早期帕金森病患者视网膜神经纤维层厚度变化与视野平均缺损的关系

目的 观察早期帕金森病(PD)患者视网膜神经纤维层(RNFL)厚度的变化及其与视野平均缺损深度(MD)的关系.方法 采用光相干断层扫描(OCT)对临床确诊为早期PD的15例患者15只眼和18名健康人18只眼进行检查.选择内注视方式,以视盘中心为圆心、直径为3.46 mm的环形扫描.扫描分为上方、下方、颞侧、鼻侧、颞上、颞下、鼻上、鼻下8个象限进行,对比分析两组受检者8个象限的RNFL厚度及平均RNFL厚度.采用Humphrey-750全自动视野计对早期PD患者进行中心30-2视野检测,记录MD值,并用直线相关和回归法分析早期PD患者平均RNFL厚度与MD的关系.结果 正常对照组上方、下方、颞侧、鼻侧、颞上、颞下、鼻上、鼻下RNFL厚度和平均RNFL厚度分别为(132.7±17.4)、(141.5±15.3)、(83.7±22.3)、(83.2±17.5)、(120.8±21.2)、(117.9±24.5)、(109.6±20.6)、(110.2±27.7)、(109.9±8.5)μm,早期PD患者上方、下方、颞侧、鼻侧、颞上、颞下、鼻上、鼻下RNFL厚度和平均RNFL厚度分别为(128.1±25.3)、(128.6±13.2)、(68.7±13.5)、(76.5±17.8)、(102.6±23.7)、(103.3±14.1)、(101.2±20.9)、(96.6±15.0)、(102.3±11.9)μm.2组比较,下方、颞侧、颞上、颞下RNFL厚度和平均RNFL厚度差异有统计学意义(t=2.595,2.700,2.330,2.153,2.131;P=0.014,0.011,0.026,0.040,0.041).早期PD患者平均RNFL厚度与MD呈负相关(t=-0.933,P<0.0001).结论 早期PD患者上方、下方、颞侧、鼻侧、颢上、颞下、鼻上、鼻下RNFL厚度较正常者明显变薄;早期PD患者的RNFL厚度与MD值呈负相关.

Changes of retinal nerve fiber layer thickness and its correlation with visual field mean defects in early Parkinson's disease

Objective To observe the changes of retinal nerve fiber layer (RNFL) thickness and its correlation with visual field mean defects(MD)in Parkinson's disease (PD). Methods Fifteen eyes of 15 PD patients in early stage and 18 eyes of 18 normal controls undertook RNFL examination by Stratus OCT-3. Circular scans (diameter is 3. 46 mm) were taken around the optic nerve head including eight quadrants (superior, inferior, temporal, nasal, temporal-superior, temporal-inferior, nasal-superior and nasalinferior). The RNFL thickness in different quadrants in the two groups was analyzed. The visual field of PD patients was measured by central 30-2 program of Humphery750 visual field analyzer, and the MD was recorded. The correlation between RNFL thickness and MD was analyzed by linear correlation and regression analysis. Results RNFL thicknesses of superior, inferior, temporal, nasal, temporal-superior, temporal-inferior, nasal-superior, nasal-inferior and average RNFL thickness in the control group were (132.7±17.4), (141. 5±15. 3),(83. 2±17. 5), (83.7±22.3) ,(120.8±21.2), (117. 9±24.5) ,(109.6±20. 6),(110.2±27.7), and(109. 9±8. 5) μm respectively, while in the PD group they were (128.1±25.3),(128. 6±13. 2),(68. 7±13. 5),(76. 5±17. 8),(102. 6±23. 7), (103.3±14.1) ,(101.2±20.9),(96.6±15.0),(102.3±11.9) μm . Compared with each other, the differences of RNFL thickness of inferior, temporal, temporal-superior, temporal-inferior and average RNFL thickness were statistically significant (t = 2. 595, 2. 700, 2. 330, 2. 153,2. 131;P = 0. 014, 0. 011, 0. 026, 0. 040, 0. 041). There was a close negative relationship between average RNFL thickness and MD in PD patients (r= -0. 933, P<0. 0001). Conclusions RNFL thickness was significantly thinner in PD patients than that in the normal controls. There was a negative relationship between RNFL thickness and MD in PD patients.