Primer açık açılı glokom tanı ve takibinde bilgisayarlı görme alanı ile optikal koherens tomografinin karşılaştırılması

Amaç: Primer açık açılı glokom (PAAG) hastalarında görme alanı (GA) indeksleri ile optikal koherens tomografi (OKT) ölçümleri arasındaki ilişkinin değerlendirilmesi ve glokomatöz progresyonun erken tespitindeki rollerinin araştırılması amaçlanmıştır.Yöntemler: 2007 Ocak ile 2012 Haziran tarihleri arasında Dicle Üniversitesi Tıp Fakültesi Göz Hastalıkları Glokom Biriminde takipli, ilaç tedavisiyle göz içi basıncı kontrolü sağlanan, PAAG tanısı almış 72 hastanın 84 gözü çalışmaya alındı. GA'daki MD değeri temel alınarak glokom evrelemesi yapıldı. Buna göre; Grup 1 MD >=-6dB olan "erken evre glokom" hastalarını, Grup 2 MD -6dB ile -12dB arası olan "orta evre glokom" hastalarını, Grup 3 MD

Comparasion of computerized visual field and optical coherence tomography in diagnosis and follow-up of primary open-angle glaucoma

Objective: To evaluate the relationship between visual field indices and optical coherence tomography measurements in primary open-angle glaucoma (POAG) patients and to investigate the role of early detection of glaucomatous progression.Methods: 84 eyes of 72 patients who diagnosed with POAG that controlled with medical treatment at Dicle University Faculty of Medicine, Unit of Ophthalmology Glaucoma follow-up between January 2007 and June 2012 included to the study. Glaucoma staging was done according to the value of visual field (VF) MD. Patients MD value >= -6dB (early-stage glaucoma) patients included in Group 1, MD value between -6dB and -12dB (middlestage glaucoma) in Group 2 and MD value <=-12dB (advanced stage glaucoma) in Group 3. The relationship between measured Optical Coherence Tomography (OCT) values and VF values has been examined. In addition, patients in each group were compared among groups by calculating the average optic nerve head (ONH) and retinal nerve fiber layer (RNFL) thickness measured by OCT with the stage of glaucoma and the relationship between RNFL thickness values was examined. 2 dB increase in MD and 20 microns thinning in Avg Thickness have been accepted as a progression and OCT in VF progression rates were calculated.Results: There was a strong relationship between VF MD index and OCT Smax/Tavg, Imax/Tavg, Smax/Navg, Max-Min, Smax, Imax, Savg, Iavg, Avgthick, RA, RCSA, RV, CA, CV, CDHR, CDVR, CDAR parameters. Significant correlation between the parameters of VF PSD index and OCT and Smax / Imax, MaxMin, Smax, Imax, Savg, Iavg, Avgthick, DA, RA, RCSA, RV, CA, CV, CDHR, CDVR, CDAR were found statistically. Also there were statistically significant differences in RNFL thickness between sub-groups of POAG in our study. The average RNFL thickness decreased with increasing stage of glaucoma. To investigate the progression, first and last measurements of VF and OCT parameters were compared in all patients. VF and OCT progression was found in 25% and 29,6% of patients respectively. In 4,6% of patients OCT progression observed without VF progression.Conclusion: There was a strong correlation between indices of VF and OCT measurements. OCT RNFL thickness in the monitoring of early progression in glaucoma are promising in terms of providing follow-up of glaucoma because it detects early signs before VF analysis.

Kaynakça

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