Stratus OCT用于评价青光眼患者药物治疗依从性的效果

目的应用Stratus OCT探讨青光眼患者药物治疗依从性对视网膜神经纤维层（retinalnerve fiber laye，RNFL）的影响。方法选择2007年2月至2010年11月在门诊就诊的原发I生开角型青光眼（primary open angle glaucoma，POAG）患者53例100只眼，采用自行设计的问卷调查患者药物治疗的依从陛，将其分为依从性好和依从性差两组，比较其1年前后OCT检测全周RNFL平均厚度和4个象限（上方、下方、鼻侧、颞侧）的平均厚度变化，并采用差值分析的方法进行统计学处理。结果POAG患者全周RNFL平均厚度和4个象限的平均厚度差值：依从懒分别为（3．13±6．64）pjn，（-4．7±12．95）μm，（-2．54±9．75）μm，（-3．28±14．86）μm，（-1．84±11．94）v；依火陛差组分别为（7．74±8．14）μm，（15．82±22．10）μm，（4．94±13．96）μm，（8．42±13．64）μm，（4．38±19．63）μm。两组间差值比较：全周RNFL平均厚度、上方、鼻侧平均厚度差异有显著性统计学意义（t分别为7．32，5．663，4．100；P均〈0．01）；下方RNFL平均厚度的差值比较差异有统计学意义（t=3．105，P〈0.05）；而颞侧的RNFL平均厚度的差值比较差异无统计学意义（t=1．914，P〉0．05）。结论药物治疗依从性与视神经损伤的范围和程度有密切关系，因此，OCT用于评价青光眼患者药物治疗依从性是较为客观、特异、敏感、定量的检测方法，为监测视神经损害提供了可靠的且可量化的临床指标，使患者易于理解和接受，便于提高其药物治疗依从性。

Effect of medication compliance of primary open angle glaucoma (POAG) patients by retinal nerve fiber layer thickness acquired by stratus OCT

Objective To investigate the affect of medication compliance on retinal nerve fiber layer thickness acquired by stratus OCT in primary open angle glaucoma (POAG) patients.Methods 100 eyes of 53 POAG outpatients from 2007 to 2010 were recruited in outpatient service.All the patients were sorted into 2 groups according to their medication compliance:high medication compliance (group A) and low medication compliance (group B).Both global and retinal nerve fiber layer (RNFL) thickness in the four quadrants (superior,inferior,nasal and temporal) were detected by OCT in both groups during 1 year follow-up and the changes were statistically analyzed.Results The changing value of RNFL thickness in global average and in the four quadrants ( superior,inferior,nasal and temporal ) is ( 3.13 ± 6.64 ) μm,( - 4.7 ± 12.95 ) μm,( -2.54 ±9.75)μm,( -3.28 ±14.86) μm,( - 1.84 ± 11.94) μm in group A,and (7.74 ± 8.14) μm,(15.82±22.10)μm,(4.94 ±13.96)μm,(8.42 ± 13.64)μm,(4.38 ± 19.63)μm in group B.The data presented striking difference between group A and group B in average,in the superior and in the nasal (t =7.32,5.663,4.10; P ＜ 0.001 ),as while as in the inferior (t =3.105,P ＜ 0.05),while not showed statistical difference in the temporal ( t =1.914,P ＞ 0.05 ).Conclusions OCT was a test method with objective,specific,sensitive and quantitative characteristics.OCT can be used to evaluate the medication compliance of POAG patient which facilitate monitoring RNFL lesion.