目的：探讨扫频源光学相干层析成像(SS-OCT)技术检测视网膜神经纤维层(RNFL)厚度及视盘参数在原发性闭角型青光眼(PACG)疗效评价中的应用价值。

方法：选择接受周边虹膜切开术、小梁切除术治疗的PACG患者60例68眼，根据术后2mo后的眼压情况将患者分为控制组(<21mmHg，39例45眼)和未控制组(≥21mmHg，21例23眼)。采用SS-OCT检测两组患者治疗前和治疗后6mo RNFL厚度及视盘参数，评价治疗效果。

结果：治疗后，两组患者眼压均明显降低，且控制组明显低于未控制组(P<0.05)。治疗后，控制组患者各RNFL厚度均较治疗前无明显差异(P>0.05)，而未控制组则明显变薄，与控制组比较差异均有统计学意义(P<0.05)。治疗后，未控制组患者视盘面积(DA)明显增大，盘沿面积(RA)、盘沿容积(RV)明显减小(P<0.05)，控制组患者各视盘参数均明显优于未控制组(P<0.05)。眼压与视盘参数DA呈正相关，与RA呈负相关(r=0.415、-0.399，均P<0.05)。

结论：SS-OCT可准确反映PACG患者眼压控制后RNFL厚度与视盘参数的变化，对于PACG病情追踪及疗效评估具有一定的临床价值。

METHODS: Totally 60 PACG patients(68 eyes)who was treated with peripheral iridotomy and trabeculectomy was selected. According to the intraocular pressure during postoperative follow-up, all the patients were divided into controlled group(<21mmHg, 39 cases 45 eyes), uncontrolled group(≥21mmHg, 21 cases 23 eyes). The SS-OCT was used to detect the RNFL thickness and optic disc parameters before and after treatment in both groups, and the therapeutic effect was evaluated.

RESULTS: The intraocular pressure in both groups were significantly reduced after treatment, and the controlled group was significantly lower than that in uncontrolled group(P<0.05). After treatment, the RNFL thickness in controlled group had not obvious difference compared with that before treatment(P>0.05), but it was obviously thinned in uncontrolled group compared with before treatment and control group(P<0.05). After treatment, disc area(DA)in uncontrolled group was increased obviously, and rim area(RA), rim volume(RV)was significantly reduced(P<0.05), and the optic disc parameters in controlled group were obviously better than those in uncontrolled group(P<0.05). Intraocular pressure was positively correlated with optic disc parameter DA, and negatively correlated with RA(r=0.415, -0.399; P<0.05).

CONCLUSION: SS-OCT can accurately reflect the change of optic disc parameters and RNFL thickness after intraocular pressure controlled in PACG patients. It has a certain clinical value in follow-up and efficacy evaluation for PACG.