应用扫描激光偏振光对原发性闭角型青光眼和原发性开角型青光眼的结构-功能相关性研究。
Structure-function correlations using scanning laser polarimetry in primary angle-closure glaucoma and primary open-angle glaucoma.
机构信息
Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.
出版信息
Am J Ophthalmol. 2010 May;149(5):817-25.e1. doi: 10.1016/j.ajo.2009.12.007. Epub 2010 Mar 4.
PURPOSE
To assess the correlations between retinal nerve fiber layer (RNFL) thickness measured with scanning laser polarimetry and visual field (VF) sensitivity in primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG).
DESIGN
Prospective, comparative, observational cases series.
METHODS
Fifty patients with POAG and 56 patients with PACG were examined using scanning laser polarimetry with variable corneal compensation (GDx VCC; Laser Diagnostic Technologies, Inc.) and Humphrey VF analyzer (Carl Zeiss Meditec, Inc.) between August 2005 and July 2006 at Taipei Veterans General Hospital. Correlations between RNFL thickness and VF sensitivity, expressed as mean sensitivity in both decibel and 1/Lambert scales, were estimated by the Spearman rank correlation coefficient (r(s)) and multivariate median regression models (pseudo R(2)). The correlations were determined globally and for 6 RNFL sectors and their corresponding VF regions.
RESULTS
The correlation between RNFL thickness and mean sensitivity (in decibels) was weaker in the PACG group (r(s) = 0.38; P = .004; pseudo R(2) = 0.17) than in the POAG group (r(s) = 0.51; P < .001; pseudo R(2) = .31), but the difference in the magnitude of correlation was not significant (P = .42). With Bonferroni correction, the structure-function correlation was significant in the superotemporal (r(s) = 0.62), superonasal (r(s) = 0.56), inferonasal (r(s) = 0.53), and inferotemporal (r(s) = 0.50) sectors in the POAG group (all P < .001), whereas it was significant only in the superotemporal (r(s) = 0.53) and inferotemporal (r(s) = 0.48) sectors in the PACG group (both P < .001). The results were similar when mean sensitivity was expressed as 1/Lambert scale.
CONCLUSIONS
Both POAG and PACG eyes had moderate structure-function correlations using scanning laser polarimetry. Compared with eyes with POAG, fewer RNFL sectors have significant structure-function correlations in eyes with PACG.
目的
评估原发性开角型青光眼（POAG）和原发性闭角型青光眼（PACG）中用扫描激光偏振仪测量的视网膜神经纤维层（RNFL）厚度与视野（VF）敏感性之间的相关性。
设计
前瞻性、对照、观察性病例系列。
方法
2005 年 8 月至 2006 年 7 月，在台北荣民总医院，使用具有可变角膜补偿的扫描激光偏振仪（GDx VCC；激光诊断技术公司）和 Humphrey VF 分析仪（卡尔蔡司医疗技术公司）对 50 例 POAG 患者和 56 例 PACG 患者进行检查。通过 Spearman 等级相关系数（r(s)）和多变量中位数回归模型（伪 R(2)）来估计 RNFL 厚度与 VF 敏感性之间的相关性，VF 敏感性用分贝和 1/Lambert 标度表示的平均敏感性表示。在全局和 6 个 RNFL 象限及其相应的 VF 区域中确定相关性。
结果
PACG 组的 RNFL 厚度与平均敏感性（以分贝为单位）之间的相关性较弱（r(s) = 0.38；P =.004；伪 R(2) = 0.17），低于 POAG 组（r(s) = 0.51；P <.001；伪 R(2) =.31），但相关性的大小差异无统计学意义（P =.42）。经 Bonferroni 校正，POAG 组的超颞（r(s) = 0.62）、超鼻上（r(s) = 0.56）、鼻下（r(s) = 0.53）和颞下（r(s) = 0.50）象限的结构-功能相关性具有统计学意义（均 P <.001），而 PACG 组仅在超颞（r(s) = 0.53）和颞下（r(s) = 0.48）象限的结构-功能相关性具有统计学意义（均 P <.001）。当以 1/Lambert 标度表示平均敏感度时，结果相似。
结论
用扫描激光偏振仪测量，POAG 和 PACG 眼均具有中度的结构-功能相关性。与 POAG 眼相比，PACG 眼的 RNFL 象限中与结构-功能相关性显著的象限更少。
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