易損區(qū)T2/D2、顳下區(qū)R-上方弓狀纖維易損區(qū)T6/D6有高度的相關(guān)性,分區(qū)域結(jié)構(gòu)損傷與功能損傷研究成為可能。(5)聊城地區(qū)人群總體上適用于FD-OCT結(jié)構(gòu)損傷與SAP功能損傷直線模型。能夠利用該模型深入分析青光眼結(jié)構(gòu)損傷與功能損傷的相互關(guān)系。
[Abstract]:Purpose The optic disc parameters and the corresponding six-zone retinal nerve fiber layer (RFL) thickness of the six-zone retinal nerve fiber layer (RFL) and the corresponding six-zone field of view were measured by frequency-domain-optical coherence tomography (FD-OCT) and standard automatic visual field (SAP), respectively. In this paper, the sensitive index of early detection and follow-up of glaucoma is studied, and the relationship between the damage of the fundus structure and the function damage caused by glaucoma in Liaocheng population and the application of the linear model are analyzed. Sex. Methods (1) From February 2009 to January 2010,14 patients with primary open-angle glaucoma were diagnosed as primary open-angle glaucoma,23 patients with open-angle glaucoma,40 eyes, and healthy control group 1. Five cases (29 eyes) were treated with FD-OCT, 3D scan pattern and Humphrey 720-center 24-2 standard threshold pattern as the target optic disc parameter of the subject and the thickness (R value) of the six-zone retinal nerve fiber layer (R-value) and the corresponding six-zone visual field linear light sensitivity (T-value) and the field-of-view light sensitivity. loss Value (D-value). (2) FD-OCT measures and analyzes the disc area (DA), the apparent cup area (CA), the disc-edge area (RA), the apparent cup volume (CV), the disc-edge volume (RV), the cup-to-plate ratio (CDR), the linear cup-to-plate ratio (LCDR), the disc depth (DH), the disc width, Degree (DW), record and keep all data: the average R value of the six-zone is recorded as the video disk drive side (R1), the upper (R2), the nose (R3), the nasal side (R4), the nose (R5), the lower (R6), the record and the protection, respectively. All data is stored; the value/ D value of the SAP 6-section corresponding to the R value is recorded as the papilla-related macular area (T1/ D1), the lower bow-like vulnerable area (T2/ D2), the lower area (T3/ D3), the crotch area (T4/ D4), the upper area (T5/ D5), the upper bow-like vulnerable area (T6/ D6), the record and the protection All the data were stored. (3) The data, the video disc parameters, the six-zone R value and the six-zone T-value group were analyzed by using the SPSS13.0 statistical software to select one-factor analysis of variance, and the two-to-group difference analysis and selection q-test were selected; each video disc parameter and the six-zone R value and the T-value were used as the Pearson. n-correlation analysis. The video disc parameter and the six-zone R value and the corresponding six-zone D-value relation are used in Spearman Rank correlation analysis. (4) The six-zone R value corresponds to the six-zone T value, and the linear model is established as follows: R = soT + b. R is the area R value, T is the area T value corresponding to the R value, so is the healthy population axis cable thickness, and the R value part, b is all the sensitivity and the axial cable loss (5) To analyze the sensitive index of early diagnosis and long-term follow-up glaucoma according to the results of the study, and to analyze the linear relationship between the measurement structure of FD-OCT and the function of SAP measurement in Liaocheng population. model Results (1) There was no significant difference between the two groups of optic disc parameters except RV and DH in the primary open-angle glaucoma group, the suspected glaucoma group and the healthy control group (P0.01). There was a statistical difference between the two groups in the three groups: RA, CV, CDR and LCDR. The significance (P0.05). (2) The mean R value of the six-zone group showed statistical significance between the groups (P0.01), in which the difference between the two groups in R1 in the three groups was statistically significant (P0.01). Significance (P0.05): The difference of R2-R6 in primary open-angle glaucoma group and the group of suspected glaucoma group and healthy control group was statistically significant. The difference of T1 and T5 between the two groups was statistically significant (P0.05), and the difference between T2-T4 and T6 in the primary open-angle glaucoma group was statistically significant (P0.05). The significance (P0.05). (4) CA, RA, CDR and LCDR were related to the different degrees of the six-zone R value (R1-R6), the six-zone T-value/ D (T1-T6, D1-D6) (P0.05), the other video disc parameters and the six-zone R-value, the T-value, the D-value, There was no significant correlation between the values of R1-T1, R2-T2, R6-T6, R1-D1, R2-D2 and R6-D6. The correlation coefficient was 0.812, 0.858, 0.751, 0.742, 0.746, 0.72, respectively. 5 (P0.001). (5) Establishment of a linear model: the lower region of the optic disc is R6 = 100.59 T6 + 50.30 (T61); R6 = 150.89 (T6-1); the upper region R2 = 92.60 T2 + 46.30 (T21); R2 = 138.90 (T2-1); the primary side region R1 = 54.80 T1 + 33.03 (T11); R1 = 87 .8 Conclusion (1) FD-OCT is used to measure the visual cup area CA of the optic disc, the area RA, the ratio of the cup to the CDR, the linear cup and the LCDR are the early diagnosis and the long-term follow-up. (2) The change of the thickness of the retinal nerve fiber layer in the six-zone measured by FD-OCT is beneficial to the early detection of the limitation of glaucoma The damage and change of regional ganglion cells. (3) The change of the sensitivity of light sensitivity in the papilla area, the lower arch-shaped fiber vulnerable area and the upper arch-shaped fiber vulnerable area measured and calculated by the SAP is beneficial to the early detection of the glaucoma. (4) Structure-function correlation: the relationship between the two-side R1-papilla-related macular bundles T1/ D1, the upper R2-lower arch-shaped fiber vulnerable region T2/ D2 and the lower region R-upper arch-shaped fiber vulnerable region T6/ D6 has a high correlation, and the sub-region structure Damage and functional damage studies have become possible. (5) The Liaocheng area population is generally applicable to FD-OCT structural loss A linear model of injury and SAP functional damage. The model can be used to analyze the glaucoma knot.
【學(xué)位授予單位】：泰山醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類號(hào)】：R775
本文編號(hào)：2483252
[Abstract]:Purpose The optic disc parameters and the corresponding six-zone retinal nerve fiber layer (RFL) thickness of the six-zone retinal nerve fiber layer (RFL) and the corresponding six-zone field of view were measured by frequency-domain-optical coherence tomography (FD-OCT) and standard automatic visual field (SAP), respectively. In this paper, the sensitive index of early detection and follow-up of glaucoma is studied, and the relationship between the damage of the fundus structure and the function damage caused by glaucoma in Liaocheng population and the application of the linear model are analyzed. Sex. Methods (1) From February 2009 to January 2010,14 patients with primary open-angle glaucoma were diagnosed as primary open-angle glaucoma,23 patients with open-angle glaucoma,40 eyes, and healthy control group 1. Five cases (29 eyes) were treated with FD-OCT, 3D scan pattern and Humphrey 720-center 24-2 standard threshold pattern as the target optic disc parameter of the subject and the thickness (R value) of the six-zone retinal nerve fiber layer (R-value) and the corresponding six-zone visual field linear light sensitivity (T-value) and the field-of-view light sensitivity. loss Value (D-value). (2) FD-OCT measures and analyzes the disc area (DA), the apparent cup area (CA), the disc-edge area (RA), the apparent cup volume (CV), the disc-edge volume (RV), the cup-to-plate ratio (CDR), the linear cup-to-plate ratio (LCDR), the disc depth (DH), the disc width, Degree (DW), record and keep all data: the average R value of the six-zone is recorded as the video disk drive side (R1), the upper (R2), the nose (R3), the nasal side (R4), the nose (R5), the lower (R6), the record and the protection, respectively. All data is stored; the value/ D value of the SAP 6-section corresponding to the R value is recorded as the papilla-related macular area (T1/ D1), the lower bow-like vulnerable area (T2/ D2), the lower area (T3/ D3), the crotch area (T4/ D4), the upper area (T5/ D5), the upper bow-like vulnerable area (T6/ D6), the record and the protection All the data were stored. (3) The data, the video disc parameters, the six-zone R value and the six-zone T-value group were analyzed by using the SPSS13.0 statistical software to select one-factor analysis of variance, and the two-to-group difference analysis and selection q-test were selected; each video disc parameter and the six-zone R value and the T-value were used as the Pearson. n-correlation analysis. The video disc parameter and the six-zone R value and the corresponding six-zone D-value relation are used in Spearman Rank correlation analysis. (4) The six-zone R value corresponds to the six-zone T value, and the linear model is established as follows: R = soT + b. R is the area R value, T is the area T value corresponding to the R value, so is the healthy population axis cable thickness, and the R value part, b is all the sensitivity and the axial cable loss (5) To analyze the sensitive index of early diagnosis and long-term follow-up glaucoma according to the results of the study, and to analyze the linear relationship between the measurement structure of FD-OCT and the function of SAP measurement in Liaocheng population. model Results (1) There was no significant difference between the two groups of optic disc parameters except RV and DH in the primary open-angle glaucoma group, the suspected glaucoma group and the healthy control group (P0.01). There was a statistical difference between the two groups in the three groups: RA, CV, CDR and LCDR. The significance (P0.05). (2) The mean R value of the six-zone group showed statistical significance between the groups (P0.01), in which the difference between the two groups in R1 in the three groups was statistically significant (P0.01). Significance (P0.05): The difference of R2-R6 in primary open-angle glaucoma group and the group of suspected glaucoma group and healthy control group was statistically significant. The difference of T1 and T5 between the two groups was statistically significant (P0.05), and the difference between T2-T4 and T6 in the primary open-angle glaucoma group was statistically significant (P0.05). The significance (P0.05). (4) CA, RA, CDR and LCDR were related to the different degrees of the six-zone R value (R1-R6), the six-zone T-value/ D (T1-T6, D1-D6) (P0.05), the other video disc parameters and the six-zone R-value, the T-value, the D-value, There was no significant correlation between the values of R1-T1, R2-T2, R6-T6, R1-D1, R2-D2 and R6-D6. The correlation coefficient was 0.812, 0.858, 0.751, 0.742, 0.746, 0.72, respectively. 5 (P0.001). (5) Establishment of a linear model: the lower region of the optic disc is R6 = 100.59 T6 + 50.30 (T61); R6 = 150.89 (T6-1); the upper region R2 = 92.60 T2 + 46.30 (T21); R2 = 138.90 (T2-1); the primary side region R1 = 54.80 T1 + 33.03 (T11); R1 = 87 .8 Conclusion (1) FD-OCT is used to measure the visual cup area CA of the optic disc, the area RA, the ratio of the cup to the CDR, the linear cup and the LCDR are the early diagnosis and the long-term follow-up. (2) The change of the thickness of the retinal nerve fiber layer in the six-zone measured by FD-OCT is beneficial to the early detection of the limitation of glaucoma The damage and change of regional ganglion cells. (3) The change of the sensitivity of light sensitivity in the papilla area, the lower arch-shaped fiber vulnerable area and the upper arch-shaped fiber vulnerable area measured and calculated by the SAP is beneficial to the early detection of the glaucoma. (4) Structure-function correlation: the relationship between the two-side R1-papilla-related macular bundles T1/ D1, the upper R2-lower arch-shaped fiber vulnerable region T2/ D2 and the lower region R-upper arch-shaped fiber vulnerable region T6/ D6 has a high correlation, and the sub-region structure Damage and functional damage studies have become possible. (5) The Liaocheng area population is generally applicable to FD-OCT structural loss A linear model of injury and SAP functional damage. The model can be used to analyze the glaucoma knot.
【學(xué)位授予單位】：泰山醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類號(hào)】：R775
【共引文獻(xiàn)】
相關(guān)期刊論文 前5條
1 王寧利;;北京同仁醫(yī)院眼科中心8年發(fā)展歷程回顧[J];首都醫(yī)科大學(xué)學(xué)報(bào);2010年04期
2 王保君;朱紅軍;張海濤;楊華;;OCT測(cè)量黃斑區(qū)神經(jīng)節(jié)細(xì)胞復(fù)合體厚度在早期原發(fā)性開(kāi)角型青光眼診斷中的作用[J];眼科新進(jìn)展;2011年11期
3 陳燕云;王寧利;梁遠(yuǎn)波;王蘭;甄毅;;原發(fā)性開(kāi)角型青光眼和閉角型青光眼早期視神經(jīng)損害特征的比較[J];眼科;2007年01期
4 朱紅軍;趙萌;王保君;李順元;張海濤;;OCT測(cè)量視網(wǎng)膜神經(jīng)纖維層厚度的可重復(fù)性分析[J];中國(guó)民康醫(yī)學(xué);2010年21期
5 彭燕一;張玉明;曾新生;黃海;丁芝祥;邱梅園;;光學(xué)相干斷層掃描在測(cè)量8~12歲國(guó)人正常眼視網(wǎng)膜神經(jīng)纖維層厚度中的應(yīng)用[J];眼科新進(jìn)展;2013年11期
相關(guān)博士學(xué)位論文 前1條
1 黃海荔;原發(fā)性開(kāi)角型青光眼結(jié)構(gòu)及功能損害一致性評(píng)價(jià)研究[D];復(fù)旦大學(xué);2012年
相關(guān)碩士學(xué)位論文 前3條
1 劉宇;OCT在原發(fā)性青光眼早期診斷中的臨床應(yīng)用研究[D];大連醫(yī)科大學(xué);2011年
2 楊月杰;OCT在區(qū)別青光眼性和非青光眼性大視杯中的作用[D];新鄉(xiāng)醫(yī)學(xué)院;2012年
3 潘艷杰;視網(wǎng)膜神經(jīng)節(jié)細(xì)胞復(fù)合體厚度與神經(jīng)纖維層厚度的相關(guān)性及其在青光眼診斷中的應(yīng)用[D];新鄉(xiāng)醫(yī)學(xué)院;2013年
，本文編號(hào)：2483252
本文鏈接：http://sikaile.net/yixuelunwen/yank/2483252.html
最近更新
教材專著
