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[摘要]
目的:通过观察频域OCT(spectral domain optic coherence tomography SD-OCT)与视野的相关性,评估其在监测原发性开角型青光眼(primary open angle glaucoma,POAG)病情进展方面的作用。
方法:回顾性分析。选取2010-01/2016-06在我院就诊的POAG患者48例48眼。随访时间14~62mo。对随访起点及终点的SD-OCT及视野参数进行总结,计算差值。根据视野平均缺损(mean deviation, MD)下降程度(MD下降-2dB)分为视野无进展组及视野进展组。两组SD-OCT各参数的差值与MD差值进行相关性分析。并通过绘制受试者工作特征(ROC)曲线评价SD-OCT各参数对视野进展的评估价值。
结果:视野无进展组25眼,视野进展组23眼。视野无进展组中SD-OCT各参数与MD均无显著的相关性。视野进展组中,盘沿体积(rim volume)(r=-0.5997, P=0.0007)、杯盘横比(C/D vertical ratio)(r=-0.6309,P=0.0003)、视网膜神经纤维层(retinal nerve fiber layer,RNFL)(r=0.4201,P=0.0260)及节细胞复合体(ganglion cell complex,GCC)(r=0.7080, P<0.01)与MD变化有显著的相关性。通过绘制ROC曲线,发现GCC与MD的变化具有较好的符合性(P=0.013)。
结论:SD-OCT作为客观的视网膜检查方法,部分指标能够准确地反映视功能的损害,为POAG病情进展监测提供了新的方法。
[Key word]
[Abstract]
AIM: To evaluate the ability of spectral domain optic coherence tomography(SD-OCT)parameters to detect progressive structural damage in primary open angle glaucoma(POAG)by contrasting with visual field.
METHODS: Retrospectively we evaluated 48 subjects(48 eyes)of POAG, followed up 14 to 62mo. The parameters of SD-OCT and visual field were obtained. The correlation between the change of visual field measurements and OCT measurements were analyzed. Visual field progression was defined as reproducible drop of at least 2dB of mean deviation(MD)from the baseline visit. ROC curve was made to evaluated the ability of OCT parameters in detect progression of POAG.
RESULTS: The 25 eyes were classified in progression group and 23 eyes were in non-progression group. No significant correlation was seen between OCT parameters and visual field in non-progression group. In progression group, OCT parameters which were significantly correlated with MD reduce were rim volume(r=-0.5997,P=0.0007), C/D vertical ratio(r=-0.6309, P=0.0003), RNFL(r=0.4201, P=0.0260), and GCC(r=0.7080,P<0.01). ROC curves showed the GCC reflected the reduce of MD accurately(P=0.013).
CONCLUSION: Part parameters of SD-OCT can reflect the progression of POAG accurately and provided a new method to detect the damage of visual function of POAG.
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