目的:探讨利用海德堡视网膜断层扫描仪-Ⅲ(HRT-Ⅲ)对原发性开角型青光眼(primary open angle glaucoma,POAG)进行视盘损伤可能度(disc damage likelihood scale,DDLS)评分,DDLS值能否反映POAG视盘结构和功能的变化。方法:共有60例POAG纳入本研究。对受检者进行HRT-Ⅲ和OCTOPUS-900视野检查,记录盘沿面积(rim area,RA)和视野平均缺损(mean defect,MD)值。根据HRT-Ⅲ的地形图、反射图和DDLS评分表,对受检者的视盘进行DDLS评分。对结果选用Persons相关系数分析各数值之间的相关性。结果:患者60眼中视盘面积3.09～3.43mm2有11眼,2.41～2.67mm2有36眼,1.64～1.81mm2有13眼。研究结果显示DDLS值与RA和MD相关;随视盘面积变化,DDLS值与MD相关性无明显变化。结论:应用HRT对POAG视盘进行DDLS分期,能够很好的对视神经结构和功能的损害程度进行分级。

AIM:To evaluate whether the disc damage likelihood scale(DDLS)graded by the map of heidelberg retina tomography(HRT) is correlated with the structural and functional change in optic nerve with primary open angle glaucoma(POAG).METHODS: Consecutive observational case series of 60 eyes 60 patients with POAG were enrolled in the study. HRT-Ⅲ examination was performed by an examiner masked to the clinical examination findings. While all eyes were detected by OCTOPUS -900 visual field perimetry (G2-TOP). Rim area(RA) and mean defect(MD)were recorded. The DDLS score were graded by topographic and reflective map of HRT-Ⅲ. Findings were assessed by the Pearsons.RESULTS: Eleven eyes with optic discs of 3.09 to 3.43mm2,36 eyes with optic discs of 2.41 to 2.67mm2 and 13 eyes with optic discs of 1.64 to 1.81 mm2 were analyzed. The results showed that DDLS was strongly correlated with RA and MD,and the correlation between DDLS and MD did not change obviously along with magnification of optic disc area.CONCLUSION: The DDLS graded by the map of HRT is a good method to grade the change of structural and function in optic nerve with POAG.

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