GDxVCC检测原发性开角型与可疑青光眼视网膜神经纤维层损害的对比研究

目的采用GDxVCC系统检测正常人、可疑开角型青光眼(suspected open angle glaucoma，SOAG)以及原发性开角型青光眼(primary open angle glaucoma，POAG)患者的视盘周围视网膜神经纤维层(retinal nerve fiber layer，RNFL)厚度，并进行对比分析，探讨GDxVCC系统在青光眼早期诊断中的价值。设计前瞻性对照研究。研究对象42例SOAG，36例POAG以及年龄相匹配的36例正常人参加此项研究。方法所有参加者进行视野与GDxVCC系统检查，选择一眼进行分析。采用方差分析，对SOAG、POAG、正常人的RNFL参数进行两两比较。主要指标GDxVCC检测RNFL厚度。结果POAG组与正常组问所有RNFL参数差异均有极显著意义(P=0．000)；POAG组与SOAG组间所有RNFL参数差异均有极显著意义(P=0．000)；SOAG组与正常组间椭圆平均值差异无统计学意义(P=0．234)，但其上方平均值与下方平均值及神经纤维指数差异均有统计学意义(P=0．044、P=0．045、P=0．035)，TSNIT标准差有极显著意义(P=0．000)。结论GDxVCC系统能更早地发现青光眼性RNFL结构损害，不仅可用于青光眼诊断和随访，亦可用于对可疑青光眼进行追踪。

Comparison of retinal nerve fiber layer defect of primary open angle glaucoma and suspected open angle glaucoma by GDxVCC

Objective To compare the retinal nerve fiber layer (RNFL) thickness in primary open angle glaucoma (POAG),suspected open angle glaucoma(SOAG) and normal subjects measured by GDxVCC.Design Prospective,comparative case series.Participants 42 cases with SOAG,36 patients with POAG and 36 age-matched normal subjects were studied.Methods Visual field and RNFL thickness of all participants were detected by using Oculus Twinfield static threshold perimetry (program 24-2) and GDxVCC(scanning laser polarimetry with variable corneal compensation).Main Outcome Measures The RNFL thickness measured by GDxVCC.Results All RNFL parameters showed statistically significant differences between POAG group and normal group as well as between POAG group and SOAG group(P=0.000).Multiple parameters showed statistically significant differences between SOAG group and normal group(P<0.05)except TSNIT average(P=0.234).Conclusion GDxVCC could earlier detect glaucomatous RNFL damage compared with visual field and be used in early diagnosis and follow-up of glaucoma.