论文部分内容阅读
目的:使用光学相干断层扫描(SD-OCT)比较早期帕金森病(PD)和原发性开角型青光眼(POAG)患者黄斑和视网膜神经纤维层(RNFL)厚度参数.方法:回顾性分析.选取48例早期POAG患者、34例早期PD患者和37例年龄及性别相匹配的健康志愿者(对照组),使用SD-OCT分别测量RNFL和9个象限的黄斑厚度(ETDRS分区).本研究纳入的早期POAG患者视野检测MD<-6 dB.PD组患者采用Hoehn和Yahr(H&Y)及统一帕金森病分级量表(UPDRS)评估PD的严重程度,纳入H&Y I-III期患者.结果:除颞侧RNFL外,三组间RNFL厚度均有显著差异(P<0.05).三组间黄斑中心凹厚度、平均黄斑厚度和黄斑外侧象限厚度均有显著差异(P0.05).PD组患者病程、UPDRS评分与黄斑厚度和RNFL厚度均呈负相关.结论:通过SD-OCT对早期POAG和PD患者黄斑和RNFL厚度参数进行检测,发现两者出现相似的变薄现象,而在早期POAG组这种现象更为明显,推测青光眼引起的黄斑神经退行性变比PD更具破坏性,但PD患者黄斑中央凹区变薄更为显著.“,”AIM: To provide an insight to the common pathophysiology of both most frequent and neurodegenerative diseases by comparing thickness parameters of macula and retinal nerve fiber layer ( RNFL) by using spectral domain optical coherence tomography ( SD-OCT ) in patients with early stage of Parkinson’ s disease ( PD ) , and early stage of primary open angle glaucoma ( POAG) .?METHODS A retrospective review was conducted of 48 patients with an early stage of POAG, 34 patients with an early stage of PD and 37 age- and gender- matched healthy eyes as a control group. The RNFL and macular thicknesses in the nine macular quadrants according to the ETDRS were measured with an SD-OCT and mean deviation ( MD) values by a visual field analyzer. POAG patients were selected only MD smaller than - 6 Db. Patients with MD values below -6 Db were considered as early stage glaucoma. PD severity was assessed using Hoehn and Yahr ( H&Y) and Unified Parkinson’ s Disease Rating Scale ( UPDRS) . The PD group selected only H&Y Stage I-Ⅲ patients.? RESULTS: Statistically significant difference was determined between all groups RNFL measurements except temporal RNFL ( P<0. 05 ) . Statistically significant difference was determined between all groups including fovea, mean macula thickness and macula outer quadrant thickness evaluations ( P 0.05) . A weak negative correlation was determined between duration of disease and UPDRS score together with macula and RNFL thickness parameters in PD group.?CONCLUSION:Similar thinning was detected by using SD-OCT for thickness parameters of macula and RNFL in early stage of POAG and early stage of PD group. However this thinning was more significant in early stage of POAG group. It can be declared that neurodegeneration on the macula which is caused by glaucoma is more destructive than PD. Thinning on foveal region is remarkable for PD patients.