| 摘要: |
| 目的探讨视网膜视盘周围神经纤维层（retinanervefiberlayer，RNFL）厚度和黄斑区神经节细胞复合体（ganglioncellcomplex，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。 |
| 关键词: 慢性闭角型青光眼 视网膜神经纤维层 神经节细胞复合体 |
| DOI：10.12056/j.issn.1006-2785.2017.39.5.2016-325 |
| 分类号: |
| 基金项目:温州市科技计划项目（Y20160456） |
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| Measurement of RNFL and GCC thickness in evaluation of chronic angle closure glaucoma |
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NI Shengrong, WANG Qinmei, WANG Jieman, HE Tao
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Wenzhou Central Hospital
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| Abstract: |
| Objective To investigate the measurement of thickness of retina nerve fiber layer (RNFL) and ganglion cell complex (GCC) in evaluation of chronic angle closure glaucoma. Methods Patients with chronic angle closure glaucoma were divided into mild, moderate and severe visual field defect groups. The average thickness of RNFL (AVGRNFL), the thickness of superio RNFL (SUPRNFL) and inferio RNFL (INFRNFL) and the average of GCC (AVGGCC), the thickness of superio GCC (SUPGCC) and inferio GCC (INFGCC) in 3 groups were measured. Using the area under the receiver operating characteristic curve (AUC) the sensitivity of each parameters in evaluation was analyzed. Multiple linear regression was applied to analyze the relationship between visual field loss and RNFL, GCC thickness in patients with chronic angle closure glaucoma. Results There were significant differences in GCC and RNFL thickness between the mild/moderate and severe visual field defect groups. The AUC of INFGCC thickness was the largest (0.801) among all parameters of RNFL and GCC in differentiation of mild from moderate/severe visual field defect with the highest diagnostic sensitivity. Multiple linear regression analysis showed that visual
field defect (MD) was negatively correlated with SUPRNFL (B=-0.156, P＜0.05) and INFGCC (B=-0.450, P＜0.01) in chronic
angle closure glaucoma. Conclusion RNFL and GCC thickness are important indicators for quantitative detection of optic nerve damage in glaucoma, and the thickness of INFGCC is the most sensitive indicator, which is negatively correlated with visual field defect. |
| Key words: Chronic angle closure glaucoma Retina nerve fiber layer Ganglion cell complex |
