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目的观察原发性开角型青光眼患者(POAG)GDx Ecc与HRTⅡ测量参数间的关系,并与单纯GDx Ecc检查异常者进行比较,探讨联合HRTⅡ提高GDx Ecc检查准确性的可能性。设计病例对照研究。研究对象原发性开角型青光眼患者32例(49眼),15例其他检查正常仅GDx Ecc检查异常者。方法对所有患者进行视野、眼压、眼底立体照相、GDx Ecc与HRTⅡ检查。采用线性回归对GDx Ecc与HRTⅡ的参量参数进行分析,采用配对X~2检验对GDx Ecc、HRTⅡ出现异常的部位是否存在对应关系进行分析。主要指标GDx Ecc测量的视网膜神经纤维层(RNFL)厚度与HRT测量的视盘形态参数。结果(1)HRTⅡ与GDx Ecc的测量参数间在POAG患者中存在相关性,以盘沿面积与神经纤维指数(NFI)值相关性最高(r=-0.68,P=0.000)。两者在上方及下方象限也存在相关性,下方象限的相关性强于上方象限,颞侧与鼻侧象限的相关性偏低。两者出现异常的部位在空间上也存在对应关系(P=0.38)。(2)单纯GDx Ecc检查异常者HRTⅡ与GDx Ecc参数间也存在相关性,以盘沿面积与NFI值相关性最高(r=-0.79,P=0.001)。但与POAG患者不同,两者出现异常的部位在空间上不存在对应关系(P=0.000)。结论POAG患者GDx Ecc与HRTⅡ出现异常的部位在空间上存在对应关系,而这种关系在单纯GDx Ecc检查异常者中并不存在,利用这种关系联合HRTⅡ进行诊断可提高GDx Ecc检查的准确性。
Objective To observe the relationship between GDx Ecc and HRT Ⅱ parameters in patients with primary open-angle glaucoma (POAG) and to compare with those with abnormal GDx Ecc to explore the possibility of improving the accuracy of GDx Ecc in combination with HRTⅡ. Design a case-control study. The study included 32 patients (49 eyes) with primary open-angle glaucoma and 15 normal subjects with normal GDx Ecc only. Methods All patients underwent visual field, intraocular pressure, stereoscopic fundus photography, GDx Ecc and HRT II examinations. Linear regression was used to analyze parameters of GDx Ecc and HRTⅡ, and paired X ~ 2 test was used to analyze whether there was a corresponding relationship between abnormalities of GDx Ecc and HRTⅡ. Key Indicators GDx Ecc Measured retinal nerve fiber layer (RNFL) thickness and HRT measured optic disc morphometry. Results (1) The correlation between measured parameters of HRT Ⅱ and GDx Ecc in patients with POAG had the highest correlation with the value of NFI (r = -0.68, P = 0.000). There is also a correlation between the quadrant above and below. The quadrant of the lower quadrant is stronger than the upper quadrant, and the correlation between the temporal quadrant and the nasal quadrant is low. There was a corresponding spatial relationship between the two sites (P = 0.38). (2) There was also a correlation between HRTⅡ and GDx Ecc parameters in patients with abnormal GDx Ecc examination. The correlation between NFI and disc area was the highest (r = -0.79, P = 0.001). However, unlike POAG patients, there was no spatially corresponding relationship between the two sites (P = 0.000). Conclusion There is a spatial relationship between the abnormalities of GDx Ecc and HRT Ⅱ in patients with POAG. However, this relationship does not exist in patients with abnormal GDx Ecc examination. Using this relationship in combination with HRT Ⅱ can improve the accuracy of GDx Ecc examination .