POAG早期上下半视盘视网膜神经纤维层的不对称性变化

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。

Asymmetry of optic disc hemifield retinal nerve fiber layer in early primary open angle glaucoma

AIM: To examine the retinal nerve fiber layer(RNFL)changes in early primary open angle glaucoma(POAG)by comparing the superior half of the optic disc with the inferior disc half.

METHODS: It was a clinical observational study. The study included 30 patients(39 eyes)with POAG and 20 normal subjects(40 eyes). Visual field was tested by Zeiss Humphrey750 and the optic disc topographic parameters and RNFL thickness were measured by Zeiss Cirru HD-OCT. Collecting information included visual field mean defect(MD), glaucoma hemifield test(GHT), intraocular pressure(IOP), C/D ratio and RNFL thickness. Data were analyzed by statistic software SPSS18.0. The differences between two groups were assessed using t test.

RESULTS: The differences of superior RNFL minus inferior RNFL thichness on the corresponding clock-hour locations were caculated in two groups. There was a significant difference in superonasal-inferonasal RNFL thickness between two groups(t=2.526, P=0.014), and there were no significant differences in the others(all P>0.05).

CONCLUSION: The asymmetry of optic disc hemifield RNFL is found in early primary open angle glaucoma patients. The superonasal RNFL(1 o'clock for right eye, and 11 o'clock for left eye)is more fragile to loss than inferonasal RNFL(5 o'clock for right eye, and 7 o'clock for left eye).