高度近视RNFL厚度在诊断原发性开角型青光眼中的临床意义

目的 评估光学相干断层成像术(Optical Coherence Tomography,OCT)定量测量视网膜神经纤维层厚度(Retinal Nerve Fiber Layer,RNFL)在诊断高度近视合并原发性开角型青光眼(primary open-angleglaucoma,POAG)中的临床意义.方法 收集高度近视患者(屈光度≥-6.00D)共40例73只眼,分为单纯高度近视组(A组)及高度近视合并POAG组(B组),所有的患者均行眼压、前房角镜、全自动视野及OCT检查.结果 (1)A组患者平均眼压(16.57±2.43)mmHg,视野检查平均敏感度(MS)23.63±3.70;OCT检查RNFL平均厚度(单位μm)分别为上象限:117.64±15.78,下象限:126.05±22.55,鼻象限:95.69±34.99,颞象限:100.1±27.25;(2)B组患者平均眼压为(26.45±6.02)mmHg,视野检查平均敏感度(MS)15.41±7.63;OCT检查RNFL平均厚度(单位μm)分别为上象限:99.38±36.39,下象限:95.10±33.85,鼻象限:68.00±17.56,颞象限:70.62±25.57.(3)分别对两组RNFL各象限厚度值进行t检验,结果显示两组间差异显著均有统计学意义(P＜0.01).结论 正确评估高度近视RNFL的定量测量在原发性开角型青光眼早期诊断中具有重要意义.

The clinical value of measuring RNFL in diagnosis of primary open-angle glaucoma with high myopia

Objective To evaluate the clinical value of measuring retinal nerve fiber layer (RNFL)thickness using optical coherence tomography (OCT) in diagnosis of primary open-angle glaucoma (POAG)with high myopia. Methods We collected 73 eyes of 40 cases diagnosed with high myopia (diopter ≥-6.00D). They were divided into simple high myopia (group A) and high myopia with POAG (group B). All patients underwent intra-ocular tension, goniscope examination, visual field and OCT. Results In group A, average intraocular pressure (lOP): 16.57±2.43 (mmHg); visual field examination: mean sensitivity: 23.63±3.70; the mean RNFL thickness around optical nerve head were in the superior: 1 17.64± 15.78 (μm), inferior:126.05± 22.55 (μ m), nasal: 95.69± 34.99 (μ m), temporal: 100.1± 27.25 (μ m), respectively. In group B, average lOP: 26.45± 6.02 (mmHg); visual field examination: mean sensitivity: 15.41 ± 7.63; the mean RNFL thickness around o7tical nerve head were in the superior: 99.38 ± 36.39 (μ m), inferior: 95.10±33.85 (μm),nasal: 68.00±17.56 (μ m), temporal: 70.62± 25.57 (μm), respectively. Independent-Samples T Test was applied for RNFL thickness comparisons of different quadrants between two groups. The results showed there was significant difference between two groups (P ＜0.01). Conclusions It has significant clinical meaning to exactly evaluate the application value of measuring retinal nerve fiber layer in POAG with high myopia.