【摘要】 目的探讨相干光断层成像(optical coherence tomography,OCT)测量黄斑厚度对青光眼的诊断价值。设计前瞻性对照研究。研究对象62例(101眼)正常人和41例(64眼)青光眼患者。方法应用Stratus OCT测量正常人和青光眼患者的黄斑厚度,观察正常人和青光眼患者的黄斑厚度地形图的图像特征;将正常人和青光眼患者黄斑厚度进行比较;用受试者工作特征曲线下面积(area under the receive operator characteristic curve,AROC)的分析方法找出青光眼早期诊断的最佳指标。主要指标黄斑厚度地形图特征及各分区黄斑厚度、AROC。结果正常人黄斑厚度地形图呈"马蹄形",青光眼患者的黄斑区视网膜呈局限性或弥漫性变薄。青光眼患者黄斑各分区视网膜厚度均比正常人减少,差异有统计学意义(P<0.05),而早期青光眼患者仅黄斑外环各分区较正常人减少,差异有统计学意义(P<0.05)。无论是正常人和青光眼患者之间还是正常人和早期青光眼患者之间,黄斑下方外环区的AROC均最大(分别为0.876、0.728)。结论OCT测量正常人黄斑厚度地形图呈"马蹄形",青光眼患者黄斑厚度呈局限性或弥漫性变薄,黄斑下方外环区改变是较佳的早期诊断指标。(眼科,2008,17:25-28)更多还原

【Abstract】 Objective To determine the diagnostic value of measurement of macular thickness with optical coherence tomography (OCT)in glaucoma.Design Prospective,comparative case series.Participants 101 eyes of 62 normal persons and 64 eyes of 41 pa- tients with glaucoma were studied.Methods OCT was used to measure the macular thickness in normal persons and patients with glau- coma.Observing the image feature of macular thickness mapping in normal persons and glaucoma patients;comparing the macular thickness between both groups;finding the strongest discriminating power parameter for glaucoma detection by area under the receive operator characteristic curve.Main Outcome Measures Macular thickness mapping and macular thickness of different sections、AROC.Results The macular thickness mapping in normal persons was"horse shoe"shaped.Diffuse or local thinning of macular thick- ness was shownin glaucoma patients.All macular parameters were statistically significantly different compared with normal subjects and glaucoma(P<0.05).Macular outer ring in four quadrants,total macular volume were statistically significantly different comparing normal suhjects and early glaucoma(P<0.05).The highest AROC was macuar inferior outer ring between normal persons and glaucoma patients (0.876)and early glaucoma patients(0.728),respective.Conclusions The maeular thickness mapping in normal persons is"horse shoe"shaped.Diffuse or local thinning of macular thickness is shown in glaucoma patients.The strongest discriminating power parameter for glaucoma detection was macuar inferior outer ring.(Ophthalmol CHN,2008,17:25-28)更多还原