应用激光扫描眼底镜检查视网膜神经纤维层

目的评价激光扫描眼底镜检查视网膜神经纤维层缺损的敏感性和特异性,以及其在临床上的应用价值。方法选择原发性开角型青光眼４９例（９５只眼）,高眼压症１９例（３７只眼）,疑似青光眼患者４３例（８３只眼）,正常志愿者１８例（３４只眼）作为研究对象。所有研究对象均散瞳后应用４８８ｎｍ的蓝色氩激光为光源,１～３ｍｍ的共焦点光圈,获得４０°和２０°视角的视网膜神经纤维层图像,记录在录像带上。由具有相当经验的研究者判断有无视网膜神经纤维层缺损以及缺损类型。在回避了第一次结果的条件下,对６８只眼视网膜神经纤维层的情况进行不同观察者及两次观察的重复性研究。结果两次观察和不同观察者判断有无视网膜神经纤维层缺损以及缺损类型的一致性分别为高度和中到高度。激光扫描眼底镜检查视网膜神经纤维层缺损的敏感性为８０．０％,特异性为９４．１％。结论激光扫描眼底镜检查视网膜神经纤维层是一种方便、快捷、准确和安全地发现视网膜神经纤维层缺损的有效方法,对于提高青光眼的早期诊断率有一定的临床实用价值。

Evaluating retinal nerve fiber layer by scanning laser ophthalmoscopy

Objective To evaluate the efficiency of scanning laser ophthalmoscopy (SLO) on detecting retinal nerve fiber layer defects (RNFLD). Methods 95 eyes with primary open angle glaucoma, 37 ocular hypertension, 83 glaucomatous suspect and 34 normal eyes were investigated by SLO to evaluate the retinal nerve fiber layer (RNFL). Recording tapes of 68 eyes were re investigated by two investigators for estimating the intra and inter observer agreement. Results The intra and inter observer agreement of the presence and types of RNFLD was fairly good (Kappa values were 0.66 0.76 and 0.59 0.65 respectively). The sensitivity and specificity in detecting RNFLD by SLO were 80 0% and 94 1% respectively. Conclusion The evaluation of RNFL by SLO is a quick, accurate and safe method. It may be clinically useful in the diagnosis of glaucoma.