目的: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,比较DDLS评分是否比杯盘比(cup/disc ratio,C/D)值更能反映POAG视野缺损的程度。方法:共有56例56眼POAG患者纳入本研究。在双盲情况下确定C/D值。完成对受检者的OCTOPUS-900视野计(G2-TOP)和HRT-Ⅲ检查后,记录视野平均缺损值(meandefect,MD),再根据HRT-Ⅲ的地形图对受检者的视盘进行DDLS评分。结果选用Pearson相关系数进行评价。结果:大视盘(视盘面积3.09~3.43mm2)9眼、中等大小的视盘(2.41~2.67mm2)34眼和小视盘(1.64~1.81mm2)13眼纳入分析。DDLS与MD强相关(总:Pearsonr=0.916,P<0.01;大视盘:Pearsonr=0.850,P=0.0037,中视盘:Pearsonr=0.934,P<0.01;小视盘:Pearsonr=0.912,P<0.01)。C/D与MD有中等程度相关(总:Pearsonr=0.676,P<0.01;大视盘:Pearsonr=0.472,P=0.199,中视盘:Pearsonr=0.682,P<0.01;小视盘:Pearsonr=0.788,P=0.0014)。结论:利用HRT-Ⅲ对POAG的视盘进行DDLS分期,是比C/D更好地对POAG视神经损害程度进行分级的方法。

AIM:To score disc damage likelihood scale(DDLS)in primary open angle glaucoma(POAG)using Heidelberg retina tomography-Ⅲ(HRT-Ⅲ)and to determine if DDLS score is better than cup/disc ratio(C/D)values in reflecting the extent of visual field defects in POAG.METHODS:A total of 56 POAG patients were included in this study.It was in double-blind case to determine C/D values.After the OCTOPUS-900 perimeter(G2-TOP)and HRT-Ⅲ examination,the value of vision mean defect(MD)were recorded.According to the topographic map of HRT-Ⅲ,DDLS score of the optic disc for subjects was gained.Results were evaluated with Pearsons correlation coefficient.RESULTS:Large optic disc(optic disc area of 3.09-3.43mm2)of 9 eyes,medium-sized disc(2.41-2.67mm2)34 eyes and small optic disc(1.64-1.81mm2)13 eyes were included in the analysis.DDLS was strongly associated with MD(total:Pearson r=0.916,P<0.01;large disc:Pearson r=0.850,P=0.0037,medium-sized optic disc:Pearson r=0.934,P<0.01;small disc:Pearson r=0.912,P<0.01).C/D had moderate correlation with the MD(total:Pearson r=0.676,P<0.01;large disc:Pearson r=0.472,P=0.199,medium-sized disc:Pearson r=0.682,P<0.01;small disc:Pearson r=0.788,P=0.0014).CONCLUSION:Using HRT-Ⅲ to do DDLS staging for POAG optic disc has better grade in the extent of optic nerve damage than the C/D.

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