摘要
目的 比较眼前段相干光断层扫描仪（SL-OCT）与超声活体显微镜（UBM）检测青光眼滤过术后滤过泡的效果。方法 比较研究。以Singh的方法，对53例（69只眼）青光眼滤过术后患者的功能性滤过泡进行检测，同时对受试患者分别进行SL-OCT与UBM检查，获取结膜下滤过泡内部形态结构图像，并对滤过泡进行归类分型；对两种检查方法所得结果进行比较，采用Fisher精确检验。结果 SL-OCT检测青光眼功能性滤过泡的形态和分型与Singh法所判定的功能性滤过泡对照，显示SL-OCT检测和识别功能性滤过泡的敏感性为92．7％（38／41），特异性为83．3％（20／24）；而UBM检测和识别功能性滤过泡（Yamamoto分型）的敏感性为66．7％（30／45），特异性为75．0％（18／24）。两组在识别功能性滤过泡的敏感性方面，差异有统计学意义（Fisher精确检验，P=0．003）。结论 SL-OCT检测和识别青光眼滤过术后功能性滤过泡的敏感性和特异性优于UBM，四种滤过泡分型为判断功能性滤过泡提供了形态和结构方面的支持，可作为判断青光眼疗效和再次手术的重要客观依据。
Objective To analyze the morphology and the function of subconjunctival filtering bleb in patients with glaucoma by slit-lamp adapted optical coherence tomography （SL-OCT） and ultrasound biomicroscopy （UBM）. Methods This retrospective study comprised 53 patients with glaucoma filtering surgery from 2002 to 2006. The post-operation blebs in 69 eyes of 53 patients were scanned by a SL-OCT or UBM and categorized by the reference of intrableb morphology. The function of post operation bleb was clarified using Singh＇s or Yamamoto＇s criterion. The results of SL-OCT scanning were compared with those of UBM. Results This is a comparative study. The blebs were classified into four categories according to the images of filtering blebs＇ by SL-OCT or UBM. SL-OCT had 92. 7% （38/41 eyes） sensitivity in predicting a functioning bleb by Singh＇s standard and 83.3% （20/24 eyes） specificity in predicting a nonfunctioning bleb, whereas, UBM had 66.7% （30/45 eyes） and 75.0% （18/24 eyes） by Yamamoto＇s criterion, respectively. The sensitivity in predicting a functioning bleb in the SL-OCT group was significantly （ P = 0. 003, Fisher exact test）different from the UBM group. Conclusions Our results suggest that SL-OCT scanning has more sensitivity and specificity than UBM in evaluating the function of filtering bleb. The close relationship between the function and the morphological classification provides an important objective basis in evaluating the outcome of antiglaucomatous surgery.
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2008年第5期402-407,共6页
Chinese Journal of Ophthalmology
关键词
青光眼
小梁切除术
眼前半段
体层摄影术
光学相干
显微镜检查
声学
治疗结果
Glaucoma
Trabeculectomy
Anterior eye segment
Slit lamp adapted Tomography, optical coherence
Microscopy,acoustic
Treatment outcome
