| Objective:Primary glaucoma is a group of disease,which feature is optic nerve atrophy and visual field defect. primary chronic angle-closure glaucoma(CACG) and primary open angle glaucoma(POAG) have no symptoms in the early time,most patients are found when optic nerve suffered serious damage. primary acute angle-closure glaucoma(AACG) have obvious symptoms in the early time,often received timely diagnosis and treatment,and optic nerve suffered little damage.Currently,this view which optic nerve damage is earlier than visual function change has been widely recognized. Retinal nerve fibre layer(RNFL)'s defect is one of early changes of optic nerve damage.This study is designed to measure RNFL thickness by Frequency -domain optical coherence tomography(OCT) in patients with different stages of primary glaucoma(CACG and POAG); to evaluate the correlation between RNFL thickness and visual field mean defect(MD);to detect RNFL thickness change of early stage primary glaucoma and to discuss the clinical significance in the early diagnosis of primary glaucoma objectively.Methods:Collected CACG and POAG patients who were in ophthalmology department of second affiliated hospital of dalian medical between august in 2010 to may in 2011 as experimental group (A). A group divides into the A1 group ,A2 group ,A3 group according to the severity of visual field defect. 20 cases of healthy person who were the volunteers as contrast group (B). RNFL thickness was measured by Zeiss Cirru HD-OCT, visual field was tested by Zeiss Humphrey-750.Results:Age,blood pressure,blood sugar and diopter between group A1,group A2, group A3 and group B was tested by independent sample T-test,p>0.05,there is no difference between satatistical significance.The ratio of sex and eye between group A1,group A2, group A3 and group B was tested by chi square test,p>0.05,there is no difference between satatistical significance.Mean RNFL thickness:A1 group was 91.43±7.67μm ; A2 group was 86.82±10.36μm;A3 group was 77.86±14.01μm;B group was 102.91±9.36μm. Visual field MD: A1 group was -4.26±1.83dB;A2 group was-7.43±2.64dB;A3 group was -17.06±5.85dB;B group was -0.88±1.53dB. Mean RNFL thickness and visual field MD between group A1,group A2, group A3 and group B was tested by ANOVA,the difference between each group were significant (p<0.05). In group A1,group A2 and group A3,mean RNFL thickness and visual field MD (A1:r=-0.537;A2:r=-0.615; A3:r=-0.804) correlated significantly by Pearson correlation coefficients (p<0.05); In group B, r=-0.056,there is no significance by Pearson correlation coefficients (p>0.05).In group A1, superior RNFL thickness is 116.32±11.65μm;inferior RNFL thickness is 105.58±9.73μm;nasal RNFL thickness is 75.40±10.91μm;temporal RNFL thickness is 70.28±13.08μm. In group B, superior RNFL thickness is 140.15±8.79μm;inferior RNFL thickness is 137.29±10.07μm;nasal RNFL thickness is 90.20±14.19μm;temporal RNFL thickness is 88.43±10.85μm. Superior and inferior RNFL thickness between group A1 and group B was tested by independent sample T-test,p<0.05,there is difference between satatistical significance;nasal and temporal RNFL thickness between group A1 and group B was tested by independent sample T-test, p>0.05,there is no difference between satatistical significance.Conclusion:1.Frequency -domain OCT detected that the average of RNFL thickness become thinning with the progression of disease in the primary glaucoma patients.2.Frequency -domain OCT detected that the average of RNFL thickness have negative correlation with vision MD,it's able to objectively reflect the degree of glaucomatous optic nerve damage.3.Frequency -domain OCT can show significantly decreased superior and inferior RNFL thickness of the early period primary glaucoma, which showed good ability in distinguishing normal from early period primary glaucomatous eyes. |
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