论文部分内容阅读
目的探讨视网膜视盘周围神经纤维层(retina nerve fiber layer,RNFL)厚度和黄斑区神经节细胞复合体(ganglion cell complex,GCC)厚度在评价慢性闭角型青光眼神经损伤中的意义。方法按视野缺损程度将慢性闭角型青光眼患者分成轻度、中度、重度视野缺损组。测量3组的RNFL平均厚度(AVGRNFL)、上方厚度(SUPRNFL)及下方厚度(INFRNFL)和GCC平均厚度(AVGGCC)、上方厚度(SUPGCC)及下方厚度(INFGCC)。计算各个参数的ROC曲线,AUC越大(越接近1)则诊断价值越大。多元线性回归分析慢性闭角型青光眼视野缺失与RNFL及GCC的相关性。结果轻/中度视野缺损组与重度视野缺损组AVGRNFL、SUPRNFL、INFRNFL、AVGGCC、SUPGCC、INFGCC差异均有统计学意义(均P<0.01);轻度视野缺损组与中重度视野缺损组间RNFL和GCC厚度的AUC比较,以INFGCC的AUC最大(0.801),诊断灵敏度最大。慢性闭角型青光眼视野缺损值与SUPRNFL(B=-0.156,P<0.05)和INFGCC(B=-0.450,P<0.01)均呈负相关。结论 RNFL和GCC厚度是青光眼视神经损伤结构定量检测的重要指标,其中以INFGCC厚度参数灵敏度最高,与视野缺损呈高度负相关。需要开发更先进的技术和相关软件来获取早期青光眼的视神经结构损伤。
Objective To investigate the relationship between the thickness of retina nerve fiber layer (RNFL) and the thickness of ganglion cell complex (GCC) in the retina of the optic disc in evaluating the nerve injury of chronic angle-closure glaucoma. Methods According to the degree of visual field defect, patients with chronic angle-closure glaucoma were divided into mild, moderate and severe visual field defect group. The mean RNFL thickness, AVRNFL, INFRNFL, AVGGCC, SUPGCC and INFGCC were measured in the three groups. Calculate the ROC curve of each parameter, the larger the AUC (the closer to 1) the greater the diagnostic value. Multivariate linear regression analysis of correlation between RNFL and GCC in patients with chronic angle closure glaucoma. Results There were significant differences in AVGRNFL, SUPRNFL, INFRNFL, AVGGCC, SUPGCC and INFGCC between mild and moderate visual field defect group and severe visual field defect group (all P <0.01) Compared with the AUC of GCC thickness, the AUC of INFGCC was the highest (0.801), and the diagnostic sensitivity was the highest. Chronic angle-closure glaucoma visual field defect values were negatively correlated with SUPRNFL (B = -0.156, P <0.05) and INFGCC (B = -0.450, P <0.01). Conclusions The thickness of RNFL and GCC is an important index for the quantitative detection of optic nerve injury in glaucoma. Among them, the highest sensitivity of INFGCC thickness parameter and the high degree of negative correlation with visual field defect. There is a need to develop more advanced techniques and related software to obtain optic nerve structural damage in early glaucoma.