原发性急性闭角型青光眼视网膜神经纤维层厚度变化研究

目的 观察原发性急性闭角型青光眼(APACG)首次发作后6个月内视网膜神经纤维层厚度(RNFLT)变化规律.方法 用光学相干断层扫描仪(OCT)测量首次单侧发作的APACG患者(24例)在眼压控制后3 d内、2周、1月、3月和6月时的双眼RNFLT,比较双眼各时间点RNFLT.对侧眼在发作眼眼压控制后3d内及6月时的RNFLT与正常人(55名55只眼)比较.结果 发作眼平均RNFLT在眼压控制后3 d内(121.49±23.84)μm,较对侧眼明显增加(P＜0.01);2周(107.22±24.72)μm和1月(93.58±18.37)μm与对侧眼的差异无统计学意义(P=0.31和0.08);3月(84.10±19.89)μm和6月(78.98±19.17)μm较对侧眼明显减少(P＜0.01).发作眼不同时间点的RNFLT变化均有统计学意义(P＜0.01～0.048).对侧眼在发作眼眼压控制后3 d内及6月的RNFLT和正常人比较差异无统计学意义(P=0.13～0.98).结论 APACG发作后RNFL厚度即有明显增加,发作后2周至1个月RNFL厚度趋向正常,1个月后RNFL厚度逐渐变薄,至术后6个月RNFL厚度较对侧眼和正常人明显减少.     

急性闭角型青光眼急性发作早期的视网膜神经纤维层厚度变化特征分析

目的　观察急性闭角型青光眼急性发作早期视网膜神经纤维层厚度的变化特点。方法　收集急性闭角型青光眼单次急性发作患者４５例,在病程２周内采用光学相干断层扫描（ｏｐｔｉｃａｌｃｏｈｅｒｅｎｃｅｔｏｍｏｇｒａｐｈｙ,ＯＣＴ）测量双眼视网膜神经纤维层（ｒｅｔｉｎａｌｎｅｒｖｅｆｉｂｅｒｌａｙｅｒ,ＲＮＦＬ）厚度,将发作眼与对侧眼的数据进行比较,并分析ＲＮＦＬ厚度与治疗前眼压、高眼压持续时间和年龄的相关性。结果　急性发作眼ＲＮＦＬ厚度为（１１８．８０±３８．４５）μｍ,上方、下方、鼻侧、颞侧分别为（１４８．６７±５８．５９）μｍ、（１５９．８０±５７．８２）μｍ、（８９．６０±３１．３７）μｍ、（７９．４７±２７．５４）μｍ;对侧眼ＲＮＦＬ厚度为（９８．２０±１６．８９）μｍ,上方、下方、鼻侧、颞侧分别为（１２０．１３±２３．６１）μｍ、（１３１．６０±２７．４１）μｍ、（７４．０１±１８．０７）μｍ、（６７．８０±１３．４１）μｍ。急性发作眼比对侧眼的ＲＮＦＬ厚度增加,且发作眼上方、下方、鼻侧和颞侧各个象限的ＲＮＦＬ较对侧眼均增厚,差异均有统计学意义（均为Ｐ＜０．０５）。急性发作眼的ＲＮＦＬ厚度与治疗前眼压呈正相关（ｒ＝０．３７０,Ｐ＜０．０５）,与高眼压持续时间呈正相关（ｒ＝０．６０３,Ｐ＜０．０１）;与年龄无关（ｒ＝－０．３１７,Ｐ＞０．０５）。结论　急性闭角型青光眼单次急性发作后,ＲＮＦＬ明显水肿,这种变化可持续到发作后２周,且治疗前眼压越高、高眼压持续时间越长,ＲＮＦＬ水肿越严重。     

不同类型闭角型青光眼患者的视网膜神经纤维层厚度的变化

目的：分析急慢性闭角型青光眼患者的视网膜神经纤维层厚度的变化及其意义。

方法：选取2016-01/2018-01我院收治的急性闭角型青光眼患者37例40眼和慢性闭角型青光眼患者35例38眼为研究对象,并选取同期在我院进行检查的正常体检者30例为正常组。所有研究对象均进行视野检查和OCT检查,根据视野检查结果将患病组分为视野缺损和视野未缺损2个亚组,对三组及亚组上方、下方、鼻侧、颞侧和平均RNFL厚度进行比较; 研究RNFL厚度与视野缺损的关系。

结果：急性组的上方、下方、鼻侧和平均RNFL厚度均明显高于正常组(160.41±39.87μm vs 124.50±14.86μm、155.38±31.79μm vs 127.75±20.08μm、96.12±32.01μm vs 75.79±13.10μm、121.49±21.46μm vs 101.79±10.34μm),而慢性组的各象限(上方：91.57±30.22μm; 下方：96.23±30.68μm; 鼻侧：65.46±16.94μm; 颞侧：63.28±16.94μm)及平均RNFL厚度(80.58±22.18μm)均明显低于正常组,差异有统计学意义(P<0.05)。急性组视野正常者上方、下方的RNFL厚度低于本组视野缺损者(159.68±27.49μm vs 163.32±37.76μm,152.31±21.86μm vs 161.27±32.09μm),差异有统计学意义(P<0.05),而鼻侧、颞侧和平均RNFL厚度两者间差异无统计学意义(P>0.05); 慢性组视野缺损者各象限RNFL厚度显著低于视野正常者(120.83±13.19μm vs 88.82±25.18μm、124.83±17.01μm vs 85.89±30.91μm、76.06±11.79μm vs 62.03±12.13μm、75.17±9.99μm vs 63.09±8.24μm),差异有统计学意义(P<0.05)。

结论：急性PACG的RNFL变厚主要原因为视神经水肿,而慢性PACG的RNFL变薄的主要原因是节细胞的损害和神经纤维的丢失,不同的原因导致不同类型PACG的RNFL厚度差异。     

急性原发性闭角型青光眼视网膜血流密度与神经纤维层的相关性

目的:观察急性原发性闭角型青光眼(APACG)患者黄斑和视盘周围血流密度及其与神经纤维层的相关性。方法:前瞻性纳入2019-03-01/12-31在徐州医科大学附属医院就诊的单眼APACG患者29例,发作眼29眼为试验组,对侧眼29眼为对照组,发作眼行复合式小梁切除术,对侧眼行预防性虹膜周边激光切除术。分别于术前、术后1wk,1、3、6mo行光学相干断层扫描血管成像(OCTA)检查,观察黄斑血流密度(MVD)、视盘周围血流密度(cpVD)及神经纤维层(RNFL)厚度的变化情况。结果:术前试验组上颞、颞上象限视盘cpVD均较对照组低(P<0.01),术后1wk试验组各象限短暂上升,但上鼻、上颞、颞上象限仍低于对照组(均P<0.05)。术后1、3、6mo时,试验组各象限cpVD和MVD随时间变化呈持续下降趋势,且RNFL厚度在术后6mo内先增厚,后逐渐下降,至术后6mo时均较对照组变薄。相关性分析显示,试验组术后6mo时视盘cpVD与RNFL厚度在上鼻、上颞、颞下、下颞、下鼻、鼻下象限呈正相关关系(均P<0.05)。结论:APACG急性发作后早期患眼RNFL增厚,3~6mo时逐渐变薄,而视盘cpVD持续降低,并在术后6mo时与RNFL厚度存在相关关系。     

急性闭角型青光眼视网膜神经纤维层改变的一年动态观察

目的观察急性闭角型青光眼视网膜神经纤维层（RNFL）厚度在发病后不同时间段的变化特征。设计前瞻性病例系列。研究对象2007—2009年就诊的急性闭角型青光眼单眼发病者35例35眼。方法人选患者经过临床治疗后眼压控制正常,利用相干光断层扫描（StratusOCT3）技术在发病后2周、3个月、6个月和12个月进行双眼RNFL扫描,并对发作眼压与RNFL厚度进行相关性分析。主要指标RNFL厚度。结果发作后2周发作眼RNFL明显较对侧眼增厚,分别为（141．85±25．22）μm、（112．95±10．54）μm（P=-0．000）;第3个月时两眼没有差异,RNFL厚度分别为（112．38±16．15）μm、（112．26±16．04）μm（P=0．966）;6个月时发作眼较对侧眼稍薄,分别为（101．22±14．06）μm、（108．65±15．03）μm（p=0．021）;12个月时发作眼明显较对侧眼薄,分别为（92．29±13．05）um、（106．77±14．90）μm（P=0．000）。发作眼在观察期内RNFL进行性变薄（阽51．48,P=0．000）,而对侧眼则无显著改变（F=1．599,P=0．192）。早期（3个月内）眼压越高,RNFL越厚（r=0．692,P=-0．000）,但在12个月RNFL的变化中,发作眼压与之无显著相关（r=0．242,P=0．081）。结论急性闭角型青光眼发作眼缓解后RNFL仍进行性丢失,发作时眼压的高低并不是决定最终病变的惟一因素;对侧眼在12个月的观察中也存在一定程度RNFL损害,其临床意义有待进一步研究。     

原发性慢性闭角型青光眼黄斑区内层和外层视网膜厚度变化

目的　观察慢性原发性闭角型青光眼（chronic primary angle-closure glaucoma,CPACG）黄斑区内层、外层视网膜厚度的变化特征。方法　选取我院就诊的CPACG患者58例（58眼）为研究对象,按病情严重程度分3组,即早期CPACG组14例,进展期CPACG组23例,晚期CPACG组21例,同时选择23名（23眼）健康无眼疾志愿者作为对照组,应用RTVue-100频域光学相干断层扫描仪对其黄斑区中心凹、近中心凹、旁中心凹处内层、外层视网膜厚度进行检测。结果　对照组、早期CPACG组、进展期CPACG组、晚期CPACG组黄斑区近中心凹处内层视网膜厚度分别为（135.62±2.96）μm、（124.21±6.47）μm、（119.74±10.67）μm、（94.95±11.24）μm,黄斑区内层视网膜近中心凹处早期CPACG组、进展期CPACG组、晚期CPACG组与对照组相比厚度均明显变薄,差异均有统计学意义（均为P<0.05）,且早期CPACG组、进展期CPACG组与晚期CPACG组两两之间比较差异均有统计学意义（均为P<0.05）。黄斑区外层视网膜中心凹、近中心凹、旁中心凹处晚期CPACG组与对照组相比厚度均明显变薄,差异均有统计学意义（均为P<0.05）。结论　晚期CPACG患者表现为黄斑区内层、外层视网膜厚度弥漫性变薄,早期患者仅有黄斑区内层视网膜近中心凹处厚度变薄的特点。     

原发性急性闭角型青光眼发作后RNFL的变化

目的:观察原发性急性闭角型青光眼(primary acute angle-closure glaucoma,PAACG)发作缓解后视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度的变化规律。方法:PAACG发作患者36例在治疗缓解后2,4,8,12wk测量平均RNFL厚度和上方、颞侧、下方、鼻侧RNFL厚度,分别与对照眼比较并分析发作眼RNFL厚度随时间的变化。结果:RNFL厚度在2wk和4wk时,发作眼和对侧眼比较差异无显著性;发作眼重复测量分析结果表明,伴随访时间的延长发作眼各个象限的RNFL厚度逐渐变薄,其中2wk与4,8,12wk比较均有统计学意义(均P<0.01)。其余各时间之间差别无显著性意义。结论:PAACG单次发作缓解后对RNFL造成损害,这种损害主要发生于下方,在眼压缓解后8wk内仍继续进展。     

急性闭角型青光眼急性发作后视网膜神经纤维层厚度与视盘血流变化的相关性

目的观察原发性急性闭角型青光眼(acute primary closure-angle glaucoma,APACG)急性发作后视网膜神经纤维层厚度(Retinal nerve fiber layer thickness,RNFLT)和视盘血流的变化。设计前瞻性比较性病例系列。研究对象抚顺市眼病医院2017年1月至2017年6月APACG急性发作的患者41例。方法急性发作41眼为观察组,同一批患者未发作41眼为对照组。在眼压控制正常后1周、3个月、6个月用Spectralis OCT测量盘周RNFLT、AngioVue OCT测量盘周血管密度(vessel density,VD)。采用广义估计方程比较不同观察时间点指标的差异性;Pearson相关分析探索RNFLT和盘周VD的相关性。主要指标盘周RNFLT值、盘周VD值。结果发作眼1周时颞侧、颞上方、颞下方RNFLT较对侧眼明显增厚(P均<0.001);3个月时鼻上方、鼻下方RNFLT明显低于对侧眼(P均<0.001);6个月时鼻侧、鼻上方、鼻下方RNFLT明显低于对侧眼(P=0.011、0.000、0.000)。发作眼3个月、6个月与1周各参数自身相比,各象限RNFL厚度均明显变薄(P均<0.001)。发作眼盘周VD于1周、3个月、6个月随访过程中呈持续下降,3个月、6个月视盘鼻侧VD均较1周明显下降(P=0.001、0.001);视盘颞上方、颞下方、鼻上方及颞侧VD均持续下降,6个月较1周明显下降(P=0.007、0.011、0.013、0.008)。发作眼较对侧眼盘周VD各个参数均明显下降(P均<0.05)。1周时盘周VD和对应象限的RNFLT无相关性(P均>0.05),而在3个月与6个月时两者的变化具有相关性(P均<0.05)。结论APACG急性发作眼压控制后早期RNFLT增厚,3~6个月持续变薄。盘周VD在半年内持续下降,且盘周VD与RNFLT整体变化趋势一致。     

原发性急性闭角型青光眼大发作缓解后视盘参数变化

目的　研究原发性急性闭角型青光眼（acute primary angle-closure glaucoma，APACG）患者大发作缓解1 a后的视盘形态学变化。方法　收集2016年1月至2017年1月在我科就诊的 APACG单眼首次大发作患者30例，男12例，女18例，应用频域光学相干断层扫描深层成像技术获取大发作缓解1 a后发作眼和对侧眼的视盘参数，并进行眼压测量，应用SPSS 20.0进行统计学分析。结果　大发作时发作眼平均眼压57.2（30～84）mmHg（1 kPa=7.5 mmHg），急性大发作持续时间3～130 h（平均50.5 h）。30眼中，19眼行虹膜周边切除术，11眼行外路小梁切除术。与对侧眼相比,APACG大发作缓解1 a后的发作眼视杯宽度增加，筛板前组织厚度与筛板厚度均变薄，差异均有统计学意义（均为P＜0.05），房角开放小于180°的发作眼变化更明显。多元线性回归分析表明，大发作时眼压升高的时间、程度均与筛板厚度、鼻侧最小盘沿宽度和颞侧最小盘沿宽度负相关，眼压升高的程度与筛板前组织厚度亦呈负相关。结论　APACG大发作时眼压升高的时间、程度与大发作缓解后视盘的远期形态学变化相关。     

光学相干断层成像术对原发性开角型青光眼视网膜神经纤维层的定性和定量检测

OBJECTIVE: To study the characteristics of optical coherence tomography (OCT) of primary open angle glaucoma (POAG), the difference of retinal nerve fiber layer (RNFL) thickness between normal persons and patients with POAG and the correlation between RNLF and visual field index. METHODS: Eighty-three cases (149 eyes) with POAG and 83 normal persons (150 eyes) were tested by OCT with circular scans around the optic nerve head (diameter = 3.46 mm) to observe the features of OCT. Statistic analysis was taken to compare the difference of RNFL thickness in quadrants and means between normal and glaucomatous group, and the difference of the thickness among the stages in POAG. Linear correlation and regression analysis was used to show the correlation between RNFL thickness and visual field index of 115 eyes of glaucomatous patients. RESULTS: The RNFL thickness measured by OCT in normal subjects is the thickest in superior and inferior quadrants, less in thickness in temporal and the thinnest in nasal quadrant. The curve showed double peaks. The RNFL of glaucomatous patients showed local thinness or defect, diffuse thinness or combination of the above two types. The mean RNFL thickness of normal group was (90.1 +/- 10.8) microm, (140.4 +/- 10.5) microm, (85.2 +/- 14.0) microm, (140.4 +/- 9.7) microm and (114.2 +/- 6.0) microm, of glaucomatous group was (56.0 +/- 31.0) microm, (81.0 +/- 36.3) microm, (47.1 +/- 27.5) microm, (73.4 +/- 38.4) microm and (64.6 +/- 28.8) microm in temporal, superior, nasal, inferior quadrant and the whole area, respectively. There is significant difference of RNFL thickness between the normal and glaucomatous group (P < 0.000), and there are significant differences among the three stages (early, developing and late) of glaucomatous group (P < 0.000). There is a close negative relationship between RNFL thickness and visual field index (r = -0.796, P < 0.0001). The sensitivity and specificity of RNFL thickness measured by OCT were 93.3% and 92.0%, respectively. CONCLUSION: OCT can quantitatively measure the RNFL thickness and show the difference of RNFL between normal persons and glaucomatous patients. The RNFL thickness gradually decreases while visual field defect increases with the development of POAG.     

原发性慢性闭角型青光眼视网膜神经纤维层损害及相关因素研究

目的 观察原发性慢性闭角型青光眼患者(chronic primary angle closure glaucoma,CACG)活体视网膜神经纤维层(retinal nerve fiberlayer thickness,RNFL)损害;分析CACG不同房角粘连程度间RNFL差异及平均RNFL厚度和视野平均缺损(mean visual fielddefects,MD)的相关性.方法 对CACG患者36例(64只眼)和正常人82名(82只眼)用光学相干断层扫描仪(optical coherence tomography,OCT)测量RNFL厚度,比较两者间的差异;比较CACG中无房角粘连、房角粘连范嗣＜1/2和≥1/2圆周眼的RNFL损害的差异;对CACG平均RNFL与相应视野的MD值进行Pearson直线相关分析.结果 CACG平均RNFL(80.61±23.96)μm与正常人(103.7±9.92)μm比较有统计学差异(P＜0.05);CACG平均RNFL厚度在无房角粘连眼(98.46±12.34)μm、粘连范围＜1/2(93.93±14.78)μm和粘连≥1,2圆周眼(69.78±23.82)μm的RNFL的差异有统计学意义(P＜0.05).CACG平均RNFL厚度与视野缺损(MD值)呈正相关(r=0.652,P＜0.001).结论 CACG的RNFL较正常人明显减少;随着CACG病程的发展,平均RNFL厚度减少,视野平均缺损增加.     

应用光学相干断层成像术测量正常人视网膜神经纤维层厚度

目的 评价光学相干断层成像术（ｏｐｔｉｃａｌ ｃｏｈｅｒｅｎｃｅ ｔｏｍｏｇｒｄｐｈｙ,ＯＣＴ）在正常人视网膜神经纤维层（ｒｅｔｉｎａｌ ｎｅｒｖｅ ｆｉｂｅｒ ｌａｙｅｒ,ＲＮＦＬ）厚度测量中的星夜价值及其测量重复性,探讨正常人各年龄组之间ＲＮＦＬ厚度是否存在差异。方法 用ＯＣＴ对１５２例（１５２只眼）正常人进行以视乳头中点为中尽,直径为３．４６ｍｍ圆周的ＲＮＦＬ厚度测量,将检查者按１０岁为一个     

Comparing glaucomatous optic neuropathy in primary open angle and chronic primary angle closure glaucoma eyes by optical coherence tomography

PURPOSE: To comparatively evaluate the optic nerve head (ONH) using Optical Coherence Tomography (OCT) in normal subjects, primary open angle glaucoma (POAG) and chronic primary angle closure glaucoma (CPACG) patients. METHODS: A total of 138 normal eyes (138 subjects) and 139 glaucomatous eyes (139 patients), were evaluated in this cross-sectional observational study. The ONH was imaged on OCT using the optic disc scan. Disc area, cup area, rim area, vertical integrated rim area (VIRA), rim volume (horizontal integrated rim volume), average cup/disc ratio, horizontal and vertical cup/disc ratios, and cup volume were evaluated. Additionally, cup depth and slope of the temporal ONH were also measured. These ONH parameters were compared between normal subjects and eyes with early POAG and CPACG. Correlation of mean deviation and corrected pattern standard deviation on full threshold 30-2 perimetry, with measured ONH parameters was carried out amongst the two groups. RESULTS: There was a significant difference in disc area (2.38 +/- 0.5, 2.77 +/- 0.4, 2.62 +/- 0.4 mm(2), p < 0.01), cup area (0.88 +/- 0.6, 1.99 +/- 0.7, 1.60 +/- 0.7 mm(2), p < 0.01), rim area (1.48 +/- 0.4, 0.86 +/- 0.4, 0.96 +/- 0.4 mm(2), p < 0.01), VIRA (1.64 +/- 0.3, 1.23 +/- 0.3, 1.22 +/- 0.4 mm(2), p < 0.01), rim volume (0.34 +/- 0.2, 0.1 +/- 0.1, 0.15 +/- 0.1 mm(3), p < 0.01) and cup/disc ratio (0.36 +/- 0.2, 0.69 +/- 0.1, 0.63 +/- 0.2, p < 0.01) in normal vs POAG vs CPACG eyes respectively. A comparison of ONH parameters between early POAG and early CPACG showed a significant difference in the disc area (2.85 +/- 0.3, 2.57 +/- 0.4 mm(2), p = 0.03), cup area (2 +/- 0.5, 1.34 +/- 0.5 mm(2), p < 0.01), rim area (0.96 +/- 0.4, 1.21 +/- 0.5 mm(2), p = 0.009), rim volume (0.12 +/- 0.1, 0.18 +/- 0.1 mm(3), p < 0.01) and cup/disc ratio (0.67 +/- 0.1, 0.53 +/- 0.2, p < 0.01). The parameters with the highest area under the receiver operator characteristic (AROC) curves for differentiating normal and early POAG eyes were rim volume, 0.89, VIRA, 0.84, and rim area, 0.76. The AROC values (normal vs early CPACG eyes) were 0.75 for rim volume, 0.72 for VIRA, and 0.66 for rim area. CONCLUSION: OCT may serve as a useful diagnostic modality in distinguishing a normal optic disc from a glaucomatous one, even in the early stages of glaucoma. Rim volume, VIRA and rim area can be used to differentiate normal from early glaucoma (both early POAG and CPACG), and most efficiently early POAG eyes. CPACG eyes have smaller discs, a smaller cup, smaller cup/disc ratio, and a larger rim area when compared with eyes with POAG.     

Damage patterns of retinal nerve fiber layer in acute and chronic intraocular pressure elevation in primary angle closure glaucoma

AIM: To observe the differences of damage patterns of retinal nerve fiber layer (RNFL) between acute and chronic intraocular pressure (IOP) elevation in primary angle closure glaucoma (PACG) using optical coherence tomography (OCT). METHODS: Twenty-four patients (48 eyes) with unilateral acute PACG (APACG) attack in the 6 months after admission and 36 patients (64 eyes) with chronic PACG (CPACG) were included in this prospective study. For all cases, IOP has been controlled under 21mmHg after treatment. Using stratus OCT, the RNFL thickness was assessed in eyes with PACG within 3 days, 2 weeks, 1, 3 and 6 months after IOP was controlled. Repeated measures ANOVA was used to examine the changes of RNFL thickness at different time after IOP being controlled in both acute attack eyes and unaffected fellow eyes of APACG and eyes with CPACG. RESULTS: The mean RNFL thickness for the APACG- attacked eyes increased significantly within 3 days (121.49±23.84)μm after acute onset and then became thinner along with time [(107.22±24.72)μm at 2 weeks,(93.58±18.37)μm at 1 month, (84.10±19.89)μm at 3 months and (78.98±19.17)μm at 6 months]. In APACG-attacked eyes, there were significant differences of average RNFL thickness at 5 different times after IOP was controlled (P＜0.001). In the APACG unaffected fellow eyes and CPACG eyes, there were no significant differences in mean RNFL thickness at 5 different times(F=0.450, P=0.104 in APACG unaffected fellow eyes and F=1.558, P=0.200 in CPACG eyes). There was significant difference for interaction between time periods and groups (F=1.912, P=0.003). CONCLUSION: RNFL damage patterns are different under different IOP elevated courses. In APACG, RNFL was found to be swollen and thickening right after acute attack and then becomes thinning and atrophy along with the time, while RNFL was found to be diffused thinness in CPACG.     

OCT测量视网膜神经纤维层厚度在青光眼诊断中的研究进展

青光眼是一种进展性视神经疾病,它能引起视神经结构改变,最终导致不可逆视功能损害。青光眼的早期诊断对保护视功能有重要的意义。光学相关断层扫描仪可以定量检测视网膜神经纤维层厚度,为早期诊断青光眼,监测视神经损害及指导青光眼的治疗提供了新的思路。本文主要反映该技术在青光眼诊断中的研究进展。许多研究都发现光学相关断层扫描仪检测的视网膜神经纤维层厚度在有视野改变的青光眼中有明显改变,且与视野损害在位置和严重程度上有很好的相关性,但仍缺乏有力的纵向研究来评价其在无视野改变青光眼中的诊断价值。     

Stratus相干光断层扫描仪检测激光虹膜切开术前后的房角变化

目的探索Stratus相干光断层扫描仪(OCT)对闭角型青光眼眼前房角观察的方法。设计前瞻性病例系列。研究对象原发性闭角型青光眼患者38例(56眼)。方法利用Stratus OCT对早期原发性闭角型青光眼患者激光虹膜切开术前及术后4周的前房角进行形态学观察,用Photoshop软件对前房角开放的角度进行描绘和测量。主要指标房角开放角度,前房深度与角膜厚度比。结果Stratus OCT可用来显示眼前房角形态,获取清晰的图像。激光虹膜切开术术前、术后的房角开放角度分别为(15.67±5.33)度、(26.56±8.17)度(P=0.000);前房深度与角膜厚度的比值分别为(0.39±0.13)、(0.89 0.32)(P=0.000)。结论Stratus OCT可便捷地用于了解前房角的宽度改变,但对量化手段和标准需进一步完善。