蓝黄视野检查与RTA视盘分析的相关研究

目的探讨视网膜厚度分析仪(RTA)视盘参数和蓝黄视野平均缺损(B／Y—MD)之间的关系。方法对20例(33只眼)正常人；25例(42只眼)可疑青光眼；17例(26只眼)早期青光眼患者分别行标准视野检查、蓝黄视野检查、并用RTA进行视盘分析。比较三组的视野检查结果及视盘参数，分析两种视野检查平均缺损与视盘参数的相关性。结果(1)蓝黄视野平均缺损在三组问均有显著差异。与正常组比较。可疑组RTA视盘参数中。平均视杯深度、最大视杯深度、周线高度偏差增加，而神经纤维层截面面积减少。早期组还表现为视杯面积、杯盘面积比、视杯容积的显著增加，而盘沿面积、盘沿容积、平均神经纤维层厚度显著降低。(2)蓝黄视野平均缺损与RTA视盘参数的相关性优于标准视野检查。(3)Logistic逐步回归分析显示：B／Y—MD诊断青光眼的灵敏度、特异度、正确鉴别率为94．7％、91．7％、93．0％，当结合神经纤维层截面面积时将提高到100％。结论RTA视盘参数与蓝黄视野缺损的相关性优于标准视野检查。两种检查方法结合对青光眼的早期诊断及随访具有重要意义。

The correlation between blue- on - yellow visual field and optic disc topography measured by retinal thick ness analyzer

Objective To investigate the correlation between the optic disc parameters measured by retinal thickness analyzer and the mean defect of blue-on-yellow perimetry. Methods Twenty normal subjects(33eyes),25 glaucoma suspects(42 eyes)and 17 early glaucoma patients(26 eyes)were recruited.All subjects were underwent optic disc topography measurement by RTA,white-on-white perimetry,and blue-on-yellow perimetry.The perimetry results and the optic disc parameters were compared among the three groups.The correlation analysis between mean defect of two methods and optic disc parameters was made. Results (1)The significant difference was existed in B/Y-MD among the three groups.Compared with the normal controls,glaucoma suspects and early glaucoma patients had significantly higher values of mean cup depth,maximum cup depth and heig variation,but had significantly lower values of RNFL cross section area.Furthermore,in early glaucoma group,values of cup area,cup/disc area ratio and cup volume were significantly increased,but values of rim area,rim volume and mean RNFL thickness were significantly decreased.(2)The B/Y-MD and W/W-MD show statistically significant correlation with optic disc parameters examined by RTA,especially for B/Y-MD.(3)The Logistic gradual regressive analysis demonstrated that the sensitivity,specificity and correct detectability were 94 7%,91 7%,93 0%,respectively.When combined with the value of RNFL cross section area,they will increase into 100%. Conclusions RTA optic disc parameters are well correlated with B-Y perimetry MD than with the W/W-MD.The combination of RTA and B-Y perimetry has vital significance in early diagnosis and follow-up of glaucoma.