Application Of HRT,OCT,Humphrey Perimetry And Electroretiongram Photopic Negative Response In Glaucoma

Objective:To apply Heidelberg Retina Tomography (HRT-Ⅱ),Optical Coherence Tomography (OCT),Humphrey Automated Perimetry and Electroretinogram Photopic Negative Response (PhNR) in order to detect the relationship of optic nerve structural and functional damage in normal subjects, Suspected Open-angle Glaucoma(SOAG) and Primary Open-angle Glaucoma (POAG) patients. Exploring the correlation and the diagnostic values related to POAG.Methods:(1) Sixty-two eyes of 62 cases with POAG, thirty eyes of 30 cases with SOAG and forty-two eyes of 42 cases of normal subjects were examined by HRT-Ⅱ,OCT, Humphrey automated perimetry and PhNR in our hospital. The following elements were selected in this investigation:Six parameters of HRT-Ⅱ:Rim Area, Rim Volume, Cup/Disc Area Ratio, Line Cup/Disc Ratio, Cup Shape Measure, Average Retinal Nerve Fiber Layer Thickness(RNFLT). Five parameters of OCT:The average and four quadrants RNFLT. Two parameters of Humphrey automated perimetry:Mean Deviation and Pattern Standard Deviation. Two parameters of PhNR: the PhNR amplitude of white-white and blue-red stimulation. The results were analyzed by using ANOVA, T test, Linear correlation analysis and ROC curve analysisResults:1,The comparison of optic nerve structural and functional detecting parameters among the three groups:Rim Area, Cup/Disc Area Ratio, Cup Shape Measure, White-White PhNR amplitude, Blue-Red PhNR amplitude shows significant difference (P<0.05). The comparison of remaining detecting parameters in normal subjects group and SOAG group shows no significant difference (P> 0.05).2,The correlation of optic nerve structural and functional detecting parameters in POAG:optic nerve structural and functional detecting parameters have significant linear correlation partly, in which Mean Deviation and blue-red PhNR amplitude have the most closely correlation, the correlation coefficients is 0.657; Mean Deviation and the inferior RNFLT and the average RNFLT have a more closely correlation, the coefficients are 0.641 and 0.632 separately.3,The diagnostic values of optic nerve structural and functional detecting parameters:the area under the ROC curve of OCT average RNFLT is the largest(AUC=0.974),which has the highest diagnostic value to POAG; The area under the ROC curve of white-white PhNR amplitude is 0.954, the diagnostic value to POAG is secondly to the average RNFLT of OCT. The sensitivity of the average RNFLT of OCT and white-white PhNR amplitude are 95%,90%,93.3% and 76.7% separately in setting specifity≥80% and≥95%. the remaining detecting parameters have better diagnostic values to POAG..Conclusions:In glaucoma, structural and functional detecting parameters of optic nerve have significant linear correlation., but the correlation is low, in which Mean Deviation and blue-red PhNR amplitude have the best correlation. OCT average retinal nerve fiber layer thickness to POAG has the highest diagnostic values and white-white PhNR amplitude has the second one. The four types equipments above have assessed the optic nerve damage characteristics of the structure and function from different view angles, and reflected the severity of glaucoma, which helps to guide the diagnosis and treatment of glaucoma.