摘要
【目的】探讨瞳孔状态对光学相干断层扫描仪(OCT3)测量视网膜神经纤维层(RNFL)厚度值的影响及其诊断青光眼的准确性。【方法】正常人38例72眼,原发性开角型青光眼患者19例34眼,分别在自然瞳孔(2.5￣3mm)和药物散瞳下(6￣8mm)用OCT3成组扫描程序(RNFLThickness3.4)进行检查。对散瞳前后各象限RNFL厚度及全周平均值进行对比,分别计算散瞳前后RNFL厚度测量值的ROC曲线下面积。【结果】正常人散瞳前颞侧、上方、鼻侧、下方、平均的RNFL厚度(!m)分别为77±12、122±16、68±13、125±16、98±9,散瞳后相应的RNFL厚度分别是75±13、122±17、71±13、125±14、98±10,散瞳前后比较,除鼻侧外(P为0.039),其余象限及全周RNFL厚度差异无显著性(P为0.478～0.870)。原发性开角型青光眼患者散瞳前颞侧、上方、鼻侧、下方、平均的RNFL厚度(!m)分别为63±13、90±20、58±15、72±22、71±9,散瞳后相应的RNFL厚度分别是65±13、93±22、60±12、74±22、73±10,散瞳前后颞侧和全周RNFL厚度平均值差异有显著性(P分别为0.011、0.008),其余各方位差异无显著性(P为0.109～0.172)。散瞳前后平均及下方视网膜神经纤维层厚度测量值的ROC曲线下面积最大,为0.971～0.983。【结论】应用OCT3测量RNFL厚度,瞳孔大小对测量值影响不大,但瞳孔不能小于2.5mm,屈光间质混浊时应散瞳检查。自然瞳孔及散瞳下运用OCT3测量RNFL厚度诊断青光眼的准确性高,结果可靠。
[Objective] To assess the effect of pupil size on measurement of retinal nerve fiber layer （RNFL） thickness using optical coherence tomography （OCT3） and its value on diagnosis of glaucoma. [Methods] Seventy- two eyes of 38 normal subjects and 34 eyes of 19 patients with primary open-angle glaucoma （POAG） were scanned before and after pupil dilation by using OCT3. Regular RNFL scan protocol （RNFL Thickness 3.4） was used. RNFL thickness measurements before and after dilation were compared. The areas under ROC curve were calculated. [Results] The temporal, superior, nasal, inferior and mean RNFL thickness measurements （pan） of normal subjects before dilation were 77±12, 122±16, 68±13, 125±16, and 98±9, respectively, while those after dilation were 75±13, 122±17, 71±13, 125±14, and 98±10, respectively. There was no significant difference between the RNFL measurement before and after dilation （P=0.478±0.870） except the nasal quadrant （P=0.039）. For the POAG patients, the temporal, superior, nasal, inferior and mean RNFL thickness measurements （μm） before dilation were 63±13, 90±20, 58±15, 72±22, and 71±9, respectively, while those after dilation were 65±13, 93±22,60±12, 74±22, and 73±10, respectively. There was no significant difference between the RNFL measurements before and after dilation （P=0.109±0.172） except the temporal quadrant and mean RNFL measurement （P=0.011 and 0.008,respectively）. The areas under ROC curve of mean and inferior RNFL thickness measurements before and after dilation were 0.971-0.983. [Conclusion] Pupil size does not affect the RNFL thickness measurement obviously using OCT3 if the pupil size is larger than 2.5 mm. And it is better to scan in dilated pupil when the optic media is blurred. The diagnosis of glaucoma by RNFL thickness measurement using OCT3 before and after pupil dilation is reliable.
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2006年第2期212-216,220,共6页
Journal of Sun Yat-Sen University:Medical Sciences
基金
广东省科技计划基金资助项目(2003C32725)
