视盘分级法评估原发性慢性闭角型青光眼视神经损害与OCT视神经纤维检查的相关性

目的用视盘损害分级(disc damage likelihood scale,DDLS)方法评估原发性慢性闭角型青光眼(primarychronic angle-closure glaucoma,PCACG)视神经损害,探讨其与光学断层相干扫描仪(optical coherence tomography,OCT)检测视神经纤维厚度参数的相关性。方法收集2009年10月至2010年8月我院眼科PCACG患者共38例(73眼),通过双面Volk 90D前置镜在裂隙灯下对视盘直径及其盘沿最窄处宽度测量,按DDLS分级标准进行分级;Stratus OCT 3000成像仪、RNFL3.4程序获取象限位、钟点位及自选参数的视网膜神经纤维(retina nerve fiber layer,RNFL)厚度。运用SPSS15.0统计软件分析DDLS分级与OCT视盘周围3.4 mm处RNFL检测参数的相关性。结果共38例(73眼)中大直径视盘17眼(占23.3%),中等直径视盘41眼(占56.2%),小直径视盘15眼(占20.6%);上方、下方、颞侧象限RNFL厚度均值与DDLS分级评分相关(r=-0.673,P=0.0001;r=-0.605,P=0.0001,r=-0.499,P=0.0014),鼻侧方象限RNFL厚度均值与DDLS分级评分不相关(r=-0.352,P=0.0602);11、7、6、10、12钟点位RNFL厚度与DDLS分级评分具有相关性(r=-0.673,P=0.0001;r=-0.605,P=0.0001;r=-0.531,P=0.0006;r=-0.525,P=0.0007;r=-0.520,P=0.0008),而3、2、8点位无统计学意义(r=-0.320,P=0.0501;r=-0.320,P=0.0510;r=-0.297,P=0.0702);DDLS分级评分与OCT检查自选参数Avg、Smax、Imax的RNFL厚度也呈中度相关(r=-0.582,P=0.0001;r=-0.504,P=0.0012;r=-0.478,P=0.0024)。结论 DDLS分级方法对PCACG视神经损害的评估与OCT视网膜神经纤维厚度主要检查参数检查具有相关性,DDLS分级方法适用于PCACG视神经损害的评估。

Relationship of disc damage likelihood scale nomogram and optical coherence tomogram for primary chronic angle-closure glaucoma:report of 73 eyes

Objective To evaluate relationships between the results of disc damage likelihood scale(DDLS) and the parameters of optical coherence tomography(OCT) for primary chronic angle-closure glaucoma.Methods Thirty-eight primary chronic angle-closure glaucoma patients(73 eyes) who admited in our department from October 2009 to August 2010 were enrolled in this study.Their DDLS score was assessed with a 90-diopters(D) Volk len under slit lamp for disc diameter and narrowest rim width,and then the eyes were graded a...