Variation And Correlation Of Retinal Nerve Fiber Layer Thickness In Primary Glaucoma Merger Of Myopia

Objective: Primary glaucoma is a severe, irreversible blinding eye disease, thepathological damage is based on the damage of the ganglion cells and optic nerve fiberloss, namely the performance for the retinal nerve fiber thickness of change. It hasbeen confirmed that measurement of retinal nerve fiber layer thickness is earlier thanperimetry in diagnosis of primary glaucoma, but due to the interference of concomitantdiseases, and often makes early diagnosis of glaucoma was severely affected, resultingin a delay of glaucoma detection. Myopia especially high myopia as primary glaucomarisk factors of the disease, also is an important early diagnosis of interference factors.Primary glaucoma and myopia can be manifested as the thinning of the retinal nervefiber layer，in primary glaucoma combined myopia examination results has its owncharacteristics. But the influence on the nerve fiber layer thickness by myopic is notclear, according to the test results to the identification of glaucoma false positivesincreases greatly reduces the diagnosis of specificity, this also gives glaucoma earlyaccurate diagnosis increases the difficulty. This study applies HD-optical coherencetomography scanners quantitative measure of patients with primary glaucoma andmyopia retinal nerve fiber layer thickness, and discusses the primary glaucoma anddifferent degree myopia patient’s retinal nerve fiber thickness variation rules and thecorrelation.Methods: Collected from the Second Affiliated Hospital of Dalian MedicalUniversity eye clinic patients with primary glaucoma. According to visual field meandefect （MD） degree, primary glaucoma subjects is divided into early andmid-glaucoma （G1group）, and advanced glaucoma （G2）; Collected during the sameperiod of different refractive voluntary subjects, as the control group （M group）. Then according to the myopic diopter，the G₁group, G₂group and M groups subjects weredivided into four groups: the emmetropia group M0，the mild myopia group M₁，themoderate myopia group M₂,and the severe myopia group M₃, Subjects underwentregular ocular examination and HD-OCT detection of peripapillary retinal nerve fiberlayer thickness，with glaucoma at the same time check the vision, and record all results.Application SPSS17.0software on the obtained data was statistically analyzed.Results:1. The collection in November2010-December2011in Dalian medicaluniversity affiliated hospital of the eye clinic patients with primary glaucoma for atotal of95patients （161eyes）, of which the G1group of60cases （113eyes）, G₂group35cases （48eyes）. Collected during the same period of different refractive voluntarysubjects as the control group a total of79cases （138eyes）.2. Patients with primary glaucoma with the progress of the course, visual fieldMD degree, the RNFL thickness becomes thin; Patient with the increase of myopia,RNFL thickness becomes thin progressively;3. The M₁, M₂, M₃RNFL thickness is thinner than the M0in Group M, and at2:00-7:00, nasal （N）,inferior（I） and average RNFL thickness were statisticallysignificant （P <0.05）; The M1, M2, M3RNFL thickness is thinner than the M0in GroupG1，and at2:00,5:00-10:00, inferior（I）, temporal（T） and average thickness werestatistically significant （P <0.05）; The M1, M2, M3RNFL thickness is thinner than theM0in Group G2，and at1:00,6:00,9:00,12：00, superior （S） and inferior （I） quadrantposition thickness were statistically significant （P<0.05）.4. Pearson correlation analysis shows that the average RNFL thickness and age ofthe control group was a negative correlation and was negatively correlated with diopter;primary glaucoma groups, RNFL thickness and visual field mean defect was positivelycorrelated.5. Multiple linear regression analysis of the control group, mean RNFL thickness（Y） and age（X₁）, diopter（X₂） correlation, regression equation Y=117.983-0.349X₁-1.774X₂，analysis of the primary glaucoma groups, RNFL thickness （Y） and age（X₁），diopter （X2） and visual field MD （X3） correlation, regression equation Y=104.379-0.146X₁-1.761X₂+1.228X₃.Conclusion:1. With the progression of visual field mean defect aggravated, theperipapillary retinal nerve fiber layer thickness of the primary glaucoma becomethinner gradually, as early and mid-term change mainly at the inferior and the temporalquadrant of the range, the advanced performance is generally change thin. 2. With the increasing diopter in myopia, peripapillary retinal nerve fiber layerthickness gradually becomes thinner, the major changes reflected in nasal, inferiorquadrant.3. The retinal nerve fiber layer thickness of primary glaucoma patients is closelyrelated to age, refractive status and the degree of visual field damage, and has somevariation. For mild to moderate myopia, when the the temporal quadrant of the retinalnerve fiber layer thickness change, it should be noted that the possibility of thepotential of early glaucoma.