相干光断层扫描仪检测正常人及青光眼患者中央角膜厚度

目的探讨相干光断层扫描仪(OCT)测量正常人、原发性开角型青光眼(POAG)、正常眼压性青光眼(NTG)、高眼压症(OHT)患者的中央角膜厚度(CCT)。方法采用OCT3测量正常人143例(143只眼)、POAG患者36例(36只眼)、NTG患者39例(39只眼)及OHT患者40例(40只眼)的CCT,并进行单因素4水平设计定量资料的方差分析;用线性回归方法分析正常人CCT与Goldmann压平眼压测量值的相关关系;对OCT测量CCT观察者间和观察者内的一致性进行类内相关系数(ICC)分析。结果正常组、POAG组、NTG组及OHT组的平均CCT值分别为(523.66±32.13)μm、(530.92±27.32)μm、(506.92±21.49)μm及(573.13±27.39)μm。POAG组与正常人组的平均CCT值差异无统计学意义(P=0.099);OHT组的平均CCT值大于其他各组,均P<0.01;NTG组的平均CCT值小于其他各组,均P<0.01。正常组CCT与眼压值呈正相关(r=0.318,R2=0.101,P<0.01)。OCT测量CCT的测量者间和测量者内的ICC值分别为0.995和0.996。结论OCT可以准确地测量CCT;NTG患者平均CCT比正常人薄,而OHT患者比正常人厚;CCT可以影响Goldmann压平眼压计的测量值,但贡献率较小。(中华眼科杂志,2006,42:199-203)

The measurement of central corneal thickness of normal subjects and glaucomatous patients with optical coherence tomography

OBJECTIVE: To evaluate central corneal thickness (CCT) of normal subjects, patients with primary open angle glaucoma (POAG), normal tension glaucoma (NTG) and ocular hypertension (OHT) using optical coherence tomography (OCT). METHODS: One hundred and forty-three eyes of 143 normal subjects, 36 eyes of 36 patients with POAG, 39 eyes of 39 patients with NTG and 40 eyes of 40 patients with OHT were enrolled. CCT were measured by OCT3 and analyzed using ANOVA. The relationship of CCT and intraocular pressure (IOP) measured by Goldmann applanation tonometry were analyzed by linear regression. The inter-observer and intra-observer agreement of CCT measurement by OCT were analyzed by interclass correlation coefficient (ICC). RESULTS: The average CCT of normal subjects, patients with POAG, NTG and OHT were (525.31 +/- 32.18) microm, (531.87 +/- 31.58) microm, (507.61 +/- 21.56) microm and (574.09 +/- 27.84) microm, respectively. There was no significant difference between normal subjects and patients with POAG (P = 0.099). The average CCT of OHT patients was larger than those of other groups (P < 0.001). The average CCT of patients with NTG was less than those of other groups (P < 0.001). There was positive relationship between CCT and IOP in normal subjects (r = 0.318, R2 = 0.101, P < 0.001). The ICC of inter-observer and intra-observer agreement of CCT measurement by OCT were 0.995 and 0.996 respectively. CONCLUSIONS: Central corneal thickness could be measured by OCT accurately. The average CCT in the patients with NTG was thinner, but the average CCT in the patients with OHT was thicker than that of normal subjects. CCT could affect IOP measurement in the application of Goldmann applanation tonometry but with little significant.