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目的探讨海德堡视网膜断层扫描仪(HRT-Ⅱ)在原发性慢性闭角型青光眼(CPACG)诊断中的意义。方法对30例(60眼)CPACG患者进行HRT-Ⅱ检测及视野检查,统计分析HRT-Ⅱ检测敏感性、病变分区特点及视盘参数与视野平均缺损的相关性。结果①60眼中视野异常53眼,HRT-Ⅱ检测异常54眼;视野异常和HRT-Ⅱ异常对应为98.15%;单眼视野组8例中有对侧2眼视野检测正常而HRT-Ⅱ检测异常,对侧5眼视野检测正常而HRT-Ⅱ检测也正常,对侧1眼HRT-Ⅱ检测正常而视野检测异常。颞下象限盘沿面积异常率最高;②盘沿面积、杯/盘面积比、盘沿容积、视杯形态测量与视野平均缺损呈直线相关。结论HRT-Ⅱ检查敏感性良好,与视野检查有良好的对应关系,可以用于CPACG患者视神经损害的监测及早期诊断。
Objective To investigate the significance of Heidelberg Retinal Tomography (HRT-II) in the diagnosis of primary chronic angle closure glaucoma (CPACG). Methods 30 cases (60 eyes) of CPACG patients were examined by HRT-Ⅱ and field of vision. The sensitivity of HRT-Ⅱ detection, the characteristics of lesions and the relationship between optic disc parameters and average field defect were statistically analyzed. Results ① There were 53 eyes with abnormal visual field and 54 eyes with HRT-Ⅱ abnormality in 60 eyes. The anomaly of visual field and HRT-Ⅱ abnormality were 98.15%. In 2 eyes of unilateral visual field group, 2 eyes with abnormal visual field and 2 HRT- The visual field of 5 eyes was normal and HRT-Ⅱ was normal. The contralateral 1 HRT-Ⅱ was normal and the visual field was abnormal. The anomaly rate of the inferior quadrant was the highest in the inferior quadrant; ② The area of the disc, the area of the cup / disc, the volume of the disc, the shape of the optic disc were linearly correlated with the average defect of the visual field. Conclusion The sensitivity of HRT-Ⅱ examination is good, and it has a good correspondence with visual field examination. It can be used for the monitoring and early diagnosis of optic nerve damage in CPACG patients.