【摘要】：目的 通過應(yīng)用光學(xué)相干斷層成像術(shù)(Optical coherence tomography, OCT)、偏振激光掃描儀聯(lián)合個(gè)體化角膜補(bǔ)償技術(shù)(Scanning laser polarimetry with variable corneal compensation, GDxVCC)檢測高度近視眼(High myopia, HM)合并原發(fā)性開角型青光眼(Primary open-angle glaucoma, POAG)的視網(wǎng)膜神經(jīng)纖維層(Retinal nerve fiber layer, RNFL)的厚度,分析HM合并POAG的視網(wǎng)膜神經(jīng)纖維層在OCT、GDxVCC檢測中的厚度特征,分析OCT、GDxVCC參數(shù)相關(guān)性,探討OCT、GDxVCC對高度近視眼合并原發(fā)性開角型青光眼的診斷作用。 方法 選取等效球鏡(Spherical equivalent, SE)-6.0D--12.0D的高度近視患者12例(12只眼),為HM組；選取SE-6.0D--12.0D高度近視眼合并原發(fā)性開角型青光眼的患者12例(12只眼),為HM-POAG組,分別進(jìn)行GDxVCC檢測、OCT快速RNFL厚度掃描(Fast RNFL thickness)、Humphrey電腦自動視野計(jì)檢查。得到GDxVCC參數(shù)：上方RNFL平均厚度(Superior Average)、下方RNFL平均厚度(Inferior Average)、橢圓環(huán)內(nèi)平均RNFL厚度(TSNIT Average)、神經(jīng)纖維指數(shù)(Nerve Fiber Indicator, NFI);OCT參數(shù)：上方平均RNFL厚度(Savg)、下方RNFL平均厚度(Iavg)、鼻側(cè)RNFL平均厚度(Navg)、顳側(cè)RNFL平均厚度(Tavg).全周RNFL平均厚度(Avg.Thick);視野參數(shù)：平均缺損(Mean defect, MD)、模式標(biāo)準(zhǔn)差(Pattern standard deviation, PSD)。并采用SPSS16.0統(tǒng)計(jì)軟件包,對所得到的RNFL厚度參數(shù)和視野參數(shù)進(jìn)行統(tǒng)計(jì)分析。 結(jié)果 HM組與HM-POAG組在年齡、SE無統(tǒng)計(jì)學(xué)差異(P0.05)。與HM組比較,HM-POAG組在參數(shù)Superior Average、Inferior Average、TSNIT Average、Savg、 Iavg、Tavg、Avg、Thick數(shù)值變小,NFI數(shù)值變大,均有統(tǒng)計(jì)學(xué)差異(P0.05)；兩組在OCT參數(shù)Navg無統(tǒng)計(jì)學(xué)差異(P0.05)；相關(guān)性分析TSNIT Average和Avg.Thick相關(guān)性好,相關(guān)系數(shù)r=0.764(P0.05)；TSNIT Average、Avg.Thick和MD相關(guān)系數(shù)分別為0.727、0.637(P0.05)；TSNIT Average、Avg.Thick和PSD相關(guān)系數(shù)別為-0.735、-0.774(P0.05)。GDxVCC.OCT各參數(shù)值Superior Average、Inferior Average. TSNIT Average、NFI、Savg、Iavg、Navg、Tavg、Avg.Thick受試者工作曲線下面積(Area Under Receiver Operating Characteristic Curve, AUROC)0.972.0.882.0.958.0.993.0.896.0.927.0.576.0.958.0.965.NFI的AUROC為最大。結(jié)論 1HM-POAG組RNFL厚度在Superior Average. Inferior Average. TSNIT Average、Savg、Iavg、Tavg、Avg.Thick均較HM組明顯變薄,兩組在Navg無顯著性差異。 2.OCT和GDxVCC在檢測HM組與HM-POAG組RNFL厚度有良好的一致性。 3.OCT及GDxVCC均對HM合并POAG有很好的診斷價(jià)值,GDxVCC優(yōu)于OCT,診斷效能從大到小依次為NFI Superior Average Avg.Thick TSNIT Average、Tavg Iavg SavgInferior Average Navg, Navg診斷效能差。
[Abstract]:Objective to detect the thickness of retinal nerve fiber layer (Retinal nerve fiber layer, RNFL) in high myopia (High myopia, HM) complicated with primary open angle glaucoma (Primary open-angle glaucoma, POAG) by optical coherence tomography (Optical coherence tomography, OCT),) polarization laser scanner combined with individualized corneal compensation technique (Scanning laser polarimetry with variable corneal compensation, GDxVCC), and to analyze the retinal nerve fiber layer of HM with POAG in OCT,. The thickness characteristics of GDxVCC were measured, the correlation of OCT,GDxVCC parameters was analyzed, and the diagnostic role of OCT,GDxVCC in the diagnosis of high myopia complicated with primary open-angle glaucoma was discussed. Methods 12 patients (12 eyes) with high myopia with equivalent spherical (Spherical equivalent, SE)-6.0D--12.0D were selected as HM group, and 12 patients (12 eyes) with SE-6.0D--12.0D high myopia complicated with primary open-angle glaucoma were selected as HM-POAG group for GDxVCC detection and OCT rapid RNFL thickness scan (Fast RNFL thickness), Humphrey computer automatic myopic examination. The GDxVCC parameters were obtained: the RNFL average thickness below the upper RNFL average thickness (Superior Average), the average RNFL thickness in the elliptical ring of (Inferior Average), the (TSNIT Average), nerve fiber index (Nerve Fiber Indicator, NFI); OCT parameter: the upper average RNFL thickness (Savg), the RNFL average thickness (Iavg), nasal RNFL average thickness (Navg), temporal RNFL average thickness (Tavg). Full-week RNFL mean thickness (Avg.Thick); visual field parameters: average defect (Mean defect, MD), model standard deviation (Pattern standard deviation, PSD). The thickness parameters and field parameters of RNFL are statistically analyzed by using SPSS16.0 software package. Results there was no significant difference in age and SE between HM group and HM-POAG group (P 0.05). Compared with HM group, HM-POAG group had significant difference in parameter Superior Average,Inferior Average,TSNIT Average,Savg, Iavg,Tavg,Avg,Thick value and NFI value (P 0.05). There was no significant difference in OCT parameter Navg between the two groups (P 0.05). Correlation analysis showed that TSNIT Average and Avg.Thick had good correlation coefficient r 鈮，

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