Scanning Laser Polarimetry In Evaluation of Retinal Nerve Fiber Layer Thickness For Normal Taiwanese

正常國人視網膜神經纖層厚度之研究－以雷射掃描式偏光儀為偵測方法

陳宏任(Hong-Jeng Chen) ； 李揚銘(Yang-Ming Lee) ； 翁林仲(Lin-Chung Woung) ； 周介仁(Jieh-Ren Jou) ； 林慧茹(Hwi-Ju Lin)

《The Kaohsiung Journal of Medical Sciences》 16卷5期 (2000/05) Pp. 223-232

https://doi.org/10.6452/KJMS.200005.0223

摘要

雷射掃描式偏光儀是一種可以偵測視網膜神經纖維厚度的新進儀器，它利用視網膜神經纖維層具有的雙折光特性，將掃描反射的雷射光經電腦分析，來偵測視網膜神經織維層的厚度。我們運用它來觀察正常人的視網膜神經纖維，並尋求一可供比較對照的基本數據。我們篩選出一百名健康的自願者，男44位、女56位，平均年齡為36.17歲(10-75歲)，按年齡分為六組，測量其屈光、眼壓、及眼軸長度，並以雷射掃描式偏光儀偵測其以視神經盤其中心，以1.75個視神經盤大小為直徑距離處， 網膜神經纖維層在四個象限(上側: 45~135度，鼻側: 135~225度，下側: 225~315度，顳側: 315~45度)之厚度，並作分析比較。結果視網膜神經纖維厚度平均而言，上側為90.69 ± 20.20μm，下側為80.45±17.4μm，鼻側為59.28± 15. 37μm，顳側為48.98±15.72μm，平均為69. 86±13.97μm。各個組別都是上側與下側較厚，鼻側與顳側較薄，網膜神經織維層厚度離視神經盤愈遠愈薄；而眼軸的長度並不影響神經纖維層的厚度。男女的差異不大，顯示神經纖維層不受性別影響；但年齡則有明顯的影響，隨年齡增大，視網膜神經纖維層厚度會遞減，兩者間呈線性相關，有統計學上的差異(p=0.0075) ，且在4個象限都有線性相關，也都有統計學上的明顯意義。所以在與正常人之網膜神經纖維層厚度作比較時，年齡的因素必須列入考慮。

並列摘要

Scanning laser polarimetry has been used recently for the measurement of retinal nerve fiber layer (RNFL) thickness, taking advantage of the birefrigence of the RNFL. We observe the RNFL with the instrument and try to find out a set of normal basic values of the RNFL thickness for clinical comparison. One hundred normal volunteers of different age groups were recruited for this study. There are 44 males and 56 females with a mean (lSD) age of 36.17(14.77) years. Three consecutive IS-degree polarimetric maps were acquired for each subject. RNFL thickness measurements were obtained at 1.75 disc diameters ring from the optic nerve. Four 90-degree quadrants were identified. As a result, the average of RNFL thickness is 90.69 (20.20) μm in the superior quadrant, 80.45 (17.4) μm in the inferior quadrant, 59.28 (15.37) μm in the nasal quadrant, and 48.98 (15.72)μm in the temporal quadrant with a mean thickness value of 69.86 (13. 97)μm. Superior and inferior quadrants showed a comparatively thicker nerve fiber layer than nasal and temporal quadrants. The temporal quadrant was always the lowest. The axial length does not affect the RNFL thickness and no significant difference between males and females exists. However, an obvious inverse linear correlation between age and the RNFL thickness in all quadrants is found. The average RNFL thickness decreased with age by 0.26μm per year. (R2=0.081, p-value=0.004) When compared with the normal range, age-match would be necessary.

並列關鍵字

scanning laser polarimetry；retinal nerve fiber layer thickness；age