GDx-VCC检测视网膜神经纤维层在青光眼早期诊断中的价值

目的比较正常人和不同程度青光眼患者GDx参数的不同,评价GDx检测RNFL各参数的敏感性、特异性,确定GDx参数早期诊断青光眼的能力和最有价值指标。方法应用GDx-VCC分别对40例（80只眼）正常人、80例（130只眼）早期青光眼和70例（90只眼）中晚期青光眼患者的RNFL进行检测。分别比较其RNFL参数的不同。绘制GDx参数ROC曲线,确定对早期青光眼诊断最有意义的GDx参数。结果早期青光眼RNFL较正常人明显变薄,中晚期青光眼RNFL较早期青光眼明显变薄,各参数均有统计学极显著性差异（P〈0.001）。所有参数ROC曲线下面积均〉0.7,具有良好地区分正常人和早期青光眼的能力。NFI和IA的ROC曲线下面积为0.81,区分能力更强。结论GDx-VCC可为临床上提供定量检测RNFL厚度的参数,并有良好地区分正常人和早期青光眼的能力,有助于临床上青光眼的早期诊断。

Retinal nerve fiber layer Images captured by GDx-VCC in early diagonsis of glaucoma

Objective To compare data of RNFL parameters from normal subjects with those with the patients of glaucoma.Then to evaluate the sensitivity and specificity of the values obtained by GDx-VCC in the diagnosis of early glaucoma.Methods 80 early diagnosed glaucoma patients(130 eyes),70 moderation or advanced glaucoma patients(90 eyes) and 40 normal controls(80 eyes) were tested by GDx-VCC.The values of normal controls and glaucoma patients in different stages were compared respectively.The ROC curves of GDx was drawn,that was used to select the most outsanding values of GDx-VCC for the diagnosis of early Glaucoma.Result There were significantly different of the thickness of RNFL(including all the values) between early glaucoma patients and normal controls(P <0.001).Moderation and advanced glaucoma patients showed more thinned RNFL and significantly thinner than that of the early patients(P <0.001).The area under ROC curve of all the parametes was more than 0.7 that has a good separation.NFI and IA are the more effective values which was 0.81 to separate early glaucoma.Conclusion GDx-VCC can provide quantitative parameters for clinic detecting RNFL thickness that has a good seperation to distinguish normal subjects or patients with glaucoma.GDx is helpful for early glaucoma diagnosis in clinic practice.