【关键词】  青光眼

    Comparative study of the value of optic disc parameters detected by HRT-Ⅱ and OCT3 for early diagnosis of glaucoma

    CHENG Yuncui， DUAN Xuanchu， GAO Limo， et al.

    Department of Ophthalmology，the Second Xiangya Hospital，Central South University，Changsha China，410011

    ［Abstract］  Objective  To compare the differences in optic disc parameters detected  by HRT-Ⅱ and OCT3 in normal subjects, suspected open-angle glaucoma (SOAG) and primary open-angle glaucoma (POAG)， to analyze the relationship of optic disc parameters measured by OCT3 and HRT-Ⅱ and to evaluate the value of OCT3 and HRT-Ⅱ in the detection of primary open-angle glaucoma in a Chinese population. Methods  The tomographies of the optic discs of 43 normal subjects, 48 patients with SOAG and 55 patients with POAG were examined using OCT3 and HRT-Ⅱ. The normal subjects were age- and refraction-matched with SOAG and POAG patients. The optic disc parameters, including disc area (DA), cup area (CA), rim area (RA), cup volume (CV), rim volume (RV), and the cup/disc area ratio (C/DAR) were analyzed. The relationship of optic disc parameters was analyzed using a linear correlation. The correlation between the mean defect (MD) of the visual field and the tomography parameters in glaucomatous eyes was also analyzed. The area under the receiver operating characteristic (ROC) curves of OCT3 and HRT-Ⅱ was calculated and compared. Results  All of the optic disc parameters obtained by OCT3 and HRT-Ⅱ showed significant differences (P＜0.01) among these three groups. The optic disc parameters were compared randomly among the three. The differences in almost all optic disc parameters obtained by OCT3 and HRT-Ⅱ were statistically significant (P＜0.05). OCT3 and HRT-Ⅱ measurements were highly correlated (r=0.358~0.798), with poor to moderate correlation between both imaging modalities with MD. The area under the receiver operating characteristic (ROC) curves of OCT3 and HRT-Ⅱ  measurements were similar. Conclusion  OCT3 and HRT-Ⅱ optic disc analyses are highly correlated and have similar associations with glaucoma disease status. All of the optic disc parameters obtained by OCT3 and HRT-Ⅱ showed significant differences among the three groups. OCT3 optic disc analysis could detect early glaucomatous damage as well as HRT-Ⅱ does.

    [Key words]  OCT3； HRT-Ⅱ； glaucoma， diagnosis； ROC curve； visual field

    [摘要]  目的  应用OCT3和HRT-Ⅱ检测正常眼、可疑性开角型青光眼(suspected open-angle  glaucoma, SOAG)和原发性开角型青光眼(primary open-angle glaucoma，POAG)患者的视盘结构参数，探讨OCT3和HRT-Ⅱ检测视盘参数的相关性及OCT3视盘分析在青光眼早期诊断中的价值。方法  用OCT3和HRT-Ⅱ检测48例SOAG、55例POAG和年龄相匹配的43例正常人的视盘参数。从视盘参数中选择视盘面积、视杯面积、盘沿面积、视杯容积、盘沿容积、杯盘面积比进行分析。对两种仪器检测视盘参数的一致性及与视野平均缺损值的相关性做对比分析；建立青光眼ROC曲线图，根据ROC曲线下面积比较两种仪器诊断青光眼的能力。结果  OCT3与HRT-Ⅱ检测正常人、SOAG和POAG三组间各视盘参数差异均有极显著性(P<0.01)。三组中任意两组间比较，两种仪器所测大部分视盘参数差异有显著性(P<0.05)。OCT3与HRT-Ⅱ检测视盘参数有较好的一致性(r=0.358～0.798)，且与视野平均缺损值有较好的相关性。两种仪器诊断青光眼的最优参数均为盘沿面积和盘沿容积，且具有基本相等的ROC曲线下面积值。结论  OCT3和HRT-Ⅱ检测视盘有较好的一致性，且与视神经损害状态密切相关，两种仪器均能检测到青光眼视盘参数改变。在青光眼组，OCT3和HRT-Ⅱ所测视盘参数与视野缺损都有一定程度的相关。OCT3与HRT-Ⅱ检测视盘参数在青光眼早期诊断中具有同等重要的价值。

    [关键词]  OCT3；HRT-Ⅱ；青光眼，诊断；ROC曲线；视野

    原发性开角型青光眼的早期诊断是早期治疗的关键。研究表明，青光眼患者视乳头病理改变早于视野损害[1]，因此，鉴别早期视盘形态学改变已成为青光眼早期诊断和病情评估的重要指标。目前最具代表性的定量检测视盘形态学改变的仪器是海德堡视网膜断层扫描仪(Heidelberg retina tomography，HRT-Ⅱ），随着光学相干断层扫描仪(Optical coherence tomography 3，OCT3）的视盘软件的研发，使得OCT定量检测视盘参数成为可能。为了研究OCT3检测视盘参数在青光眼早期诊断中的价值，本研究设计应用HRT-Ⅱ、OCT3检测同一组研究对象的视盘参数，并将HRT-Ⅱ、OCT3视盘参数的一致性及与视野平均缺损值(mean defect，MD)的相关性做对比研究，探讨HRT-Ⅱ、OCT3检测视盘参数在原发性开角型青光眼早期诊断中的价值。

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