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Purpose: To assess diagnostic consistency and relation between spectral-domain optical coherence tomography (SD-OCT) and standard automated perimetry (SAP) in patients with primary open-angle glaucoma (POAG). Methods: This retrospective study comprised 51 eyes of 51 patients with a confirmed diagnosis of POAG. The qualitative and quantitative SD-OCT parameters (retinal nerve fiber layer thicknesses [RNFL; average, superior, inferior, nasal and temporal], RNFL symmetry, rim area, disc area, average and vertical cup/disc [C/D] ratio and cup volume) were compared with parameters of SAP (mean deviation, pattern standard deviation, visual field index, and glaucoma hemifield test reports). Results: Fifty-one eyes of 51 patients with POAG were recruited. Twenty-nine eyes (56.9%) had consistent RNFL and visual field (VF) damage. However, nine patients (17.6%) showed isolated RNFL damage on SD-OCT and 13 patients (25.5%) had abnormal VF test with normal RNFL. In patients with VF defect, age, average C/D ratio, vertical C/D ratio, and cup volume were significantly higher and rim area was lower when compared to those of the patients with normal VF. In addition to these parameters, worsening in average, superior, inferior, and temporal RNFL thicknesses and RNFL symmetry was significantly associated with consistent SD-OCT and SAP outcomes. Conclusions: In routine practice, patients with POAG can be manifested with inconsistent reports between SD-OCT and SAP. An older age, higher C/D ratio, larger cup volume, and lower rim area on SD-OCT appears to be associated with detectable VF damage. Moreover, additional worsening in RNFL parameters might reinforce diagnostic consistency between SD-OCT and SAP.  相似文献   

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青光眼视网膜神经节细胞及其轴突损害导致视网膜神经纤维层(RNFL)进行性萎缩,伴随出现视功能的损害.青光眼视野缺损典型表现为神经纤维束性视野缺损.一般认为先出现RNFL损害,再出现视野缺损,且视野缺损和RNFL损害的位置具有对应性.与HRT、GDx相比,OCT测量的RNFL厚度能更好地用于评价青光眼损害的结构与功能关系.青光眼结构损害和功能性改变之间的对应关系,对于青光眼的诊断、分期和视功能评估起着重要作用.本文就青光眼结构与功能损害关系的研究进展做一综述.  相似文献   

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陈瑛 《眼科研究》1997,15(3):211-214
青光眼的主要病理过程是视网膜节细胞轴突(即视神经纤维)的丢失,故测量视网膜神经纤维层(retinalnervefiberlayer,RNFL)来确定轴突丢失的程度在青光眼的早期诊断和治疗上具有非常重要的意义。近年来,计算机图像分析技术应用于眼科,它能对RNFL作出客观的量化检测。该文综述有关文献,就RNFL定量测定方法的原理,以及它们在青光眼RNFL损害检测方面的应用情况作一介绍。  相似文献   

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视野缺损计分与OCT测量RNFL厚度的关系   总被引:1,自引:0,他引:1  
赵炜  卢艳 《国际眼科杂志》2009,9(7):1310-1312
目的:探讨视野缺损计分值与视网膜神经纤维层损害的关系。方法:收集开角型青光眼患者30例30眼,分别进行OCT视网膜神经纤维层厚度及视野检查。根据视野结果进行视野缺损计分并分组。组间分析各象限视网膜神经纤维层厚度值与视野缺损计分,平均缺损(MD)的关系和相关性。结果:根据视野缺损计分将患者分为四组,上侧、下侧,平均视网膜神经纤维层厚度在组间有显著性差异(P=0.010,P<0.01,P<0.01)。四组间随视野缺损程度加重,上侧、下侧,平均视网膜神经纤维层厚度变薄。在重度缺损组视网膜神经纤维层厚度最薄。视野缺损计分与上、下、鼻、颞侧及平均视网膜神经纤维层厚度均明显负相关(r=-0.610,P=0.001;r=-0.779,P<0.01;r=-0.463,P=0.015;r=-0.500,P=0.008;r=-0.782,P<0.01),视野指数MD与上侧,下侧及平均RNFL厚度明显正相关(r=0.557,P=0.003;r=0.431,P=0.025;r=0.532,P=0.004)。结论:视野缺损计分对视野缺损的客观评估,与OCT测得的视网膜神经纤维层厚度的结果负相关,是反应青光眼视神经损伤的可靠的观察指标。  相似文献   

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李雯  邓媛  周丹  厉君  林丁  叶长华 《国际眼科杂志》2015,15(7):1204-1206
目的::探讨原发性开角型青光眼( primary open angle glaucoma, POAG)早期上下半视盘周围视网膜神经纤维层( retinal nerve fiber layer, RNFL)的变化特征。方法:临床观察研究,研究对象为2012-05/2014-05在我院门诊确诊为原发性开角型青光眼早期患者30例39眼和健康成人20例40眼,使用Humphrey视野计和光学相干断层成像术( optical coherence tomography,OCT)检查,分别记录视野平均缺损( mean defect,MD)、青光眼半视野检测( glaucoma hemifield test, GHT)、眼压、C/D比值及视盘周围FNFL厚度。使用SPSS 18.0统计软件对测量值进行统计分析,计量资料组间比较采用t检验。结果:两组上半视盘各钟点位的RNFL厚度减去下半视盘相对应钟点位的RNFL厚度,两组间比较,仅上鼻-下鼻的差值具有统计学意义(t=2.526,P=0.014),其余上下半视盘相对应钟点位RNFL厚度的差值比较,两组间均无统计学意义(均为P>0.05)。结论:原发性开角型青光眼早期上下半视盘周围RNFL存在不对称性变化,上鼻部位(右眼1:00位,左眼11:00位)的RNFL较下鼻部位(右眼5:00位,左眼7:00位)的RNFL更容易受损变薄。  相似文献   

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青少年型青光眼的临床分析   总被引:3,自引:1,他引:2  
目的 分析青少年型青光眼的临床特点。方法 对 3 4例青少年型青光眼的临床资料进行回顾性研究 ,分析其一般情况、眼压特点、视网膜神经纤维层缺损、视野与C/D值和眼压的关系。结果 青少年型青光眼的男女比例为 2 8:1 ,就诊时平均年龄 2 0 2 1± 6 2 8岁 ,41 1 8%患者有自觉症状。眼压不高于 3 0mmHg者占 67 65 % ,而仅有 7 3 5 %眼压高于 40mmHg ,个体眼压的差异较大。C/D值大于 0 6者占 82 % ,大于 0 8者占 3 5 %。已有视野损害者占 65 0 8% ,早、中、晚三期视野损害分别为 3 3 3 3 %、 2 2 2 2 %、 9 5 %。结论 青少年型青光眼症状轻微 ,眼压轻中度升高且个体间差异大 ,发现时常为中晚期。临床工作中对可疑青少年型青光眼患者应详细检查 ,密切随访。  相似文献   

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探讨不同时期剥脱性青光眼(PXG)患者视盘视网膜神经纤维层(RNFL)厚度与视野缺损的相关性。方法:病例对照研究。连续性选取2013年1月至2018年1月在石家庄市第一医院青光眼科住院治疗的PXG患者97例(97眼),并将其分为早期PXG组28例,中期PXG组27例,晚期PXG组42例。另选择与PXG组匹配的正常志愿者32例(32眼)作为正常对照组。所有纳入对象均采用SD-OCT对视盘各区RNFL厚度进行扫描,采用单因素方差分析比较4组受检者视盘各区RNFL厚度差异,采用 Pearson相关分析对视盘RNFL厚度与视野平均缺损相关性进行分析。结果:正常对照组及早、中、晚期PXG组平均视盘RNFL厚度分别为(104±11)μm,(92±14)μm,(82±12)μm,(54±18)μm。4组受检者鼻侧、鼻上方、颞上方、颞侧、颞下方、鼻下方及平均RNFL厚度总体差异均具有统计学意义(F=24.38、36.40、47.84、8.70、95.46、54.75、82.28,均P<0.001)。进一步两两比较发现,正常对照组与早期PXG组颞上方、颞下方、鼻下方及平均视盘RNFL厚度差异有统计学意义(均P<0.05);正常对照组与中期PXG组鼻侧、鼻上方、颞上方、颞下方、鼻下方及平均RNFL厚度差异有统计学意义(均P<0.05);正常对照组与晚期PXG组各区RNFL厚度差异均有统计学意义(均P<0.001)。中、晚期 PXG组视盘平均RNFL厚度与视野平均缺损呈正相关(r=0.404,P=0.037;r=0.582,P<0.001)。结论:中、晚期PXG眼视盘平均RNFL厚度与视野缺损呈正相关,SD-OCT监测视盘RNFL厚度变化可以作为PXG诊断分期和随访的重要参考指标。  相似文献   

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目的:评价并比较青光眼早期诊断仪GDxVCC、短波视野计(SWAP)、标准自动视野计(SAP)各参数诊断早期开角型青光眼的敏感性和特异性。方法:采用GDxVCC和SWAP及SAP对正常人42例42眼和早期开角型青光眼患者84例84眼进行检查,绘制GDxVCC各参数(TSNIT,SA,IA,IES,NFI)ROC(receive operating characteristic curve)曲线,比较GDxVCC,SAP,SWAP的敏感性和特异性。结果:TSNIT,SA,IA,IES,NFI的ROC面积分别为0.77,0.76,0.80,0.85,0.87。GDxVCC,SWAP,SAP的敏感性分别为80.6%,74.2%,67.8%;特异性分别为95.2%,85.7%,76.2%。结论:GDxVCC参数中,NFI和IES是区分正常人和青光眼最有效指标。GDxVCC诊断能力优于SWAP,SWAP优于SAP。  相似文献   

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目的:观察神经生长因子(NGF)治疗非动脉炎性前部缺血性视神经病变(NA-AION)的临床疗效。 方法:前瞻性随机对照研究。选择2016年7月至2019年6月涟水县人民医院眼科收治的NA-AION患 者58例(58眼),根据随机数字表法分为对照组和观察组,对照组29例(29眼)予以糖皮质激素+活血 通络颗粒+复方樟柳碱治疗,观察组29例(29眼)在对照组基础上加NGF治疗。比较2组治疗的总有 效率、治疗前后最佳矫正视力(BCVA)、30°范围视野检查平均缺损(MD)、视盘视网膜神经纤维层 (RNFL)厚度。数据采用Fisher精确检验、t检验及非参数检验。结果:治疗后,观察组总有效率明 显高于对照组(P=0.04),观察组BCVA小数视力0.1以上所占百分比明显高于对照组(P<0.001),但 观察组的MD和RNFL厚度均明显低于对照组(t=2.59,P=0.01;t=4.86,P<0.001)。2组治疗后均无明 显不良反应。结论:加用NGF治疗NA-AION可获得更好的疗效,能提高患者视力,改善视野,降低 RNFL厚度。  相似文献   

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Objective: To observe the effects of nerve growth factor (NGF) in the treatment of non-arteritic anterior ischemic optic neuropathy (NA-AION). Methods: This was a prospective, randomized, controlled study. Fifty-eight NA-AION patients (58 eyes) admitted to Lianshui County People's Hospital from July 2016 to June 2019 were selected, and then were divided into a control group and an observation group based on the random numerical table method. The control group (29 patients with 29 eyes) were given glucocorticoid hormones, Huoxue Tongluo granules and an anisodine compound. While the observation group (29 patients with 29 eyes), were treated with NGF in addition to the treatment plan previously described. The total effective rate, best corrected visual acuity (BCVA), the 30-degree visual-field examination mean deviation (MD) and the disc retinal nerve fiber layer (RNFL) thickness of the two groups were compared. Data were analyzed by the Fisher's exact test, a t test and a non-parametric test. Results: After treatment, the total effective rate for the observation group was significantly higher than that for the control group (P=0.04),the percentage of BCVA above 0.1 in the observation group was significantly higher than that in the control group (P<0.001), and both the MD and RNFL thickness in the observation group were significantly lower than those in the control group (t=2.59, P=0.01; t=4.86, P<0.001). There were no obvious adverse reactions for either group after treatment. Conclusions: The treatment of NA-AION with NGF can obtain a better effective rate, improve the patient's vision, improve the visual field and reduce RNFL thickness.  相似文献   

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陈燕云  王宁利  梁远波  王兰  甄毅 《眼科》2007,16(1):28-32
目的比较原发性开角型青光眼(POAG)和原发性闭角型青光眼(PACG)的早期视神经损害特征和视野损害特点的差异。设计前瞻性病例系列。研究对象早期POAG患者23例(30眼),早期PACG患者22例(30眼)。方法进行静态视野和偏振激光扫描仪GDx ECC检查。分别比较两组间GDx ECC各个参数和视网膜神经纤维层缺损(RNFLD)类型(弥漫性、局限性)的差异。在组间分别比较视野参数、视野检测光标点对点的光敏度丢失。主要指标GDx ECC参数及其RNFLD类型、视野参数、视网膜光敏度丢失。结果两组中GDx ECCTM参数除了上方均值和对称性以外,其余各个参数在两组间的差异均有统计学意义。弥漫性RNFLD在POAG和PACG中的比例分别为40%和10%(P〈0.05),局限性RNFLD分别为53%和63%。视野指数中PSD和CPSD在两组间差异有统计学意义(P〈0.05)。在视野检测的点对点比较中,早期PACG的局部光敏度丢失在颞上方视野中较早期POAG严重(P〈0.05)。结论早期POAG有较多弥漫性RNFLD,而早期PACG主要表现为局限性RNFLD。早期PACG在颞上方的局部光敏度丢失较早期POAG严重,这与其RNFL缺损特征相一致。POAG和PACG不同的发病机制可能是导致RNFL损害特征和视野损害特点差异的原因。(眼科,2007,16:28-32)  相似文献   

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苏锐锋  苏畅  谭小波  张垒 《国际眼科杂志》2020,20(1):154-157
目的:观察经全视网膜激光光凝(PRP)治疗的重度非增生型糖尿病视网膜病变(NPDR)患者视网膜神经纤维层(RNFL)厚度变化和视野缺失情况及相关性。方法:前瞻性临床研究。选取2017-01/2018-03经我院眼科确诊的重度NPDR患者35例52眼(光凝组,常规药物治疗的同时行PRP治疗),另选取同期入院、年龄和性别等相匹配的重度NPDR患者35例52眼作为对照组(常规药物治疗)。随访1a,分析比较两组患者最佳矫正视力(BCVA)、RNFL厚度和视野变化情况。结果:治疗后1a,光凝组患者BCVA无明显改善(P>0.05),而对照组BCVA明显降低(P<0.05);光凝组患者颞侧RNFL厚度无明显变化(74.5±13.7μm vs 70.8±11.3μm,P>0.05),其余象限RNFL和平均RNFL厚度均较治疗前变薄(均P<0.05),且颞侧神经纤维对应视野MS值无明显变化(22.5±8.7dB vs 20.8±7.2dB,P>0.05),其余象限和平均MS值均较治疗前降低(均P<0.05)。光凝组患者治疗前后鼻侧、鼻上方、颞上方、颞侧、颞下方、鼻下方及平均RNFL厚度变化值与神经纤维所对应视野MS变化值呈正相关或无相关性。结论:PRP能有效控制重度NPDR进一步发展,维持患者视力,但PRP对RNFL和视野的损伤作用不容忽视。  相似文献   

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Objective To evaluate the diagnostic capabilities of ganglion cell complex (GCC) thickness in preperimetric glaucoma (PPG) with spectral domain optical coherence tomography (SD-OCT). Design Self control study and case control study. Participants Primary open-angle glaucoma (POAG) patients were 20 cases(40 eyes), of which 20 eyes without visual field defects as PPG, and healthy controls were 30 cases(30 eyes). Methods All subjects were underwent macular scanning and peripapillary retinal nerve fiber layer (RNFL) scanning using the RTvue SD-OCT. The area under the receiver operating characteristic curve (AUC) was used to assess the ability to discriminate PPG from normal control. Main Outcome Measures The thickness of GCC and RNFL, and their AUCs. Results Compared with normal eyes, the thickness of average GCC, superior GCC, inferior GCC, average RNFL, superior RNFL, and inferior RNFL in PPG eyes decreased (P<0.001). However, these parameters were thicker than POAG eyes (P≤0.002). The values of GCC-GLV and GCC-FLV increased compared with normal eyes (P<0.001, P=0.021), but decreased compared with POAG eyes (P<0.001). GCC-GLV had highest AUC for detecting PPG (0.983) from normal eyes, followed by average RNFL (0.930). However, the difference between the two parameters was not statistically significant (P>0.05). Conclusions In addition to RNFL, the GCC could be a structural parameter for detecting PPG. (Ophthalmol CHN, 2017, 26: 10-14)  相似文献   

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目的:探讨原发性开角型青光眼(POAG)非对称性视野损害的相关因素,并了解非对称性视野损害者双眼间眼部参数的差异。方法:横断面研究。收集2014年1月至2018年12月温州青光眼进展研究 (WGPS)中确诊的POAG患者,分析双眼眼部参数,包括眼压、眼轴长度(AL)、中央角膜厚度(CCT)、 前房深度(ACD)、晶状体厚度(LT)、视野平均偏差(MD)、视网膜神经纤维层厚度(RNFLT)、盘沿 面积、视盘面积、杯盘比、视杯容积。非对称性视野损害定义为双眼视野MD的绝对差值≥5 dB, 根据此标准将受检者分为对称组和非对称组,分析2组眼部参数与非对称性视野损害的关系。非对称组进一步行双眼间眼部参数的比较。采用独立样本t检验、Mann-Whitney U检验、配对t检验、 Wilcoxon检验、Logistic回归分析对数据进行分析。结果:共纳入POAG患者142例(284眼),对称组 92例(64.8%),男39例(42.4%),年龄(65.3±1.0)岁;非对称组50例(35.2%),男32例(64.0%),年 龄(67.6±9.1)岁。男性[OR=4.52,95%可信区间(CI):1.90~10.73,P=0.001]、较差眼的CCT较薄 (OR=0.97,95%CI:0.95~0.99,P=0.003)、双眼平均RNFLT差值增大(OR=1.10,95%CI:1.04~1.15, P<0.001)为非对称性视野损害的危险因素。非对称组中,视野损害较重眼相比对侧眼,其平均 RNFLT较薄(Z=-7.80,P<0.001),盘沿较窄(t=-4.97,P<0.001),视盘面积较大(t=2.38,P=0.02), 平均杯盘比(Z=-4.51,P<0.001)和垂直杯盘比(Z=5.16,P<0.001)均较大,视杯容积较大(Z=-3.31, P<0.001),但双眼间眼压、等效球镜度(SE)、AL、CCT、LT和ACD的差异均无统计学意义。结论:男性、CCT较薄、双眼平均RNFLT差值增大为POAG非对称性视野损害的独立危险因素,而非对称性视野损害者其双眼中的较大视盘眼,更容易发生视神经损害。  相似文献   

17.
目的 利用光学相干断层扫描(opticalcoherencetomography,OCT)检测早期原发性开角型青光眼和可疑青光眼患者视网膜神经纤维层(retinalnervefiberlayer,RNFL)厚度的变化,并分析其与视野缺损的相关性。方法 收集来我院就诊的可疑青光眼患者35例(63眼)为A组,早期原发性开角型青光眼患者41例(72眼)为B组,对照组34例(66眼)为C组,采用OCT仪和Humphrey740i全自动视野计分别对3组受检者进行视盘周围RN-FL厚度和视野检测,比较3组患者的RNFL厚度,分析青光眼组RNFL厚度与视野缺损间的关系。结果 A组的上方、下方象限及平均RNFL厚度与C组对应象限比较,差异均有统计学意义(均为P<0.05);B组与C组比较平均及各象限RNFL厚度差异均有统计学意义(均为P<0.05);A组与B组比较上方、下方、鼻侧象限及平均RNFL厚度差异均有统计学意义(均为P<0.05)。三组受检者各象限及全周视野缺损两两比较,差异均有统计学意义(均为P<0.05)。B组平均及各象限RNFL厚度与视野缺损程度均呈负相关(均为P<0.05)。结论 青光眼患者RNFL厚度变薄,并且与视野缺损程度呈负相关。  相似文献   

18.
原发性闭角型青光眼已成为不可逆性致盲的最常见病因之一。对原发性闭角型青光眼的研究,除了关注眼前节,特别是房角的情况外,也有必要对其视神经损害模式进行研究。本文通过文献回顾,总结了原发性闭角型青光眼特别是急性闭角型青光眼眼底形态和视功能的改变,希望能更好地了解早期原发性闭角型青光眼的疾病特征,为临床治疗和研究提供帮助。  相似文献   

19.
Huang L  Fan N  Shen X  He J 《眼科学报》2011,26(3):132-137
 Purpose: To evaluate and compare the diagnostic ability of retinal nerve fiber layer (RNFL) thickness measurements using time domain (Stratus) and spectral domain (Cirrus HD) optical coherence tomography (OCT) in preperimetric and early primary open angle glaucoma (POAG). Methods: A total 62 eyes of 62 normal subjects, 47 eyes of 47 early perimetric damage POAG patients and 30 eyes of 30 preperimetric glaucoma patients were chosen in the study. All the subjects underwent peripapillary RNFL thickness measurements using Stratus OCT and Cirrus HD-OCT on the same day by a single trained operator. The RNFL thickness measured by Stratus OCT and Cirrus HD-OCT was statistically compared using paired t-tests. The relationship between RNFL thickness measured by two OCT instruments was evaluated using Pearson’s correlation coefficient. Areas under the receiver operating characteristic curves (AROC) were calculated and compared. Results: RNFL thickness measured using Stratus OCT was generally thicker than that using Cirrus HD-OCT(P<0.05). A highly significant correlation between the two OCT instruments measurements was found in four quadrants and average RNFL thickness measurements (P<0.001). The average RNFL thickness of Cirrus HD-OCT had significantly (P = 0.006) higher diagnostic ability (AROC = 0.951) than that of Stratus OCT (AROC = 0.881) in preperimetric glaucoma. There were no significant differences between the AROCs for other RNFL thickness parameters from Cirrus HD-OCT and Stratus OCT in preperimetric and early glaucoma (P>0.05). Conclusion: Significant differences and an excellent correlation were noted in terms of RNFL thickness measurements using Stratus OCT and Cirrus HD-OCT. Cirrus HD-OCT presented higher diagnostic ability for preperimetric glaucoma.  相似文献   

20.
目的 探讨原发性开角型青光眼(primary open-angle glaucoma,POAG)和慢性原发性闭角型青光眼(chronic primary angle-closure glaucoma,CPACG)患者频域光学相干断层扫描(optical coherence tomography,OCT)检测的视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度与视野平均缺损(mean defect,MD)的相关性.方法 采用RTVue100-2频域OCT和OCTO-PUS101视野计对POAG患者22例(22眼)及CPACG患者22例(22眼)进行检测,将两组患者RNFL厚度及视野MD值进行比较,应用Pearson积矩相关分析法确定RNFL厚度与视野MD值、上方和下方RNFL厚度与相对应半侧视野MD值的相关性.结果 POAG患者RNFL厚度、上方RNFL厚度及下方RNFL厚度分别为(91.19±15.85)μm、(94.93±18.76) μm、(87.82±15.65) μm,CPACG患者相应的RNFL厚度分别为(88.22±13.01) μm、(90.41±14.16)μm、(86.49±16.63) μm,两组患者各RNFL参数的比较差异均无统计学意义(均为P>0.05).POAG组总MD值、上方半侧视野MD值、下方半侧视野MD值分别为(8.41±6.07)dB、(8.46±5.39)dB、(6.79±6.67) dB,CPACG组相应的MD值分别为(10.69±3.76) dB、(11.17±3.52) dB、(9.71±5.86)dB,两组患者各MD参数比较,差异均无统计学意义(均为P>0.05).POAG组总RNFL厚度、上方RNFL厚度及下方RNFL厚度与视野相对应区域MD值呈中度负相关(r分别为:-0.574、-0.464、-0.600,均为P<0.05),CPACG组总RNFL厚度、上方RNFL厚度及下方RNFL厚度与视野相应区域MD值呈高度负相关(r分别为-0.819、-0.884、-0.812,均为P =0.000);两组患者RNFL厚度与MD的相关系数和下方RNFL厚度与上方半侧视野MD的相关系数的差异均无统计学意义(P>0.05),两组患者上方RNFL厚度与下方半侧视野MD的相关系数的差异有统计学意义(P<0.05).结论 POAG患者RNFL厚度与视野MD呈中度负相关,CPACG患者RNFL厚度与视野MD呈高度负相关;相对于POAG患者,CPACG患者上方RNFL厚度与下方半侧视野MD具有更好的相关性.  相似文献   

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