视盘三维参数对青光眼视神经损害评价的应用研究

目的通过对海德堡视网膜断层扫描仪Ⅱ型（HRT-Ⅱ）视盘参数与激光扫描偏振仪（GDX）视网膜神经纤维层（RNFL）厚度的相关性分析,探讨HRT-Ⅱ盘沿参数对青光眼视神经损害的评价。方法使用HRT-Ⅱ和GDX仪器对原发性慢性闭角型青光眼患者51例（73眼）,进行视盘参数和RNFL厚度测量,并进行视盘参数与RNFL厚度的相关分析。结果 RNFL厚度与盘沿面积（RA）、盘沿体积（RV）无相关性;RNFL厚度全周平均值与盘沿面积/视盘面积（RA/DA）、盘沿体积/视盘体积（RV/DV）呈正相关（=0.430、0.444,〈0.05）;视神经纤维指数（NFI）与盘沿面积/视盘面积（RA/DA）、盘沿体积/视盘体积（RV/DV）呈负相关（=-0.564、-0.545,〈0.01）;RNFL厚度上方平均值与上方盘沿体积/上方视盘体积（SRV/SDV）呈正相关（=0.472,〈0.05）;RNFL厚度下方平均值与下方盘沿体积/下方视盘体积（IRV/IDV）呈正相关（=0.426,〈0.05）。结论 HRT-Ⅱ视盘参数中,应用盘沿/视盘参数优于直接应用RA、RV参数,应用RV/DV三维参数优于RA/DA参数。

Evaluation of optic nerve damage with 3D parameters of optic disk among glaucoma patients

Objective To probe the application of the HRT-II rim parameters in the evaluation of optic nerve damage in glaucoma,by means of the analysis of the correlation between the rim parameters from Heidelberg Retina Tomography-II（HRT-II） and the retinal nerve fiber layer（RNFL） thickness from scanning laser polarimetry（GDx）. Methods HRT-II and GDx equipments were used to measure the parameters of the optic disk and the RNFL thickness in 51 patients（73 eyes） with primary chronic angle-closure glaucoma,and the correlation between optic disk parameters and RNFL thickness was analyzed.Results The analysis of the correlation between the RNFL thickness and the rim area（RA）,rim volume（RV） showed no statistical significance（P〉0.05）;there was a positive correlation between TSNIT average and rim area/disk area（R/DA）（r=0.430,P〈0.05）,and there was also a positive correlation between TSNIT average and rim volume/disk volume（R/DV）（r=0.444,P〈0.05）.It showed a negative correlation between nerve fiber index（NFI） and rim R/DA（r=-0.564,P0.01）,and it also showed a negative correlation between NFI and R/DV（r=-0.545,P〈0.01）.The correlation was positive（r=0.472,P〈0.05）,between the superior average of RNFL thickness and the Superior rim volume/Superior disk volume（SR/DV）,and the correlation was also positive（r=0.426,P〈0.05）,between the inferior average of RNFL thickness and the Inferior rim volume/Inferior disk volume（IR/DV）.Conclusions Among the parameters of the optic disc from HRT-II,the effect of parameters of rim/disk are better than the parameters of rim area and rim volume directly,and there is advantage for 3D parameters of rim volume/disk volume over parameters of rim area/disk area.