开角型青光眼患者视盘及脉络膜变化分析

目的　通过频域OCT检查探讨开角型青光眼（open-angle glaucoma，OAG）患者视网膜及脉络膜各参数的变化。方法　回顾性病例对照研究。临床检查确诊为OAG的19例（30眼）患者为OAG组，健康人15名（30眼）为对照组。采用频域OCT的EDI模式测量2组视盘周围神经纤维层厚度、视盘周围脉络膜厚度及黄斑中心凹处神经纤维层厚度、黄斑中心凹处脉络膜厚度，并作对比。结果　OAG组受检眼6方位视盘周围神经纤维层厚度均明显低于对照组，差异均有统计学意义（均为P＜0.05）；5方位（颞上方、颞侧、鼻上方、鼻侧及鼻下方）视盘周围脉络膜厚度均明显低于对照组（均为P＜0.05），尤其以鼻侧及鼻下方变薄更明显。OAG组黄斑处神经纤维层厚度［（11.27±1.93）μm］及黄斑中心凹处脉络膜厚度［（217.37±11.46）μm］与正常对照组［（11.57±1.65）μm、(215.65±12.42)μm］相比，差异均无统计学意义（均为P>0.05）;两组间黄斑部直径3 mm的内环鼻侧、颞侧区域和直径6 mm的外环鼻侧、颞侧区域脉络膜厚度差异均无统计学意义（均为P>0.05）。结论　OAG患者与正常人相比，视盘周围脉络膜厚度减少，且视盘鼻侧及鼻下方脉络膜厚度变薄更为显著，可能与脉络膜血供减少造成的青光眼缺血性损伤相关。OAG患者黄斑部脉络膜厚度并未发生明显变化。

Choroid structure changes and optic disc analysis in open-angle glaucoma patients

Objective　To investigate the changes of retinal and choroid parameters in open-angle glaucoma patients by using the enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT).Methods　A retrospective case-control study was conducted in 19 patients (30 eyes) with open-angle glaucoma (OAG) and 15 normal controls (30 eyes),who were enrolled in this study.EDI-OCT was used to measure the peripheral nerve fiber layer thickness (pRNFLT),peripheral choroidal thickness (pCT),the macular nerve fiber layer thickness (RNFLT) and macular choroidal thickness(mCT).The OCT parameters of the two groups were compared.Results　The pRNFLT in 6 sections in the OAG group were significantly lower than the control group (all P<0.05)；the pCT in 5 sections (superior temporal,temporal,superior nasal,nasal and inferior nasal section) in the OAG group were significantly lower than those of the control group (all P<0.05),especially thinner on the nasal and inferior nasal section.The RNFLT and mCT was (11.27±1.93)μm and (217.37±11.46)μm in the OAG group,and (11.57±1.65)μm and (215.65±12.42)μm in the normal control group,respectively,and the difference was not statistically significant (both P>0.05);There was no significant difference in the choroidal thickness on the nasal and temporal section of inner regional around a diameter of 3 mm and the nasal and temporal section of outer regional around a diameter of 6 mm (all P>0.05).Conclusion　Compared with normal people,patients with OAG have thinner pCT and the thinning of the choroid in the nasal side and inferior nasal section of optic disc may be more significant,and this may be related to the loss of glaucoma ischemic injury caused by the decrease of choroid blood supply.There wis no significant change in the mCT in OAG patients.