摘要
目的探讨后极部视网膜厚度分析在青光眼早期诊断中的应用价值。方法用视网膜厚度分析仪(RetinalThicknessAnalyzer,RTA)对正常人61例(61只眼)、青光眼患者30例(46只眼)及青光眼待排者12例(20只眼)行后极部视网膜厚度测量,所取图像经计算机处理后,得到该处视网膜厚度的数据及二维、三维图像。所得数据用SAS软件包进行分析。结果正常人后极部视网膜厚度图呈马蹄形,上下对称,黄斑鼻侧视网膜较颞侧厚10.45%(p<0.01)。青光眼患者的视网膜呈弥漫性或局限性变薄,伴有正常形态的消失。正常人与青光眼患者后极部平均视网膜厚度及9个测量点之间视网膜厚度分别相比差异均有极显著性意义(p<0.01)。25只早期青光眼中,11只眼有早期青光眼视野改变,14只眼视野检查正常。该25只眼中,6只眼RTA检查正常,其余19只眼视网膜均有不同程度变薄及厚度图形态异常。RTA检查对早期青光眼的敏感性较视野检查要高(p<0.05)。正常人与青光眼待排者后极部平均视网膜厚度及9个测量点视网膜厚度分别比较,第7个点差异无统计学意义(p>0.05),第3、5、6、9点差异有显著性意义(p<0.05),第1、2、4、8点及后极部平均视网膜厚度差异有极显著性意义(p<0.01)。20只待排眼中除1只眼视野检查有下方可疑旁中心暗点外,其余眼视野检查均正常;10只眼RTA检查发现视网膜有不同程度变薄及厚度图形态异常,另10只眼RTA检查正常。青光眼患者及青光眼待排者共10例(18只眼)在平均追踪观察9.6个月后,再行后极部RTA复查,结果显示复查前后视网膜厚度改变差异无统计学意义(p>0.05)。结论后极部视网膜厚度分析有助于青光眼的早期诊断,并可用于青光眼患者治疗和病情进展的监测及青光眼待排患者的跟踪观察。
Objective To explore the practical value of retinal thickness analysis in the early diagnosis of glaucoma. Methods The posterior pole was examined by using retinal thickness analyzer （RTA） in 61cases of normal subjects （61 eyes）, 30 cases of glaucoma patients （46 eyes）, and 12 cases of glaucoma suspects （20 eyes）. Retinal thickness was obtained by analyzing the detected images with computer. All the data were analyzed by SAS software package. Results The retinal thickness map at the posterior pole expressed a horseshoe shape with symmetry between above and below the fovea, and the nasal retinal thickness was 10.54% thicker than the temple in normal human （p〈0.01）. RTA examination results in posterior pole of 30 glaucoma patients （46 eyes）. The retinal thickness of the glaucoma patients became diffusely or locally thinner with the disappearance of normal shape, significant difference was obtained in retinal thickness of 9 detecting point between the normal and the glaucoma subjects （p〈0.01）. Of 25 eyes of glaucoma of early stage, lateral-central scotoma or/and nasal ladder was detected in 11 eyes and visual field was normal in 14 eyesby using automatic perimetric examination; while retinal thickness was normal only in 6 eyes, and retinal thickness was detected to different extent thinner and retinal thickness maps detected abnormal in the rest eyes by using RTA examination. RTA examination in glaucoma of early stage was more sensitive than automatic perimetric examination （p〈0.05）. RTA examination results in 12 glaucoma suspects （20 eyes）. Significant difference of retinal thickness existed at 3, 5, 6, 9 point （P〈0.05） and at 1, 2, 4, 8 point （p〈0.01） as well as of the average retinal thickness of posterior pole between normal subjects and glaucoma suspects but at 7 point （p〉0.05）. Of the 20 eyes examined, only one was detected suspected lateral central scotoma, all the rest detected normal by using automatic perimetric examination, while, by using RTA, 10 eyes （7 patients） detected to different extent thinner of retina and abnormal alteration of retinal thickness maps, and the results of the rest 10 eyes were normal. In 10 cases （18 eyes）of the glaucoma patients and the glaucoma suspects, no significant difference existed between the RTA results of the reexamination and the results of the first examination （p〉0.05）. Conclusion Retinal thickness analysis may provide a sensitive method for the detection and monitoring of early glaucomatous tissue loss in the posterior pole.
出处
《中国实用眼科杂志》
CSCD
北大核心
2006年第5期480-485,共6页
Chinese Journal of Practical Ophthalmology
关键词
视网膜厚度分析
青光眼
诊断
Glaucoma
Retinal thickness analysis
Diagnosis
