目的观察阴虚体质型的正常眼压性青光眼(NTG)患者中医治疗后的视功能变化情况。方法连续入选2016年1月1日至2017年5月31日在我院眼科首诊诊断为NTG,且经中医体质分型为阴虚型的患者54例,纳入患者均未接受眼部手术或激光治疗。将阴虚体...目的观察阴虚体质型的正常眼压性青光眼(NTG)患者中医治疗后的视功能变化情况。方法连续入选2016年1月1日至2017年5月31日在我院眼科首诊诊断为NTG,且经中医体质分型为阴虚型的患者54例,纳入患者均未接受眼部手术或激光治疗。将阴虚体质类型NTG患者随机分为2组,试验组28例(56只眼),局部使用拉坦前列素并根据体质类型口服明目地黄汤(即明目地黄丸组方的水煎剂)治疗;对照组26例(52只眼),仅局部使用拉坦前列素降眼压治疗。口服中药周期3个月,停药后继续局部使用降眼压药物,观察试验组停口服中药3个月后与对照组局部用药6个月后最佳矫正视力(BCVA)、视野平均缺损(MD)、视盘周围视网膜神经纤维层(RNFL)平均厚度及眼压的变化。结果两组治疗前各项指标差异无统计学意义(P>0.05)。中药治疗结束3个月后,试验组患者视野MD值较治疗前降低(P<0.001),并低于同期对照组(P=0.022),对照组视野MD值较治疗前略有增加(P=0.046)。试验组眼压较治疗前下降(3.8±0.6) mm Hg(1 mm Hg=0.133 kPa)(t=49.589,P<0.001),对照组较治疗前下降2.8±0.8(t=25.721,P<0.001),试验组眼压相对更低(t=-3.128,P=0.002)。两组BCVA、视盘周围RNFL厚度均未见明显变化(P>0.05)。结论现有短期观察结果显示,明目地黄汤对阴虚型NTG患者的视功能具有保护作用。展开更多
AIM： To analyze the diagnostic capabilities of peripapillary retinal nerve fiber layer（p RNFL） thickness and segmented inner macular layer（IML） thickness measured by spectraldomain optical coherence tomography fo...AIM： To analyze the diagnostic capabilities of peripapillary retinal nerve fiber layer（p RNFL） thickness and segmented inner macular layer（IML） thickness measured by spectraldomain optical coherence tomography for detection of early glaucoma. METHODS： Fifty-three patients with primary open angle glaucoma（POAG）, 60 patients with normal tension glaucoma（NTG） and 32 normal control subjects were enrolled. Thicknesses of p RNFL, total macular layers（TML）, and the IML, including macular RNFL（m RNFL） and macular ganglion cell layer（m GCL） were assessed. The areas under the receiver operating characteristic curves（AROC） were calculated to compare the diagnostic power of different parameters. RESULTS： There were no differences in the parameters of p RNFL, TML, and IML between POAG and NTG groups. The thicknesses of superior and inferior m GCL showed significant correlation with mean deviation of visual field（R2=0.071, P=0.004; R2=0.08, P=0.002）. The m GCL thickness significantly correlated with the p RNFL thickness in the superior and inferior quadrants（R2=0.156, P〈0.001; R2=0.407, P〈0.001）. The thickness of the inferior-outer sector of macula had greater AROCs than those in the inferior-inner sector of macula. The AROCs for superior（0.894） and inferior（0.879） p RNFL thicknesses were similar with the AROCs for superior（0.839） and inferior m GCL（0.864） thicknesses. Sensitivities at 80% specificity for global p RNFL, inferior-outer m GCL and inferior-outer m RNFL thicknesses were 0.938, 0.867, and 0.725, respectively. CONCLUSION： The diagnostic capability of the m GCL thickness is comparable to that of the p RNFL thickness in patients with early glaucoma. The inferior-outer sector of IML has a better diagnostic capability than the inferiorinner sector of IML for detection of early glaucoma.展开更多
文摘目的观察阴虚体质型的正常眼压性青光眼(NTG)患者中医治疗后的视功能变化情况。方法连续入选2016年1月1日至2017年5月31日在我院眼科首诊诊断为NTG,且经中医体质分型为阴虚型的患者54例,纳入患者均未接受眼部手术或激光治疗。将阴虚体质类型NTG患者随机分为2组,试验组28例(56只眼),局部使用拉坦前列素并根据体质类型口服明目地黄汤(即明目地黄丸组方的水煎剂)治疗;对照组26例(52只眼),仅局部使用拉坦前列素降眼压治疗。口服中药周期3个月,停药后继续局部使用降眼压药物,观察试验组停口服中药3个月后与对照组局部用药6个月后最佳矫正视力(BCVA)、视野平均缺损(MD)、视盘周围视网膜神经纤维层(RNFL)平均厚度及眼压的变化。结果两组治疗前各项指标差异无统计学意义(P>0.05)。中药治疗结束3个月后,试验组患者视野MD值较治疗前降低(P<0.001),并低于同期对照组(P=0.022),对照组视野MD值较治疗前略有增加(P=0.046)。试验组眼压较治疗前下降(3.8±0.6) mm Hg(1 mm Hg=0.133 kPa)(t=49.589,P<0.001),对照组较治疗前下降2.8±0.8(t=25.721,P<0.001),试验组眼压相对更低(t=-3.128,P=0.002)。两组BCVA、视盘周围RNFL厚度均未见明显变化(P>0.05)。结论现有短期观察结果显示,明目地黄汤对阴虚型NTG患者的视功能具有保护作用。
基金Supported by grants CMRPG8E1251 from Chang Gung Memorial Hospital,Taiwan
文摘AIM： To analyze the diagnostic capabilities of peripapillary retinal nerve fiber layer（p RNFL） thickness and segmented inner macular layer（IML） thickness measured by spectraldomain optical coherence tomography for detection of early glaucoma. METHODS： Fifty-three patients with primary open angle glaucoma（POAG）, 60 patients with normal tension glaucoma（NTG） and 32 normal control subjects were enrolled. Thicknesses of p RNFL, total macular layers（TML）, and the IML, including macular RNFL（m RNFL） and macular ganglion cell layer（m GCL） were assessed. The areas under the receiver operating characteristic curves（AROC） were calculated to compare the diagnostic power of different parameters. RESULTS： There were no differences in the parameters of p RNFL, TML, and IML between POAG and NTG groups. The thicknesses of superior and inferior m GCL showed significant correlation with mean deviation of visual field（R2=0.071, P=0.004; R2=0.08, P=0.002）. The m GCL thickness significantly correlated with the p RNFL thickness in the superior and inferior quadrants（R2=0.156, P〈0.001; R2=0.407, P〈0.001）. The thickness of the inferior-outer sector of macula had greater AROCs than those in the inferior-inner sector of macula. The AROCs for superior（0.894） and inferior（0.879） p RNFL thicknesses were similar with the AROCs for superior（0.839） and inferior m GCL（0.864） thicknesses. Sensitivities at 80% specificity for global p RNFL, inferior-outer m GCL and inferior-outer m RNFL thicknesses were 0.938, 0.867, and 0.725, respectively. CONCLUSION： The diagnostic capability of the m GCL thickness is comparable to that of the p RNFL thickness in patients with early glaucoma. The inferior-outer sector of IML has a better diagnostic capability than the inferiorinner sector of IML for detection of early glaucoma.
