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目的探讨相干光断层扫描仪(OCT)测量正常人、原发性开角型青光眼(POAG)、正常眼压性青光眼(NTG)、高眼压症(OHT)患者的中央角膜厚度(CCT)。方法采用OCT3测量正常人143例(143只眼)、POAG患者36例(36只眼)、NTG患者39例(39只眼)及OHT患者40例(40只眼)的CCT,并进行单因素4水平设计定量资料的方差分析;用线性回归方法分析正常人CCT与Goldmann压平眼压测量值的相关关系;对OCT测量CCT观察者间和观察者内的一致性进行类内相关系数(ICC)分析。结果正常组、POAG组、NTG组及OHT组的平均CCT值分别为(523.66±32.13)μm、(530.92±27.32)μm、(506.92±21.49)μm及(573.13±27.39)μm。POAG组与正常人组的平均CCT值差异无统计学意义(P=0.099);OHT组的平均CCT值大于其他各组,均P<0.01;NTG组的平均CCT值小于其他各组,均P<0.01。正常组CCT与眼压值呈正相关(r=0.318,R2=0.101,P<0.01)。OCT测量CCT的测量者间和测量者内的ICC值分别为0.995和0.996。结论OCT可以准确地测量CCT;NTG患者平均CCT比正常人薄,而OHT患者比正常人厚;CCT可以影响Goldmann压平眼压计的测量值,但贡献率较小。(中华眼科杂志,2006,42:199-203)
Objective To investigate the measurement of central corneal thickness (CCT) in patients with normal open angle glaucoma (POAG), normal tension glaucoma (NTG) and ocular hypertension (OHT) by coherence tomography (OCT) Methods 143 normal subjects (143 eyes), 36 eyes (36 eyes) with POAG, 39 eyes (39 eyes) with NTG and 40 eyes (40 eyes) with OHT were measured by OCT3, and single factor 4 level design quantitative analysis of variance; linear regression analysis of normal subjects CCT and Goldmann applanation IOP measurement of correlation; OCT measurement of CCT between observers and observers consistency within the class correlation coefficient (ICC )analysis. Results The average CCT values of the normal group, POAG group, NTG group and OHT group were (523.66 ± 32.13) μm, (530.92 ± 27.32) μm, (506.92 ± 21.49) μm and (573.13 ± 27.39) μm, respectively. There was no significant difference in the mean CCT between POAG group and normal group (P = 0.099). The mean CCT value in OHT group was greater than that in other groups (P <0.01). The average CCT value in NTG group was lower than that in other groups <0.01. CCT in normal group was positively correlated with intraocular pressure (r = 0.318, R2 = 0.101, P <0.01). The ICC values for inter-measurement and measurement for CCT for OCT were 0.995 and 0.996, respectively. Conclusion The CCT can be accurately measured by OCT. The average CCT in patients with NTG is thinner than that in normal people, while the patients with OHT are thicker than those in normal people. CCT can affect the measurement of Goldmann applanation tonometry, but the contribution rate is small. (Chinese Journal of Ophthalmology, 2006,42: 199-203)