光学相干断层成像术在原发性慢性闭角型青光眼诊断中的应用

目的 探讨光学相干断层成像术（opticalcoherence tomography，0CT）检测视网膜神经纤维层（retinal nenre fiber laver，RNFL）厚度与原发性慢性闭角型青光眼（primary chronic angole-dosure glaucoma，Chronic PACG）病程进展的关系，评价OCT在早期诊断青光眼中的意义。方法正常人20例（40眼）及分成早期、进展期、晚期的Chronic PACG 20例（38眼），采用OCT进行视盘周围RNFL厚度检测，比较正常组及Chronic PACG组的各象限及平均RNFL厚度。结果 Chronic PACG组较正常组RNFL平均厚度明显变薄（P〈0．001）；早期Chronic PACG表现为局限性RNFL缺损，以下方最为显著（P〈0．001），晚期Chronic PACG表现为弥漫性RNFL缺损；早期、进展期、晚期Chronic PACG患者RNFL厚度差异有显著性（P〈0．001）。结论 随着Chronic PACG病情的发展，RNFL厚度逐渐减少，OCT能够反映青光眼RNFL厚度的改变，并能为临床早期诊断青光眼提供更多的信息。

The implication of optical coherence tomography to the diagnosis of primary chronic angle-closure glaucoma

Objective To evaluate the relationship between disease development and retinal nerve fiber layer thickness(RNFL) measured by optical coherent tomography(OCT)and to access the significance of OCT in the early diagnosis of primary chronic angle-closure glaucoma(Chronic PACG).Methods The thickness of RNFL was quantified by OCT in 20 normal controls(40 eyes),and 20 patients with Chronic PACG(38 eyes).Chronic PACG case were divided into early,advanced and last stages.Average and segmental RNFL thickness values were compared between two groups.Results The average RNFL was significantly thinner in Chronic PACG than in normal controls(P<0.001);The RNFL of early glaucomatous patients showed local defect,especially in inferior quadrants(P<0.001),The RNFL of late glaucomatous patients showed diffuse defect;There are significant difference among the three stages(early,advanced and last)of glaucomatous group(P<0.001).Conclusion The RNFL thickness gradually decrease while the development of Chronic PACG.Measurement of RNFL thickness by OCT is useful in detecting early RNFL damage.Furthermore,OCT measurement of RNFL thickness may provide clinically relevant information in monitoring glaucomatous changes.