【摘要】 目的利用频域光学相干断层扫描(OCT)观察视网膜神经纤维层厚度(RNFLT)、黄斑神经节细胞复合体厚度(mGCCT)在视神经萎缩诊断和视功能评价中的作用。方法选择视神经萎缩患者50例,其中健眼26眼、患眼68眼纳入研究,行最佳矫正视力(BCVA)检查,BCVA≥0.05者行视野检查。利用频域OCT测量mGCCT及RNFLT,分析OCT主要参数对视神经萎缩诊断的价值及其与BCVA、视野等视功能指标的相关性,以及区分正常眼与视神经萎缩眼的能力和对BCVA的影响程度。结果单因素分析显示,平均mGCCT、整体丢失体积(GLV)、局部丢失体积(FLV)、平均RNFLT对各评价指标均有统计学意义(P<0.05)。多因素分析显示,平均mGCCT、GLV对视神经萎缩的诊断,平均mGCCT、GLV对BCVA,平均mGCCT对视野平均偏差(MD)、视野模式标准偏差(PSD),FLV对视野MD,GLV对视野PSD有统计学意义(P<0.01),而平均RNFLT对视神经萎缩的诊断、BCVA、视野分析等均无统计学意义(P>0.05)。受试者工作特征曲线下面积(AUC)分析显示,平均mGCCT,上、下方平均mGCCT,平均RNFLT,颞侧、上方平均RNFLT对视神经萎缩诊断准确性较高(0.9<AUC<1.0),下方、鼻侧平均RNFLT诊断准确性中等(0.7<AUC≤0.9)。平均mGCCT对BCVA评价准确性较高(0.9<AUC<1.0),其余各项评价准确性中等(0.7<AUC≤0.9)。结论频域OCT测量特别是mGCCT测量对视神经萎缩的诊断和视功能评价具有重要意义。更多还原

【Abstract】 Objective To observe the roles of retinal nerve fiber layer thickness(RNFLT) and the macular ganglion cell complex(mGCCT) in the diagnosis of optic atrophy and the evaluation of visual function by using frequency domain optical coherence tomography(OCT).Methods 26 normal eyes and 68 sick eyes were selected from 50 patients with optic atrophy.Best-corrected visual acuity(BCVA) was measured for all the eyes and visual field for those whose BCVA was ≥ 0.05.Frequency domain OCT was used to measure mGCCT and RNFLT.The study evaluated the main parameters provided by OCT in the diagnoses of optic atrophy and their relativities to the visual function indices,such as BCVA and visual field.Furthermore,the study explored the capability of these parameters to distinguish normal optic nerves from optic atrophy and the effects on BCVA.Results In univariate analysis,mGCCT,general loss of volume(GLV),focal loss of volume(FLV) and RNFLT showed significant correlations with all the evaluation indexes(P<0.05).In multiple analysis these significant correlations were found: average mGCCT and GLV with the diagnosis of optic atrophy,average mGCCT and GLV with BCVA,average mGCCT with visual field mean deviation(MD) and visual field pattern standard deviation(PSD),FLV with visual field MD,and GLV with visual field PSD.Average RNFLT showed no correlations with diagnosis of the optic atrophy,BCVA and visual field(P>0.05).Average mGCCT,superior and inferior average mGCCT,average RNFLT,temporal and superior average RNFLT were accurate to diagnose optic atrophy(0.9<AUC<1.0),while inferior and nasal average RNFLT showed moderate accuracy to the diagnosis(0.7<AUC≤0.9).Among the thickness parameters measured by OCT,average mGCCT was accurate to evaluate BCVA(0.9<AUC<1.0),while the others were moderately accurate(0.7<AUC≤0.9).Conclusion The parameters provided by frequency domain OCT especially mGCCT are important in the diagnosis of optic atrophy and evaluation of visual functions.更多还原