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目的探讨青光眼视杯深度变化规律及视杯深度在青光眼诊断中的作用。方法对正常人116例(116只眼)和原发性开角型青光眼患者63例(99只眼)进行了共焦激光扫描眼底镜(HRT)检查,获得12个视盘相关的参数,选取平均视杯深度(MCD)、最大视杯深度(MxCD)和视杯形态测量(CSM)进行两组间的比较。统计学采用双侧-t检验,方差分析,其在青光眼诊断中的作用采用受试者工作曲线(ROC)分析。结果MCD正常组和青光眼组分别为0.196±0.096mm和0.389±0.167mm;MxCD正常组和青光眼组分别为0.559±0.228mm和0.821±0.253mm;CSM正常组和青光眼组分别为-0.213±0.076mm、-0.056±0.088mm。正常人与青光眼患者间三个参数差异均有统计学意义(P值均为0.000)。正常人MCD和MxCD一般以颞侧最深,青光眼患者则多为上方最深。在诊断分析中,CSM、MCD和MxCD的ROC曲线下面积分别为0.892,0.850和0.757。结论视杯深度随着青光眼视杯的扩大、视网膜神经纤维的丢失逐渐加深,以上方的改变最明显。CSM、MCD和MxCD在青光眼的诊断分析有较重要的作用。
Objective To investigate the changes of optic disc depth in glaucoma and the role of optic disc depth in the diagnosis of glaucoma. Methods Sixty-six eyes (116 eyes) of primary open angle glaucoma and 63 eyes of primary open-angle glaucoma (99 eyes) underwent confocal laser scanning fundus (HRT) examination. Twelve parameters related to optic disc were obtained. The average The MCD, MxCD and CSM were compared between the two groups. Bilateral t-test and analysis of variance (ANOVA) were used in the statistics. The role of glaucoma in the diagnosis of glaucoma was analyzed by receiver operating characteristic curve (ROC). Results The MCD normal group and the glaucoma group were 0.196 ± 0.096mm and 0.389 ± 0.167mm respectively; the MxCD normal group and the glaucoma group were 0.559 ± 0.228mm and 0.821 ± 0.253mm respectively; the normal CSM group and the glaucoma group were -0.213 ± 0.076mm , -0.056 ± 0.088mm. The differences of the three parameters between normal and glaucoma patients were statistically significant (P = 0.000). Normal MCD and MxCD generally the deepest temporal side, glaucoma patients are mostly above the deepest. In the diagnostic analysis, the areas under the ROC curve of CSM, MCD and MxCD were 0.892, 0.850 and 0.757, respectively. Conclusion As the optic disc depth increases with the enlargement of glaucoma optic cup, the loss of retinal nerve fibers gradually deepens, and the changes above are most obvious. CSM, MCD and MxCD in the diagnosis of glaucoma have a more important role.