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1.
【目的】探索青光眼患者角膜生物力学与视盘生物力学间的关系。【方法】前瞻性病例观察研究。观察32例原发性开角型青光眼(POAG)患者、20例正常眼压性青光眼(NTG)患者、15例高眼压症(OHT)者和26例正常者的角膜生物力学参数及筛板厚度特征,评估测量筛板厚度(LCT)的可重复性,采用单因素方差分析比较不同类型青光眼者间筛板厚度差异,并应用Spearman相关分析方法分析角膜生物力学参数与筛板厚度相关性。【结果】扫频OCT所测量筛板厚度的Cronbach′sα系数0.911,组内相关系数ICC也大于0.8,重复性较好。POAG、NTG患者LCT较OHT患者和正常者偏薄(P<0.05)。OHT与正常者间LCT未见明显统计学差异(P=0.653)。LCT与角膜生物力学参数最大变形幅度(DA)、最大压陷时间(HCT)、第二次压平速度(A2V)及最大压陷屈膝峰间距(PD)间存在明显相关性。【结论】筛板厚度在青光眼患者中具有特征性,是青光眼疾病的重要参数。且LCT与角膜生物力学代表性参数间存在明显相关,角膜生物力学具备评估视盘生物力学的可能。  相似文献   

2.
目的:分析光学相干断层扫描技术测量原发性开角型青光眼(primary open-angle glaucoma,POAG)视网膜神经纤维层(Retinal Nerve Fiber Layer,RNFL)厚度的可重复性.方法:顺序选取2009年6月至2010年6月之间来自我院眼科就诊的POAG患者50例50眼,采用双盲法,检查者A和检查者B间隔4小时对被检查者进行RNFL程序的扫描,每位被检查者扫描5次,取质量清晰信号强度指数较大(均大于50)的4幅图像的RNFL厚度值为当次被检查者的厚度值,次日和隔日进行同样的检查操作.记录全周平均RNFL厚度及颞侧、上方、鼻侧、下方RNFL厚度,计算检查者A和B测量RNFL厚度值的变异系数,利用SPSS 13.0统计软件,变异系数(Coefficient of Variation,CV)分析测量数据的可重复性,两操作者之间变异系数比较采用配对t检验.结果:操作者A利用OCT测量POAG全周平均RNFL厚度及颞侧、上方、鼻侧、下方RNFL厚度的CV分别为:(2.00±1.02)%、(6.44±1.49)%、(4.34±0.79)%、(5.73±1.22)%、(2.73±0.72)%;操作者B利用OCT测量全周平均RNFL厚度及颞侧、上方、鼻侧、下方RNFL厚度的CV分别为:(2.29±0.84)%、(6.23±1.17)%、(4.64±0.86)%、(6.10±0.81)%、(2.99±0.53)%;操作者A、B两者之间利用OCT测量全周平均RNFL厚度及颞侧、上方、鼻侧、下方RNFL厚度的CV值均无统计学差异(P>0.05).结论:OCT测量POAG患者RNFL厚度具有较好的可重复性,可以作为一种精确可靠的RNFL厚度的定量检测工具.  相似文献   

3.
梁勇  具尔提  刘军 《新疆医学》2007,37(6):28-30
目的:运用光学相干断层扫描仪(opticai coherence tomography,OCT)检测正常人与原发性开角型青光眼(primary openangle glaucoma,POAG)患者的视盘周围视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度并分析。方法:研究对象分二组:正常组和POAG组,均接受常规眼科检查,视野检查及OCT检测RNFL厚度,并进行统计学分析。结果:入选的研究对象正常组148例(294眼),POAG组48例(89眼)。经统计学分析正常组与POAG组早期、进展期、晚期的颞侧、上方、鼻侧、下方及平均RNFL厚度差异均有统计学意义(P=0.000)。分析POAG组,以年龄(X1)、眼压(X2)、平均视野(X3)、病程(X4)作为自变量,以平均RNFL厚度(Y)作为因变量,建立多元线性回归方程。结论:通过OCT对RNFL厚度的检测,有助于了解和监测POAG对RFNL的损伤,是一种很有价值和潜力的青先眼客观辅助诊断方法。  相似文献   

4.
目的:评价傅立叶域相干光断层成像术[Fourier-Domain Optical Coherence Tomography,FD-OCT, using the RTVue -100 (Optovue Inc, Fremont, California,USA)]在鉴别正常眼及早期原发性开角型青光眼(POAG)中的能力。 方法:横断面研究。对符合入选标准的早期原发性开角型青光眼组及正常组的所有受试者行FD-OCT及Humphrey视野(Humphrey Field Analyzer model 740, Carl Zeiss Meditec, Dublin, CA, USA)检查。比较早期POAG患者及正常人各视盘测量参数、神经纤维层厚度及后极部神经节细胞复合体(GCC)厚度;对早期POAG患者及正常人各测量参数绘制受试者操作特征曲线(ROC),计算ROC曲线下面积(AROC),敏感性、特异性及阳性和阴性似然比评估各参数的诊断性能。 结果:分析34例早期POAG患者及42例正常人结果。在特定特异度(95% and 85%)下垂直杯盘比(C/D vertical ratio)的灵敏度和阳性似然比最高,分别为79.4%和88.2%,33.4和7.4。在所有单一参数中,垂直杯盘比的AROC最大,为0.930。使用logistical诊断模型联合垂直杯盘比、RNFL AT on 3.45mm和盘沿面积,AROC为0.949。 结论:FD-OCT所测得的视盘、神经纤维层厚度及GCC厚度改变在早期POAG患者及正常人差异有显著性。以AROC、敏感性、特异性及阳性和阴性似然比为评价指标,位居前三位的指标为:垂直杯盘比、RNFL AT on 3.45mm和盘沿面积。  相似文献   

5.
目的:使用光学相干断层成像术(OCT)评估原发性开角型青光眼(POAG)各个病程时期的视网膜神经纤维层(RNFL)与视盘参数的差异,从而探讨青光眼RNFL厚度的变化与盘沿面积和杯盘面积比(C/D AR)之间的关系,确定OCT检测参数对青光眼病程变化的参考意义。方法:应用OCT检查技术分别对40例(60只眼)的POAG患者的RNFL及视盘进行检测。数据包括颞侧(TEMP)、上方(SUP)、鼻侧(NAS)、下方(INF)RNFL厚度以及平均RNFL厚度与盘沿面积和C/D AR。按青光眼诊断标准和视野分期法分为早期、中期和晚期3组。比较和分析3组的RNFL变化趋势以及与视盘参数的相关性。结果:青光眼早期、中期和晚期3组之间RNFL和视盘参数的比较具有显著性差异(P<0.01)。RNFL平均厚度与盘沿面积有正相关性,r=0.719,P<0.01;与C/D AR有负相关性,r=-0.712,P<0.01。结论:POAG各个时期中RNFL厚度逐渐变薄,同时盘沿面积减少和C/D AR扩大。盘沿面积占影响RNFL厚度的因素比重较大,比C/D AR更能反映RNFL的变化。青光眼的病程发展能通过RNFL的减少变化来反映。OCT的客观检查所得的各项参数也对原发性青光眼的病情发展的评估具有一定的意义。  相似文献   

6.
目的:探讨黄斑区神经节细胞复合体(GCC)厚度在正常眼压性青光眼(NTG)与原发性开角型青光眼(POAG)人群中的分布特征。方法:采用频域光学相干断层扫描(SD-OCT)对NTG患者81例81眼、POAG患者125例125眼及年龄、性别、屈光度相匹配的正常对照者56例56眼黄斑区视网膜、视盘进行扫描,分析计算出黄斑区整体上方GCC厚度(GCC-Sup)、下方GCC厚度(GCC-Inf)、平均GCC厚度(GCC-Avg)、视盘旁上方视网膜神经纤维层厚度(RNFL-Sup)、下方RNFL厚度(RNFL-Inf)及平均RNFL厚度(RNFL-Avg),Zeiss Humphrey 750型视野计检测各组中心30°视野平均缺损(MD)值,比较3组患者GCC、RNFL及MD参数的差异,并分析GCC厚度值、RNFL厚度值与MD值的相关性。结果:POAG组及NTG组的GCC-Avg、GCC-Sup、GCC-Inf、RNFL-Avg、RNFL-Sup、RNFL-Inf值及视野MD值均低于正常对照组,差异有统计学意义(P<0.05)。所有研究对象GCC-Sup、GCC-Inf、GCC-Avg值与对应区域RNFL厚度值均呈显著正相关(r=0.675、0.669、0.698,P<0.01)。RNFL-Avg值与视野MD值呈显著正相关(r=0.741,P<0.01),GCC-Avg与视野MD值亦呈显著正相关(r=0.613,P<0.01)。结论:频域OCT能定量检测黄斑区GCC厚度,并与RNFL和视野损害有较好的相关性,可为青光眼的诊治提供重要依据。  相似文献   

7.
【目的】探讨激光偏振光扫描仪对开角型青光眼诊断的临床应用价值。【方法】收集正常人159例252眼及不同病程开角型青光眼共107例175眼,采用激光偏振光扫描仪(GDxVCC)进行视网膜神经纤维层(RNFL)厚度测量,测量参数包括:RNFL厚度上方平均值、下方平均值、全周平均值、TSNIT标准差、双眼对称性及神经纤维层指数(NFI)。独立样本t检验比较正常组与青光眼组RNFL厚度及正常组与早期青光眼组RNFL厚度,单因素方差分析比较早、中、晚期青光眼RNFL厚度,对GDxVCC诊断青光眼的效能进行ROC曲线下面积分析。【结果】GDxVCC测量的正常人全周RNFL厚度为(58&#177;5)μm,青光眼患者全周RNFL厚度为(48&#177;11)μm,较正常人明显变薄(P〈0.001)。早期青光眼患者的全周、上方、下方RNFL厚度均较正常人变薄,差异有统计学意义(P=0.000);但早期青光眼患者的双眼对称性仍较好,与正常人相比差异无统计学意义(P=0.058)。随着青光眼的进展,早、中、晚期青光眼患者的全周、上方、下方RNFL厚度明显变薄,TSNIT标准差及双眼对称性明显减低,神经纤维指数明显增高(P〈0.005)。GDxVCC各参数诊断青光眼的ROC曲线下面积达到0.743~0.992。【结论】GDxVCC可定性和定量测量RNFL厚度,其各参数诊断青光眼的效能较高,对青光眼的早期诊断有较高的临床应用价值。  相似文献   

8.
目的探讨Cirrus HD-OCT测量原发性开角型青光眼(POAG)视盘旁视网膜神经纤维层(RNFL)厚度与视野缺损的相关性。方法选择2010年5月~2013年12月于中国石油天然气集团公司中心医院确诊的POAG患者62例(80眼)及视力正常人30例(40眼,正常组),POAG患者分为早期POAG组(28例,34眼)、进展期POAG组(22例,26眼)和晚期POAG组(12例,20眼),采用频域Cirrus HD-OCT和Synemed EP-930自动视野计对和POAG患者和正常组分别进行RNFL厚度和视野检测。频域Cirrus HD-OCT检测RNFL厚度采用optic disc cube 200×200模式。视野检测采用Synemed EP-930自动视野计30°-2程序。将各组患者全周平均RNFL厚度及视乳头周围4个象限(上方、下方、鼻侧、颞侧)RNFL厚度进行比较;计算平均RNFL厚度和视野平均缺损的相关性。结果正常组、早期POAG组、进展期POAG组和晚期POAG组平均RNFL厚度分别为(101.10±9.80)、(94.32±14.05)、(82.73±15.21)、(64.57±14.73)μm,而不同阶段的青光眼患者全周平均RNFL厚度及视乳头周围4个象限(上方、下方、鼻侧、颞侧)RNFL厚度均比正常人减少,差异均有高度统计学意义(P<0.01)。随着青光眼病程的发展,RNFL厚度逐渐下降,而且平均RNFL厚度和视野平均缺损(MD)之间呈负相关(r=-0.659,P=0.000)。结论平均RNFL厚度和视野MD呈线性相关。Cirrus HD-OCT测量的RNFL厚度参数,能客观、定量分析POAG对RNFL损伤进展速度,有助于对青光眼的诊断和随访,从而为POAG患者得到更早的早期诊断和用药指导提供帮助。  相似文献   

9.
胡赛静  蒋自培 《当代医师》2013,(10):1416-1417
【摘要】目的利用光学相干断层扫描仪(optical coherence tomography,OCT)监测原发性开角型青光眼(primaryopen—angle glaucoma,POAG)术前与术后3个月视网膜神经纤维层厚度(retinal narver fiberlayer,RNFL)的改变。方法原发性开角型青光眼17例(31眼),采用抗青光眼滤过性手术控制眼压,眼压均有效下降〉25%,利用OCT测量患眼术前和术后3个月盘周RNFL厚度,分析其与眼压的相关性。结果(1)原发性开角型青光眼术前与术后各象限RNFL厚度比较差异无统计学意义(均P〉0.05)。(2)各象限RNFL厚度改变与眼压变化无明显相关(均P〉0.05)。结论原发性开角型青光眼滤过性手术前后,眼压有效控制后,视网膜神经纤维层厚度无改变,说明青光眼对RNFL损伤是不可逆性变薄(早期)。  相似文献   

10.
目的采用光学相干断层扫描技术(OCT)测得正常人、高眼压者和原发性开角型青光眼患者的视网膜神经纤维层(RNFL)的厚度并进行比较。方法选取门诊就诊的患者和正常志愿者,根据眼压、视野和视乳头形态分为正常组76名(152眼),高眼压组70例(109眼),原发性开角型青光眼组67例(112眼),采用OCTCIRRUSZeiss分别测得3组的平均RNFL和4个象限的RNFL。结果正常组平均RNFL为(107.61±8.03)μm,高眼压组平均RNFL为(105.26±9.22)μm,原发性开角型青光眼组平均RFNL为(91.00±10.55)μm。正常人平均、上方和下方RNFL与原发性开角型青光眼患者比较差异有统计学意义(P〈0.01);高眼压组与原发性开角型青光眼组之间平均RNFL比较差异有统计学意义(P〈0.01);正常组和高眼压组之间平均RNFL比较差异无统计学意义(P〉0.05)。结论通过对RNFL厚度的分析,为高眼压和原发性开角型青光眼的鉴别诊断提供帮助。  相似文献   

11.
Background Optical coherence tomography (OCT) is a high resolution noncontact imaging modality which can quantitatively detect the optic disc and retinal structure.This study was designed to evaluate the diagnostic capability of parameters of the optic disc, retinal nerve fiber layer thickness, and ganglion cell complex (GCC) using a new technology called Fourier-domain OCT (FD-OCT) for early primary open angle glaucoma (POAG) patients.Methods Two groups of patients, early perimetric damage POAG and normal subjects were included in this observational cross-sectional study.All patients underwent FD-OCT and visual field examination in addition to full ophthalmic examinations.Receiver operating characteristic curves (ROC) were studied for all parameters.The sensitivity and specificity for distinguishing between normal and early glaucomatous eyes, the areas under the receiver operating characteristic curves (AROC) and positive, negative likelihood ratios were evaluated for all the single parameters and selected combined parameters using arbitrary cutoffs.Results Thirty-four eyes of 34 early POAG patients and 42 eyes of 42 normal subjects were analyzed.Cup/disc (C/D)vertical ratio presented the best sensitivity and positive likelihood ratio for selected specificities (95% and 85%) which were 79.4% and 88.2%, 33.4 and 7.4, respectively.Among all single parameters, the C/D vertical ratio demonstrated the highest AROC which was at 0.930.The average thickness of circumpapillary RNFL on 3.45 mm showed the highest AROC among all of the peripapillary RNFL parameters.The sensitivity at selected specificity and AROC of GCC were not as high as C/D vertical ratio and RNFL AT on 3.45 mm.When the C/D vertical ratio, RNFL AT on 3.45 mm, and rim area were combined using a logistical diagnostic model, the AROC was raised to 0.949 but not significantly different from the top single parameter, C/D vertical ratio.Conclusions The key parameters obtained by FD-OCT were able to show the significant differences of optic discs,thickness of RNFL and GCC between POAG patients and normal subjects.According to sensitivity, specificity, likelihood ratio and AROC, the top three parameters from FD-OCT for early diagnosis of POAG were C/D vertical ratio, RNFL AT on 3.45 mm, and the rim area.  相似文献   

12.
目的: 研究RTVue 频域OCT 在正常人和青光眼中的视神经纤维层厚度和视盘参数测量中的重复性。 方法: 临床观察性研究。89名正常人和63名不同程度的青光眼患者入组,随机选择一眼连续3次测量视神经纤维层厚度和视盘参数。所有测量均由同一操作者完成。通过计算标准差、精确度、变异系数、和组内相关系数(ICC)来评价备的重复性。 结果: 神经纤维层厚度呈现双峰型。所有的视盘参数和均有良好的重复性。对于正常人,ICC介于0.98至1。对于不同程度的青光眼,则介于0.94至1。神经纤维层厚测量也显现良好的重复性,所有受检者的ICC值为0.95至1。对于不同区域的神经纤维层厚度测量,正常人ICC为0.94至0.98,轻度的青光眼患者则为0.94至1,中度0.87至1,重度0.77至0.97,其中重度青光眼的鼻侧变异最大,鼻下和鼻侧分别为0.77和0.87。 结论: RTVue OCT 在正常人和青光眼中的视神经纤维层厚度和视盘参数测量的中有良好的重复性。  相似文献   

13.
Background RTVue spectral-domain optical coherence tomography (OCT) is a new, ultra high-speed and high-resolution instrument, potentially to measure the presence of glaucoma or its progression accurately. The objective of this study was to evaluate its reproducibility of retinal nerve fiber layer (RNFL) thickness and optic nerve head (ONH) measurements in normal and glaucoma eyes. Methods This study was an observational clinical study. One eye was selected randomly from each of 89 normal individuals and 63 glaucoma patients in a range of severity. RNFL thickness and ONH were measured 3 times on the same day to determine intrasession variability. The same instrument was used by the same operator for all scans. Intrasession within-subject standard deviation (Sw), precision (1.96xSw), coefficient of variation (CVw, 100xSw/overall mean), and intraclass coefficient (ICC) were calculated to evaluate reproducibility. Results RTVue OCT demonstrated double hump patterns in the RNFL profiles. High reproducibility was observed in all ONH parameters. For normal eyes, the value of ICC ranged between 0.98 and 1.00. For eyes with different extent of glaucoma, it ranged between 0.94 and 1.00. High reproducibility was also observed in RNFL thickness measurements. The values of ICC for averaged RNFL thickness ranged between 0,95 and 1.00 in all cases. For regional parameters, it ranged from 0,94 to 0.98 for normal eyes, 0.94 to 1.00 for mild glaucoma eyes, 0.87 to 1.00 for moderate glaucoma eyes, and 0.77 to 0.97 for severe glaucoma eyes. The nasal regions of severe glaucoma appeared to be most variable, as nasal lower region and inferior nasal region had the ICC values of 0.77 and 0.87. Conclusion Reproducibility of RTVue RNFL and ONH measurements was excellent in normal and glaucoma groups.  相似文献   

14.
目的:探讨光学相干断层成像术(OCT)检测开角型青光眼视网膜神经纤维层(RNFL)厚度与视野损害的关系,评价OCT在早期诊断青光眼中的意义。方法:正常人30例(52眼),高眼压9例(14眼)以及分成早期、进展期、晚期的原发性开角型青光眼48例(74眼)。采用Humphrey全自动视野计、Zeiss鄄HumphreyOCT分别进行视野以及视盘周围RNFL厚度检测。比较正常组、高眼压组以及青光眼组的RNFL厚度,分析青光眼组视野检测的平均缺损(MD)与RNFL厚度的关系。结果:正常组与高眼压组RNFL厚度差异无显著性(P>0.05);青光眼组较正常组、高眼压组RNFL厚度明显变薄,晚期青光眼表现为弥漫性RNFL缺损。视野检测的平均缺损与RNFL厚度呈负相关(P<0.05)。结论:OCT能够反映青光眼RNFL厚度的改变,为临床早期诊断青光眼提供更多的信息。  相似文献   

15.
Objectives To investigate image characteristics and thickness of the retinal nerve fiber la yer (RNFL) in normal and glaucomatous eyes using optical coherence tomography ( OCT), and analyze the relationship between RNFL thickness and visual field index. Methods Eighty-three normal persons (150 eyes) and 83 patients with primary open angle glaucoma (POAG, 149 eyes) underwent OCT examinations with 3.4 mm diameter circ le scan to calculate the RNFL thickness. Statistical analysis was used to compa re differences in RNFL thickness in quadrants and means between the normal and g laucomatous groups and the different stages of POAG. Linear correlation and reg ression analysis were used to show the correlation between RNFL thickness and vi sual field index of 115 eyes in glaucomatous patients. Reproducibility, sensiti vity and specificity of RNFL measurements using OCT were evaluated.Results RNFL thickness measured by OCT in normal subjects was thicker in superior and in ferior, less in temporal, and thinnest in nasal quadrants. The curve showed dou ble peaks. RNFL of glaucomatous patients showed local thinning or defect, diffu se thinning, or both. The mean RNFL thicknesses of the normal group in the temp oral, superior, nasal and infeior quadrants were 90.1±10.8 μm, 140.4±10. 5 μm, 85.2±14.0 μm, and 140.4±9.7 μm, respectively with a mean of 1 14.2±6.0 μm.The numbers for the glaucomatous group were respectively 56.0 ±31.0 μm, 81.0±36.3 μm, 47.1±27.5 μm, and 73.4±38.4 μm for th e four quadrants, with a mean of 64.6±28.8 μm. There was a significant dif ference in RNFL thickness between the normal and glaucomatous groups (P&lt;0. 000), and the three stages (early, developing and late) of glaucomatous groups ( P&lt;0.000). There was a close negative relationship between RNFL thickness a nd visual field index (r=-0.796, P&lt;0.0001). The sensitivity and speci ficity of RNFL thickness in POAG measured using OCT were 93.3% and 92.0%, res pectively.Conclusions OCT can quantitatively measure RNFL thickness differences between normal persons and glaucomatous patients. RNFL thickness gradually decreases while visual fie ld defect increases with the development of POAG.  相似文献   

16.
Background Fundus changes associated with high myopia (HM) may mask those associated with primary open-angle glaucoma (POAG).This study aim to determine the characteristics of RNFL thickness changes in...  相似文献   

17.
Background Fundus changes associated with high myopia (HM) may mask those associated with primary open-angle glaucoma (POAG). Characteristic retinal nerve fiber layer (RNFL) thickness profiles in patients with POAG and HM were examined using optical coherence tomography (OCT) and scanning laser polarimetry with variable corneal compensation (GDxVCC), and the diagnostic capabilities of these imaging modalities were compared. Methods Twenty-two eyes with POAG and HM (spherical equivalent [SE] between -6.0 and -12.0 D) were evaluated, and 22 eyes with HM were used for comparison. RNFL parameters evaluated included superior average (Savg-GDx), inferior average (Iavg-GDx), temporal-superior-nasal- inferior-temporal (TSNIT) average, and nerve fiber indicator (NFI) on GDxVCC and superior average (Savg-OCT), inferior average (Iavg-OCT), nasal average (Navg-OCT), temporal average (Tavg-OCT), and average thickness (AvgThick-OCT) on OCT (fast RNFL scan). Visual field testing was performed and defects were evaluated using mean defect (MD) and pattern standard deviation (PSD). Results The RNFL parameters (P < 0.05) that were significantly different between groups included Savg-GDx, Iavg-GDx, TSNIT average, NFI, Savg-OCT, Iavg-OCT, Tavg-OCT, and AvgThick-OCT. Significant correlations existed between TSNIT average and AvgThick-OCT (r = 0.778), TSNIT average and MD (r = 0.749), AvgThick-OCT and MD (r = 0.647), TSNIT average and PSD (r = -0.756), and AvgThick-OCT and PSD (r = -0.784). The area under the receiver operating characteristic curve (AUROC) values of TSNIT average, Savg-GDx, Iavg-GDx, NFI, Savg-OCT, Iavg-OCT, Navg-OCT, Tavg-OCT, and AvgThick-OCT were 0.947, 0.962, 0.973, 0.994, 0.909, 0.917, 0.511, 0.906, and 0.913, respectively. The NFI AUROC was the highest value. Conclusion RNFL thickness was significantly lower in all but the nasal quadrant in patients with POAG and HM, compared to patients with only HM. Measurements with OCT and GDxVCC were well-correlated, and both modalities detected RNFL thickness changes. However, GDxVCC was better than OCT in detecting POAG in HM patients.  相似文献   

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