【摘要】 目的　视网膜神经纤维层 (retinalnervefiberlayer,RNFL)的检测是青光眼早期诊断的重要手段 ,但照片冲洗难度大 ,部分患者难以显示清晰的RNFL图像 ,为此进行RNFL的数码摄影及模糊影像图像处理的研究。方法　采用Nikon眼底摄像机 ,连接高分辨Kodak数码摄像机。图像处理采用Photoshop软件。对首都医科大学附属北京同仁医院眼科 10 5例青光眼患者 ,32例白内障患者 ,2 9例视网膜色素上皮层缺失患者的RNFL图像进行分析。采用阈值分割法观察RNFL的大体分布形态 ,在视盘鼻、颞侧的影像置黑时 ,观察颞上、颞下处RNFL白色反光的强度。结果　正常人RNFL在颞上、颞下、鼻上、鼻下处厚 ,分布形态像蝴蝶的翅膀。青光眼患者视神经早期损伤是以颞上、颞下的RNFL束丢失为特点 ,使对称的蝶状分布形态改变。但视网膜色素上皮颜色明显变浅或脉络膜缺损者 ,仍不能评价RNFL的分布。结论　采用RNFL的数码眼底摄像技术为计算机图像处理提供了必要条件 ,免除了复杂的暗房工作。此方法不要求看到RNFL的清晰细节 ,仅分析不同区域RNFL反光的情况 ,适用于屈光间质混浊所致模糊影像的分析 ,但对色素上皮及脉络膜缺失者无效。更多还原

【Abstract】 Objective Red-free photographs are effective in detecting retinal nerve fiber layer (RNFL). The reasons why it is not used by most clinics are difficulty in laborious developing and blurred image evaluating. To account for getting real-time image and blurred image evaluating, the digital photography and computerized image processing are used. Methods RNFL photographs were taken by Nikon Fundus Camera connected with a high resolution digital camera (Kodak) and a green filter. As usual it is necessary to see the texture of RNFL in evaluating its image, but blurred images due to media opacities greatly lose their resolution. The way we used no focus on seeing the texture of RNFL, but on evaluating the distribution pattern of RNFL. RNFL images have more white reflex in temporal superior, temporal inferior, nasal superior and nasal inferior sections around optic disc according to the thickness of RNFL. Threshold segmentation was used, we shift a threshold bar to the position until the nasal or temporal section around optic disc is black with the software Photoshop. Results In the normal RNFL image, the white reflex was of butterfly pattern, i.e., the temporal superior and temporal inferior sections around optic disc were white. In cases with glaucoma, the characteristic of early damage of optic nerve was the loss of RNFL at the temporal superior and temporal inferior part of the retina, thus the normal butterfly pattern was changed, the temporal superior or/and temporal inferior sections were black. With this method it is more effective to evaluate RNFL. However, in cases with retinal pigment epithelium faint in color and in cases with choroidal defect, it is still difficult to evaluate the distribution of RNFL. Conclusions It is an easy and effective way to detect glaucomatous damage with the digital photography and RNFL pattern evaluation.更多还原