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目的探讨应用频域光学相干断层扫描(spectral-domain optical coherence tomo-graphy,SD-OCT)-RTVue OCT、偏振激光扫描(scanning laser polarimetry,SLP)-偏振光青光眼检测联合个性化角膜补偿系统(glaucoma detection with variable corneal compensation,GDxVCC)和海德堡视网膜断层扫描-Ⅲ(Heidelberg retina tomography-Ⅲ,HRT-Ⅲ)测量所得的视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度参数在青光眼诊断中的作用。方法应用RTVue OCT、GDx VCC和HRT-Ⅲ分别测量62人正常个体和72例青光眼患者总的以及各区域的RNFL厚度,比较正常个体和青光眼患者RNFL厚度。用受试者工作特性曲线下面积(area under the receiver operating characteristic curve,AUC)来评价每一个参数区分正常眼与青光眼的能力大小。结果正常个体和青光眼患者各参数测量值(总的及各区域RNFL厚度)之间比较,差异均有统计学意义(均为P<0.001)。平均RNFL厚度RTVue OCT正常个体为(109.758±9.095)μm,青光眼患者为(80.455±19.353)μm;GDx VCC正常个体为(57.013±5.132)μm,青光眼患者为(45.374±10.417)μm;HRT-Ⅲ正常个体为(295.833±69.485)μm,青光眼患者为(201.385±105.235)μm。各测量参数中,诊断效能最高的是RTVue OCT测得的平均RNFL厚度,其AUC值为0.914±0.026,最低的是颞侧TU和TL区域,其AUC分别为0.783±0.040和0.805±0.039。结论 RTVue OCT测得RNFL厚度参数具有很好的区别正常个体和青光眼患者的能力,在青光眼诊断方面是一个有用的工具。
OBJECTIVE: To investigate the clinical effect of glaucoma with spectral-domain optical coherence tomography (SD-OCT) -TVT OCT and scanning laser polarimetry (SLP) -polarized glaucoma China Objective To investigate the role of retinal nerve fiber layer (RNFL) thickness in the diagnosis of glaucoma by Heidelberg retina tomography-Ⅲ (HRV-GD) and detection of variable corneal compensation (GDxVCC) and Heidelberg retina tomography- Methods The total and regional RNFL thickness of 62 normal subjects and 72 patients with glaucoma were measured by RTVue OCT, GDx VCC and HRT-Ⅲ, and the RNFL thickness was compared between normal subjects and glaucoma patients. The area under the receiver operating characteristic curve (AUC) was used to evaluate the ability of each parameter to distinguish between normal and glaucoma. Results There was significant difference (all P <0.001) between the measured value of each parameter (total and regional RNFL thickness) in normal subjects and glaucoma patients. The average RNFL thickness was (109.758 ± 9.095) μm for RTVue OCT, (80.455 ± 19.353) μm for glaucoma, (57.013 ± 5.132) μm for GDx VCC, and 45.374 ± 10.417 μm for glaucoma; HRT-Ⅲ The normal individual was (295.833 ± 69.485) μm and the glaucoma was (201.385 ± 105.235) μm. Among the measured parameters, the mean RNFL thickness measured by RTVue OCT was 0.914 ± 0.026, with the lowest being the temporal TU and TL regions with AUC of 0.783 ± 0.040 and 0.805 ± 0.039, respectively. Conclusions The RNFL thickness parameter measured by RTVue OCT has a good ability to distinguish between normal individuals and patients with glaucoma and is a useful tool in the diagnosis of glaucoma.