频域-OCT在观察高眼压症视网膜神经纤维层及神经节细胞复合体中的应用

使用频域相干光断层扫描（ SD-OCT）观察高眼压症患者视盘形态学参数、视网膜神经纤维层（RNFL）及黄斑区神经节细胞复合体（GCC）的表现。方法选取52例（96只眼）高眼压患者，按照眼压高低分为两组，与20例（40只眼）正常人进行SD-OCT检查，测量视盘形态学参数、整体平均RNFL厚度（RNFL-Avg）、上方平均RNFL厚度（RNFL-Sup）、下方平均RNFL厚度（RNFL-Inf）、整体平均GCC的厚度（GCC-Avg）、上方平均GCC厚度（ GCC-Sup）、下方平均GCC厚度（ GCC-Inf），比较两组高眼压症患者与正常对照组之间的差异，并分析高眼压症组RNFL与GCC的相关性。结果两组高眼压症患者与正常对照组比较，视盘各形态学参数（ P ＞0．05）、RNFL-Avg（ P ＝0．9017）、RNFL-Sup（ P ＝0．9659）、 RNFL-Inf（ P ＝0．7465）、 GCC-Avg（ P ＝0．3498）、GCC-Sup（ P ＝0.4203）、GCC-Inf（ P ＝0．3071）均无显著的统计学差异。而RNFL与GCC在整体、上方及下方的厚度均呈明显的正相关（ r ＝0．5631 P ＝0．001；r ＝0．5122 P ＝0．005；r ＝0．5459 P ＝0．002）。结论 SD-OCT是一种比较敏感的能够观察到视网膜结构改变的检查方法，对青光眼的早期诊断具有重要的作用。高眼压症患者在眼压明显高于正常的情况下，并无RNFL及GCC的改变，对于高眼压症应该强调严格随诊。

The measurement of retinal nerve fiber layer and ganglion cell complex thickness in ocular hypertension using spectral domain optic coherence tomography

Objective The purpose of this study was to investigate the morphology changes of optic disc , retinal nerve fiber layer and macular ganglion cell complex in ocular hypertension .Methods Ninety-six eyes of 52 ocular hyper-tension patients were selected and assigned into two groups according to intraocular pressure .Forty normal eyes of 20 healthy subjects served as control .Optic disc parameters, average, superior and inferior RNFL thickness , and average, su-perior and inferior GCC thickness were measured with SD-OCT.The correlation between RNFL and GCC were analyzed . Results No significant changes were found between the normal group and two ocular hypertension groups in optic disc pa -rameters, RNFL thickness or GCC thickness .RNFL thickness was positively correlated to GCC thickness （ r =0.5631, P=0.001 for average thickness;r =0.5122, P =0.005 for superior thickness;r =0.5459, P =0.002 for inferior thick-ness）.Conclusion SD-OCT provides a sensitive way to observe the structural changes of retina , and plays an important role in the early diagnosis of glaucoma .Although there were no RNFL and GCC changes were found in ocular hypertension , these patients need to be followed-up.