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目的分析鞍结节脑膜瘤患者的视盘参数特征及视盘周围视网膜神经纤维层(p RNFL)厚度的变化。设计回顾性病例系列。研究对象2010年7月至2011年12月北京天坛医院鞍结节脑膜瘤患者40例(80眼)、正常对照40例(80眼)和青光眼患者40例(80眼)。方法采用眼底照相和相干光断层扫描(OCT)测量视盘及不同象限p RNFL厚度,比较鞍结节脑膜瘤患者与正常对照组和青光眼组的视盘参数及p RNFL厚度,分析视盘参数改变与肿瘤大小的相关性。主要指标视盘形态、视盘面积、杯盘面积比、水平杯盘比、垂直杯盘比、盘沿面积、视杯面积,视杯体积和不同象限p RNFL厚度。结果鞍结节脑膜瘤组的杯盘面积比、水平杯盘比、垂直杯盘比、视杯面积和视杯体积与正常对照组相比均明显增大,而盘沿面积明显减小(P均=0.000);且杯盘面积比、水平杯盘比、盘沿面积和盘沿体积与青光眼组相比均较大,而垂直杯盘比、视杯面积和视杯体积较青光眼组明显减小(P均=0.000)。肿瘤组视盘周围不同象限p RNFL厚度分别为上方颞侧(124.022±26.100)μm,上方鼻侧(105.856±23.410)μm,鼻侧上方(75.784±19.260)μm,鼻侧下方(65.983±15.708)μm,下方鼻侧(105.915±25.526)μm,下方颞侧(133.591±24.429)μm,颞侧下方(76.592±19.679)μm,颞侧上方(77.352±26.100)μm,与正常对照组相比差异均具有统计学意义(P均<0.05);与青光眼组相比上方鼻侧象限不具有统计学意义(P=1.114),其余象限均具有统计学意义(P均<0.05)。鞍结节脑膜瘤盘沿体积与肿瘤大小相关(r=0.492,P=0.011)。结论鞍结节脑膜瘤视盘形态表现为颞侧变窄、颜色变淡,p RNFL厚度与正常人群比较下方鼻侧变薄最明显,与青光眼组相比除上方鼻侧外其他各象限均变薄,下方颞侧最明显。
Objective To analyze the characteristics of optic disc parameters and the thickness of retinal nerve fiber layer (p RNFL) in patients with saddle nodular meningioma. Design retrospective case series. Participants 40 patients (80 eyes), 40 normal controls (80 eyes) and 40 eyes (40 eyes) of saddle nodular meningioma from July 2010 to December 2011 in Beijing Tiantan Hospital. Methods The thickness of p RNFL in optic disc and different quadrant was measured by fundus photography and coherence tomography (OCT). The parameters of optic disc and thickness of p RNFL in patients with sad nodular meningioma, normal control group and glaucoma group were compared. The changes of optic disc parameters and tumor size Relevance. The main indicators of optic disc morphology, optic disc area, cup area ratio, horizontal cup ratio, vertical cup ratio, disk area, cup area, cup volume and different quadrant p RNFL thickness. Results Compared with the control group, the cup-plate area ratio, horizontal cup-to-plate ratio, vertical cup-to-cup ratio, cup area and cup volume of saddle nodular meningioma group were significantly increased (P All = 0.000); and the cup plate area ratio, horizontal cup plate ratio, plate area and rim volume compared with the glaucoma group were larger, and the vertical cup and cup area and cup volume glaucoma group was significantly reduced Small (P = 0.000). The thickness of p RNFL in the different quadrants around the optic disc in the tumor group was 124.022 ± 26.100 μm on the upper side, 105.856 ± 23.410 μm on the upper side, 75.784 ± 19.260 μm on the nasal side, and 65.983 ± 15.708 μm on the nasal side , Lower nasal (105.915 ± 25.526) μm, lower temporal (133.591 ± 24.429) μm, lower temporal (76.592 ± 19.679) μm and superior temporal (77.352 ± 26.100) μm respectively. Compared with the normal control group, (P <0.05). Compared with glaucoma group, the upper quadrant of nasal quadrant had no statistical significance (P = 1.114), the other quadrants had statistical significance (all P <0.05). The size of the sella tubercle meningioma along the tumor volume was correlated (r = 0.492, P = 0.011). Conclusions The morbid nodules of meningioma of the sella nodules exhibit temporal narrowing and fading on the optic disc. The thickness of the p RNFL is significantly lower than that of the normal group, except for the upper nasal side of the glaucoma group , The most obvious temporal lower side.