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OCT检测Bruch 膜开口-盘沿最小宽度在鉴别原发性开角型青光眼及生理性大视杯中的应用

张志豹  张琪  徐捷   

  1. 100005 首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科研究所 眼科学与视觉科学北京市重点实验室
  • 收稿日期:2018-06-20 出版日期:2018-11-25 发布日期:2018-12-11
  • 通讯作者: 徐捷,Email:fionahsu920@foxmail.com E-mail:fionahsu920@foxmail.com
  • 基金资助:

    北京市医院管理局“青苗”计划专项经费资助(QML20170206)

Application of Bruch’s membrane opening-minimal rim width on the identification of primary open angle glaucoma from physical macrocup

ZHANG Zhi-bao, ZHANG Qi, XU Jie   

  1. Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China
  • Received:2018-06-20 Online:2018-11-25 Published:2018-12-11
  • Contact: XU Jie, Email: fionahsu920@foxmail.com E-mail:fionahsu920@foxmail.com

摘要:

目的 探讨通过Bruch膜开口-盘沿最小宽度(Bruch’s membrane opening-minimal rim width, BMO-MRW)鉴别原发性开角型青光眼与生理性大视杯的价值。设计 诊断技术评价。研究对象 2018年4-5月北京同仁医院频域相干光断层扫描(spectral domain optic coherence tomography, SD-OCT)检查的正常人56例(93眼)、生理性大视杯32例(38眼)及原发性开角型青光眼55例(89眼)。方法 SD-OCT进行视盘星状扫描,BMO-MRW定义为Bruch膜开口到内界膜的最短距离(μm),使用海德堡固有软件分别测量12个象限上BMO-MRW值,并进一步分为上方、颞侧、下方及鼻侧进行分析。主要指标 ROC曲线下面积。结果 原发性开角型青光眼组上方(181.5±71.2)、颞侧(133.8±55.0)、下方(178.9±71.7)及鼻侧(180.9±78.4)的BMO-MRW显著小于正常对照组及生理性大视杯组(P均<0.001),生理性大视杯组各个象限的BMO-MRW显著小于正常对照组(P<0.001)。受试者工作特征曲线显示下方、上方、鼻侧及颞侧的BMO-MRW对生理性大视杯及原发性开角型青光眼的鉴别具有较高的准确性(P<0.001),曲线下面积分别为0.91±0.03,0.84±0.04,0.79±0.04及0.72±0.05。结论 BMO-MRW可做为评估和鉴别生理性大视杯与原发性开角型青光眼的一种重要的临床参数。

关键词: 原发性开角型青光眼, Bruch膜开口-盘沿最小宽度, 生理性大视杯

Abstract:

Objective To explore the value of Bruch’s membrane opening-minimal rim width (BMO-MRW) in the identification of primary open angle glaucoma (POAG) and physical macrocup. Design Diagnostic technique evaluation. Participants Individuals underwent spectral domain optic coherence tomography (SD-OCT) in Beijing Tongren Hospital from April to May 2018 were selected and subdivided into normal control group (56 cases, 93 eyes), POAG group (55 cases, 89 eyes) and physical macrocup group (32 cases, 38 eyes). Methods Using SD-OCT radial scan mode, BMO-MRW was defined as the minimal width between Bruch’s membrane opening and internal limiting membrane (the vertical distance between Bruch’s membrane opening and internal limiting membrane). The BMO-MRW was measured in 12 quadrants with Heidelberg intrinsic softwere and were divided into superior, temporal, inferior and nasal quadrants. Main Outcome Measures Area under curve of receiver operator characterestics. Results BMO-MRW in superior, temporal, inferior, nasal quadrants was significantly smaller in POAG group (181.5±71.2, 133.8±55.0, 178.9±71.7, 180.9±78.4 μm) than in the physical macrocup group and control group (all P<0.001). POAG group showed significantly smaller BMO-MRW than physical macrocup group (all P<0.001). In receiver operator characteristics(ROC) analysis, area under curve (AUC) was 0.91±0.03 in inferior, 0.84±0.04 in superior, 0.79±0.04 in nasal and 0.72±0.05 in temporal. Conclusion BMO-MRW has important implications for evaluation and identification of physical macrocup and POAG.

Key words: primary open angle glaucoma, Bruch’s membrane opening-minimal rim width, physical macrocup