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目的使用光学相干断层扫描(OCT)比较青光眼患者和正常人群视乳头旁视网膜神经纤维层(RNFL)厚度、黄斑厚度,比较两者的青光眼早期诊断价值。方法搜集就诊于本眼科中心青光眼患者60例(76眼)、早期青光眼患者34例(40眼)和正常人66例(93眼),应用OCT测量视乳头旁RNFL厚度、黄斑厚度及工作特征曲线下面积(AROC),进行统计学分析。结果早期青光眼及青光眼组视乳头旁各象限、平均RNFL厚度、中环区下方及颞侧、外环各区黄斑厚度均比正常人减少,差异有统计学意义(P=0.027~0.000)。两组青光眼患者视乳头旁、平均RNFL及黄斑区外环下方和颞侧厚度的AROC值均>0.7,与正常对照组比较,差异有统计学意义(P=0.016~0.003)。结论应用OCT测量视乳头旁RNFL厚度比黄斑厚度具有更高的早期诊断价值。
Objective To compare the thickness of retinal nerve fiber layer (RNFL) and the thickness of macula in patients with glaucoma and normal controls by optical coherence tomography (OCT). The early diagnosis value of glaucoma was compared between the two groups. Methods Sixty eyes (76 eyes) of glaucoma, 34 eyes of early glaucoma (66 eyes) and 66 eyes of normal (66 eyes) were enrolled in this Ophthalmology Center. The thickness of RNFL, the thickness of macula and the working characteristic curve Under the area (AROC), for statistical analysis. Results In the early glaucoma and glaucoma groups, the quadrant of the optic nerve, the average RNFL thickness, the area below the middle ring and the temporal lobe, and the outer ring were all significantly lower than those in the normal controls (P = 0.027-0.000). The AROC values of optic nerve side, average RNFL and outer and inner temporal thicknesses of glaucoma in both groups were both> 0.7. The difference was statistically significant (P = 0.016-0.003) compared with the normal control group. Conclusions The use of OCT to measure the thickness of RNFL near the optic disc has a higher early diagnostic value than the thickness of the macula.