论文部分内容阅读
目的:通过分析光学相干断层扫描(OCT)测量颅咽管瘤患者黄斑区视网膜神经节细胞复合体(GCC)及视盘周围视网膜神经纤维层(pRNFL)厚度的变化及其与视野平均缺损度(MD)及视野平均敏感度(MS)的相关性,探讨OCT检查应用于评估颅咽管瘤患者视路损伤的可行性。方法:对2014-09/2015-04在我神经外科就诊的颅咽管瘤患者95例175眼进行视野和OCT检查,测量神经纤维层厚度和GCC层厚度,利用Spearman等级相关系数(r s)评价其与MD、MS的相关性,并分析其视乳头及视野改变的特点。结果:pRNFL厚度异常眼占53.1%(93/175),其中,视乳头水肿占3.4%(6/175),视神经萎缩占47.4%(83/175),视乳头类青光眼样改变者占7.4%(13/175)。视野缺损占71.4%(125/175)。双眼的pRNFL平均厚度(r s右眼=-0.411,r s左眼=-0.354)及GCC平均厚度(r s右眼=-0.400,r s左眼=-0.314),与MD相关(P<0.01);双眼的pRNFL平均厚度(r s右眼=0.412,r s左眼=0.342)及GCC平均厚度(r s右眼=0.414,r s左眼=0.299),与MS相关(P<0.01)。结论:pRNFL和GCC厚度与视野损害相关,可定量的评估鞍区肿瘤患者的视神经损害程度。pRNFL和GCC厚度越薄,视功能损害越严重。在临床工作中,将视野检查和OCT检查结合起来,更有利于发现及评估患者的视路损害及预后。
OBJECTIVE: To measure the changes of thickness of retinal ganglion cell complex (GCC) and retinal nerve fiber layer (pRNFL) in macular area and their relationship with the average visual field defect (MD) by analyzing optical coherence tomography (OCT) ) And visual field average sensitivity (MS), and to investigate the feasibility of using OCT in assessing optic path injury in patients with craniopharyngioma. Methods: 95 cases (175 eyes) of craniopharyngioma treated in our department of neurosurgery from September 2014 to April 2015 were examined by field of vision and OCT. The thickness of nerve fiber layer and thickness of GCC were measured by Spearman rank correlation coefficient (rs) Its correlation with MD, MS, and analysis of the characteristics of the optic disc and visual field changes. Results: Abnormal thickness of pRNFL accounted for 53.1% (93/175). Among them, optic disc edema accounted for 3.4% (6/175), optic atrophy accounted for 47.4% (83/175), optic nerve head like glaucoma accounted for 7.4% (13/175). Visual field defects accounted for 71.4% (125/175). The average thickness of pRNFL in both eyes (rs = -0.411 for rs, -0.354 for left eyes for rs = -0.354) and mean thickness for GCC (rs = -0.400 for left eyes and -0.314 for left eyes) were significantly associated with MD (P <0.01) The average thickness of pRNFL (rs right eye = 0.412, rs left eye = 0.342) and GCC mean thickness (rs right eye = 0.414, rs left eye = 0.299) were associated with MS (P <0.01). CONCLUSIONS: The thickness of pRNFL and GCC correlates with visual field damage, which can quantitatively assess the extent of optic nerve damage in patients with secundum tumors. The thinner the pRNFL and GCC, the more severe the impairment of visual function. In clinical work, the combination of visual field examination and OCT examination, more conducive to the discovery and assessment of patients with optic path injury and prognosis.