目的：探讨利用光学相干断层扫描技术(optical coherence tomography， OCT)测量视乳头旁视网膜神经纤维层(retinal nerve fiber layer， RNFL)厚度、视盘形态和黄斑区视网膜厚度在原发性开角型青光眼(primary open angle glaucoma， POAG)早期诊断中的应用价值。

方法：选取2016-01/2017-06本院收治的POAG 患者65例85眼作为研究组， 随机选取同期在本院进行身体检查的健康者52例78眼作为对照组，采用OCT测量视乳头旁RNFL厚度、黄斑区视网膜厚度和视盘参数包括杯/盘比(C/D)、视杯面积(cup area， CA)、视杯容积(cup volume， CV)、视盘面积(disc area， DA)、盘沿面积(rim area， RA)和盘沿容积(rim volume， RV)，并对检测结果进行比较分析。

结果：研究组视乳头旁RNFL厚度在上方、下方、颞侧、鼻侧和均值均明显小于对照组，差异有统计学意义(P<0.001)； 研究组CA、CV、C/D明显高于正常对照组，差异有统计学意义(P<0.001)，而DA、RV明显小于正常对照组，差异有统计学意义(P<0.001)，DA则略小于正常对照组，差异无统计学意义(P>0.05)。研究组黄斑区视网膜厚度在上方、下方、颞侧、鼻侧均明显小于对照组，差异有统计学意义(P<0.001)。

结论：OCT能够定量客观检测RNFL厚度、黄斑区视网膜厚度和视盘参数，这有助于POAG的早期诊断。

METHODS: Sixty-five patients(eighty-five eyes)were selected as a study group and fifty-two normal people(seventy-eight eyes)were selected as a control group. The retinal nerve fiber layer thickness, optic disc parameters, including cup/disc(C/D)rate, cup area(CA), cup volume(CV), disc area(DA), rim area(RA)and rim volume(RV), and macular thickness were detected by Cirrus HD-OCT. The data were compared and analyzed.

RESULTS: The retinal nerve fiber layer thickness of superior, inferior, temple, nasal and average in the study group were all significantly thinner than those of the control group(P<0.001). The cup area, cup volume and cup/disc ratio in the study group were significantly higher than those of the control group(P<0.001); while the rim area and rim volume in the study group were significantly lower than those of the control group(P<0.001). But the disc area was not significantly different between two groups(P>0.05). The macular thickness of superior, inferior, temple and nasal in the study group were all significantly thinner than those of the control group(P<0.001).

CONCLUSION: OCT can detect the change of retinal nerve fiber layer thickness, optic disc parameters and macular thickness, it is helpful for early diagnosis of POAG.