摘要
目的对比分析急性期Vogt-Koyanagi-Harada综合征(VKH)和急性期中心性浆液性脉络膜视网膜病变(CSC)患眼视盘参数及环视盘RNFL厚度的差异。方法回顾性临床病例对照分析。2014年1月至2018年2月在广东医科大学附属医院眼科确诊为急性期VKH的20例患者38只眼(VKH组)以及急性期CSC 37例患者37只眼(CSC组)纳入研究。两组患者年龄(t=0.45,P=0.65)比较,差异无统计学意义。纳入同期年龄、性别、眼别均与VKH组、CSC组相匹配的健康体检者57例75只眼作为正常对照组。所有受检眼均进行视盘3D-OCT检查。视盘面积、视杯面积、盘沿面积、C/D面积比、C/D水平直径比、C/D垂直直径比、环视盘(CP)-RNFL平均厚度及鼻侧、上方、颞侧、下方各象限的CP-RNFL厚度由系统自带软件自动测量计算所得。应用PicPick软件对OCT断层图像进行后处理,测量视盘两端RPE终末端延长线的夹角(简称视盘RPE夹角)。对比分析3组受检眼视盘RPE夹角以及VKH组、CSC组患眼的视盘参数和CP-RNFL厚度。3组间视盘RPE夹角比较采用方差分析,两两比较采用最小显著差法 t 检验。结果 VKH组中29只眼(76.32%)出现视盘旁视网膜脱离(RD),21只眼(55.26%)出现视盘充血;CSC组12只眼(32.43%)出现视盘旁RD,未发现视盘充血。两组出现视盘旁RD的眼数比较,差异有统计学意义(χ2=14.57,P<0.01)。VKH组、CSC组、正常对照组受检眼视盘RPE夹角分别为(138.62±11.96)°、(154.09±5.85)°、(153.41±5.77)°。VKH组患眼视盘RPE夹角较CSC组(t=-2.05,P=0.00)、正常对照组(t=-1.68,P=0.00)变小,差异有统计学意义。CSC组患眼视盘RPE夹角与正常对照组比较,差异无统计学意义(t=-1.88,P=0.72)。VKH组患眼视盘面积、盘沿面积较CSC组变大,差异有统计学意义(t=4.61、2.71,P=0.00、0.01);两组患眼其余视盘各参数比较,差异无统计学意义(P>0.05)。VKH组患眼CP-RNFL厚度以及鼻侧、上方、颞侧、下方各象限CP-RNFL厚度�
Objective To compare the differences of optic nerve head (ONH) parameters and the thickness of circumpapillary retinal nerve fiber layer (CP-RNFL) between acute Vogt-Koyanagi-Harada syndrome (VKH) and acute central serous chorioretinopathy (CSC) patients. Methods Retrospective clinical case control analysis. This study included 38 eyes of 20 acute VKH patients (VKH group) and 37 eyes of 37 acute CSC patients (CSC group). Seventy five eyes of 57 normal healthy subjects, matching patients with age and gender, were collected as control group. The disc RPE angle, the thickness of average CP-RNFL, the nasal, superior, temporal and inferior quadrant CP-RNFL thickness, and ONH parameters including optic disc area, cup area, rim area, C/D area ratio, linear CD ratio (CDR), vertical CDR were measured by 3D-OCT. Analysis of variance was performed for comparison among three groups. Minimum significant difference t test was performed for comparison between two groups. Results The differences of ONH parameters between VKH group and CSC group: 29 eyes of VKH group appeared retinal detachment next to disc, only 12 eyes appeared in CSC group. Twenty one eyes of VKH group appeared optic disc hyperemia while none in CSC group. The three groups' disc RPE angles were (138.62± 11.96)°,(154.09±5.85)° and (153.41 ±5.77)°. VKH group were significantly smaller than CSC group (/=-2.05, P=0.00) and control group (t=~ 1.6& P=0.00), while there was no significant diflerence between CSC group and control group (t=-1.88, P=0.72). The optic cup area and rim area were significantly bigger in VKH group than in CSC group (/=4.61, 2.71;P=0.00, 0.01), and the thickness of mean CP-RNFL, all quadrants of CP-RNFL were significantly thicker in VKH group than in CSC group (/=6.25, 4.40, 3.53, 5.4& 2.69;P=0.00, 0.00, 0.00, 0.00, 0.01). Conclusion Compared with the acute CSC, VKH patients are likely to appear retinal detachment next to disc, their disc RPE angles are smaller, their optic cup area and rim area are bigger, and their CP-RNFL thickness a
作者
庞燕华
聂利娇
谭志
周凤燕
袁雪晖
吕秋荣
赵桂玲
Pang Yanhua;Nie Lijiao;Tan Zhi;Zhou Fengyan;Yuan Xuehui;Lyu Qiurong;Zhao Guiling(Department of Ophthalmology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524023, China)
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2019年第4期369-373,共5页
Chinese Journal of Ocular Fundus Diseases
