hiin m i c STIs nhu: Dau byng dudi (39,3%), chdy mu/huylt tring/khi hu b i t thydng (34,8%), ngua b i ph§n sinh dye (11,1%), tiiu tidn dau bult (7%). dau rdt b i ph$n sinh dye (2,2%). lodt siii b i phdn sinh dye (2,2%). bilu hipn tn§u chirng khde nhy dau khi QHTD (3,3%),
5. M$t sd mdi lien quan
K i t qud phdn tieh eho thIy d mit s i m i i liin quan cd y nghTa thing kS nhy sau: Trinh d i hpe v l n , nghe ndi v l TDAT vd TCAT, logi hinh hogt ding, sy sSn d BCS vd kiln thiKC v l HIV d lidn quan tdi hdnh vi sO- dyng BCS khi QHTD vdi d e logi bgn tinh eiia PNMD, M i l s i nghidn ciru khdc cOng eho kit qud tuang ty [1] [2] [5],
Bdng 4 M i i lidn quan giO'a mit s i y l u t l vdi hdnh vi sir dyng BCS trong l i n QHTD g i n ddy nhlt cua PNMD
Bi^n sA Trinh (30 hgc vdn
s C 4 p 1
> C d p 1 Tirng nghe nfli v6 TDAT
Khfinq nqhe C6 nqhe Tunq nqhe n6l v6 TCAT
Khflng nghe C6 nqhe Logi hinh hogt d^nq
MDDP MDNH NghT khdch I g c f l s i r
dunq ma tuy khflng
C6 S^n cd BCS noi Idm
vi$c Khflng
0 6 Kifin thuc ve HIV
Khflnq dat D^l
S u d g Khflnq 45 16 36 34 42 22 16 54
56 14
14 56 23 47
q B C S Cd 44 156 48 152 84 116
10 190
75 125
11 189 13 167
OR, P, KTC 95%
OR=1t,96, KTC (6,24; 22.93),
P<0,001 OR=3,35, KTC
(1,89,5,92), P<0,001 OR=3,01,KTC
(1,69,5,36), P<0.001 OR=5,63. KTC
(2.41, 13,11).
P<0,001 OR=6,66, KTC
(3,47; 12,79), P<0,001 OR=4,29, KTC
(1,84; 9.99), P<0,001 OR=7.03, KTC
(3,32; 14.92), P<0,001 KET LUAN vA KHUYEN NGHI I . K l t l u ^ n
Hdnh vi nguy ca Idy nhilm HIV a nhdm PNMD bao gim. Ty 1$ su dyng BCS khi QHTD vdi cde logi bgn tinh chua cao. QHTD dydng miing/hdu mdn (6,6%), sir dyng ma tiiy (1,1%), m i c STIs (73%).
- Ty l i PNMD cd kiin thire dgt vd HIV (86,7%).
- Cde y l u t i liin quan tdi hdnh vi siV dyng BCS khi QHTD d nhdm PNMD: TDHV thIp, tin tadng bgn tinh khdng sii' dyng ma tuy, s i lupng bgn tinh trong thdng eao (trin 50 ngydi). logi hinh hogt ddng, nghe ndi vi TDAT vd TCAT, kiln thac phdng ching HIV/AIDS.
2. K h u y i n nghj
- D l y mgnh cde hogt ddng truyin thdng: Tuydn truyin rd han v l dydng Idy, dudng khdng idy, vai trd cua TDAT, TCAT trong phdng, ehing HIV eho PNMD vi ehu chya,
- Khuyin khich sy tham gia cua chu nhd hdng, khdch sgn, PNMD vdo mgng lydi CTV, GDVDD, thydng xuyin tdp huln ndng cao kiln thirc, ky ndng phdng ehing HIV cho hp.
- Tdng cydng khd ndng tilp d n cua PNMD vdi cdc ehyang trinh can thi$p gidm tdc hgi: Ta v l n , xdt nghifm HIV ty nguy$n, khdm STIs luu ddng, d p phdt BKT, BCS miln phi.
T A I L l f U THAM K H A O
1. B i Y t l vd V i i n v i sinh djch t l Trung uang (2005 - 2006), Kit qud ehyang trinh gidm sdt kit hpp hdnh vi vd d e ehi s l sinh hpc HIV/AIDS (IBBS) tgi Vigt Nam.
Nhd xult ban Y hpc, Hd N i l .
2. Cye phing, ching HIV/AIDS-BO Y te (2009), 'Mii liin quan giO-a d e nhilm khuin Idy tnjyIn qua dying tinh dye (STIs) vd nhilm HIV/AIDS', Dgc san d a Cgc phdng, chong HlV/AIDS-Bd Y t l , (02), tr.lO- 13.
3. Nguyin Thj Minh Tdm vd d n g sy (2009), "Kiln thiKC, thdi d i vd hdnh vi liin quan d i n HIV/AIDS eua phy nCf mgi ddm tgi 7 tinh/thdnh p h i Vi$t Nam", Cdc cing trinh nghien cu-u khoa hpe v l HIV/AIDS giai dogn 2006- 2010, Tgp chi Y hpc thy^ hdnh. (742+743). tr 658 - 661, Bd Y te xuat ban. Ha Npi.
4 Nguyen Thi Nhu et al (2007), "Clients of female sex workers as a bringing population in Viet Nam', Journal of practical medicine. (742+743), p.351-354.
Published by Ministry of health. Ha Noi.
5. Duong Le Quyen et al (2009), 'Behavioral sun/ey on condom use and HIV voluntary counseling and testing uptake among male clients of female sex workers in 2009 in Viet Nam", Journal of practical medicine. (742+743), p.293-296. Published by Ministry of health. Ha Noi.
KHAO SAT Sir PHU HOP v i KET QUA KHAM DANH GIA SEO BONG SAU M 6 CUT BE CUNG MAC BANG DEN KHE VA B&NG MAY VISANTE OCT
DAO TH| L A M Hl/dNG - B^nh vi^n Mat trung wong T 6 M TAT
Muc tiiu: khio sit s y phu hgp vi kit qui dinh gii s?o bgng sau md gidcdm bing ky thuit chup cit Idp phan trwdc nhan ciu (Visante OCT) vi bing din khe (Slit-lamp) tren sinh hien vi. Dii twgng: 67 mit cOa 67 NB gidcdm nguyin phit di <Tiiu trj bing PT cSt bi CGM t^i khoa Gidcdm bgnh vi$n MSt trung wong tir thing 1/2010 din thing 8/2010. Phuung phip: Md ti, dt ngang, cd phin tich. Kit qui: 94,1% mit sgo typ I,
100% mit s^o ti'p 11 theo khim nghiim den khe tuwg Ong vdi 84,6% s^o d^ng nang vi 96,6% spo dgng toi Ian theo khim bing miy Visante OCT cd NA <
21mmHg. /Vguvc /gi ty 1$ mit cd NA £ 21 mmHg cao han d nhdm sgo t^p III (42,9%) vi IV (33.3%) tuung Ong vdi nhdm s^o d^ng dgt (25%) vi d^ng v6 bao (52,9%).
Mil liin quan giira 2 phuung phip lam sing vi Wsanfc OCT cd y nghla thing ki vdi p <0.01 (ca Pearson Chi- Square test vi Fisher's Exact test). S y phO hgp d miJc
Y HOC THVC HANH (810) - S6 3/2012
tnjng binh khi giwa 2 phuung phip dinh gii seo bgng nay vdi chi si K = 0,5 vi chi s6 Spearman = 0,6. Kit luin: GiO-a 2 phuung phip dinh gii die <Tiim sgo bgng bang din khe (Slit-lamp) vi miy Visante OCT cd mil lien quan vi phu hgp. Ca hai phuung phip diu cho phip dinh gii sw hinh thinh sgo bgng vi tiin Iwgng vi khi ning diiu chinh NA sau phiu thu$t. Tuy nhiin dinh gii sgo bgng thim bing OCT cd nhiiu uv diim han vi di sij- dgng. khong xim h^i, cho sd do chinh xic vi luv giu l^i hinh inh ve cic dgc diem cua sgo bgng sau mi.
Tu- khoi- gidcdm, cat bi cOng giic mac, sgo bong, den khe, Visan OCT.
THE CORRELATION IN EVALUATING SUBCONJUNCTIVAL BLEB FUNCTION AFTER TRABECULECTOMY USING SLIT-LAMP AND VISANTE OCT
SUMMARY
Puqjose: To investigate the correlation in evaluating subconjunctival bleb function after trabeculectomy using slit-lamp and Visante OCT. Subject: 67 post- trabeculectomy eyes of 67 primary glaucoma subjects, treated at Glaucoma departement - VNIO from 1/2010 to 8/2010, were studied. Method, obsen/ation, analysis study. Result: 94.1% of type I blebs and 100% of type II blebs classified with reference to slit lamp morphology, to compare with 84.6% of cystic blebs and 96.6% of diffuse blebs dassified on the basis of Visante OCT images, has lOP <21mmHg. On the contrary, 42.9% of type III and 33.3% of type IV, to compare with 25% of fattened blebs and 52.9% of encapsulated blebs has lOF^ 21mmHg. There is a significant correlation between these two methods with p<0.01 (Pearson Chi- Square and Fisher's Exact test). The correlation was at average level with K=0.5 and Speannan index = 0.6.
Conclusion: There is a significant correlation in evaluating subconjunctival bleb function after trabeculectomy using slit-lamp and Visante OCT. They both allowed the assessement of the postoperative healing course of filtering blebs and the prognosis of blebs function However. Visante OCT showed more advantages because of its easy - to- use. non - contact, precise and documentable character
Keywords: glaucoma, trabeculectomy, filtering bleb, silt-lamp, Visante OCT
DAT V A N Bt
Glicdm Id mit trong nhu'ng nguyin nhdn hdng dau gay mil vd gidm thj lye. Cdc phyang phdp dieu trj gidcdm deu nhIm hg nhdn dp (NA) v l muc an toan, khdng gay ton hgi tilp tye thj than kinh. Hipu qua hg NA cua phau thudt (PT) d t be eung gide mgc (CGM) dilu trj gidcdm phy thudc vdo sy hinh thdnh spo bpng thIm sau m i . Tren thyc t l Idm sdng hipn nay d phln Idn d e ca sd nhan khoa Vipt Nam vipc ddnh gid tinh trgng spo bpng thIm thydng daac dya vdo quan sdt bang den khe (Slit-lamp) tren sinh hien vi (SHV). Tuy nhien d mpt so trung tdm Idn dd cd dieu kipn trang bj d c phuang tipn chin dodn hinh anh. trong do d may chyp d t lap ban phln trade nhdn d u Visante OCT vdi kha nang vapl trii cho phep danh gia va ghi Igi dupe d u true npi tgi d a spo bpng. Chiing tdi tien hdnh d i tdi nghidn cuu ndy nhIm myc tieu khao sat sy phti hpp v l kit qua
ddnh gid sgo bpng sau m i gldeim bing ky thugt chyp c i t Idp phln trudc nhan d u (Visante OCT) vd bdng ddn khe (Slit-lamp) trin sinh hiin vi.
D 6 I TU'Q'NG vA PHU'aNG P H A P NGHIEN CIJU D i i typng nghidn cii'u: Ngodi binh (NB) glieim nguyin phdt dd diiu trj bing PT d t bd CGM tgi khoa Glieim binh vi§n Mit trung uang tir thdng 1/2010 din thdng 8/2010.
Tiiu chuIn logi trie: mit ed cdc t i n thuang v i kit mgc (KM), gide mgc (GM), mi dnh hydng din spo bpng, NB qud gid ylu, khdng hpp tde.
Phuang phdp nghidn cuu; Md td d t ngang, khdng cd nhdm chirng.
NB dypc khdm ddnh gid sgo bpng thIm sau m i bing ddn khe (Slit-lamp) tren sinh hiin vi vd bdng mdy Visante OCT eiia hdng Carl Zeiss Meditec (My) trong eung mdt thdi gian
Tidu chuIn ddnh gid spo bpng bing din khe dya theo phdn logi eua Kronfeld [4]: TJp I- Bpng mdng, cd nhilu nang nhd (da nang) do cd ddng fhiiy djch ehay qua KM. T^p II - Bpng mdng, dpt, Ian tda, vd taang doi vd mgch. Dudi dp phdng dgi eao thudng nhin thIy d c vi nang d trong bilu md KM. Typ III - Bpng dpt. khdng d cde vi nang vd d nhieu mgch mdu trdn b l mgt bpng, the hipn sy thIm Ipe khdng t i t do hinh thdnh mang xa dudi KM.Typ IV - Bpng ed bao (nang Tenon) khu trii. g i eao, hinh vim, cd thdnh ddy thing thyang tn/c tilp vdi tiln phdng vd d nhieu mgch mau d b l m$t.
Tidu chuIn danh gia spo bpng bing mdy Visante OCT dya theo phdn logi eua Zhang Yi vd cing sy [10]' T;i'P C (sgo dgng nang Cystic) - thdnh spo taang doi mdng, da dgng v l chilu cao, thudng ed mdt khe hd rpng hodc mit vdi khe hd nho hode tnjng binh d phia tren vat cung mgc (CM), trong dd mpt so d t h i thdng vdi khe phia dydi KM, dydng djch dadi vgt CM khdng ro rang.
Typ D (spo tda Ian Diffuse)- thadng Id 1 vdi nang hodc khe dodi KM cd dp phan am thIp ho$e trung binh, KM thydng day, Ian tda, khoang djch tren vgt CM, dodng d[ch dadi vgt CM vd d e khe nii tgi hiin thj mit d e h ro rdng Typ E (Spo dgng vd bao Encapsulated) - thdnh spo day cd d i phdn dm eao bao quanh mit khoang djch tren vgt CM, khong d hoc trong d ldp dadi CM. CM va KM dinh vao nhau. Typ F (Spo dpt Flattened) - thdnh sgo rit ddy, khdng ed khe dudi KM va tren CM, KM vd CM dinh vdo nhau vd d dp phan am cao giing vdi phan am cua CM.
Cac thdnh phln khdc khdng xult hiin.
Xir \^ s l liiu: bing phln mIm SPSS cho Windows (phidn ban 17.0).
K t T QUA
Nghien cO-u dype tiln hdnh tren 67 mat eua 67 NB glieim nguyen phat, 25 nam (37,3%), 42 ny (62,7%);
tuli tir 16-80, trung binh Id 57,0 ±11,7; thdi gian sau mo trung binh Id 26,2 ±48,3 thdng, 31,3% s i mat sau mo trong vdng 1 thdng. Cd 55 mit (82,1%) diing d a t chong chuyin hod (GCH). Glddm gde ding chiem 82,1% (55 mit), g i c md la 17,9% (12 mit). V i giai dogn binh: 15 m i t sa phdt (22,3%), 31 m i t tiln triln (46,3%), 16 mdt trim trpng (23,9%) vd 5 m i t g i n mil (7,5%). 53 mat (79,1%) eiNA<21mmHg:14mlt(20,9%) d NA > 21 mmHg (20,9%).
Y HOC THirc HANH (810) - S6 3/2012
v l hinh thdi sgo bpng theo khdm nghiim ldm sdng bing ddn khe trin SHV g i m 17 m i t typ I (25,4%), 19 mdt typ II (28,4%), 28 m i t typ III (41,8%), 3 m i t t^p IV (4,5%); theo khdm nghiim bing mdy Visante OCT cd 13 mdt typ C (19,4%), 29 m i t typ D (43,3%), 17 m i t t<?p E (25,4%), 8 mit t^pF (11,9%)
Bdng 1. Liin quan gifra hinh thdi spo bpng trin Idm sdng (Slit-lamp) vd nhdn dp
Bdng 3. Hinh thdi sgo bpng trln Idm sdng vd OCT (mit)
sdng Phan loai spo
Typ' T'^Pl' Typ IV
<21 mmHg
Nhan dp mat nghtftn ci>u
T y i j
2 21 mmHg
"s5"
i l l I Ty 1$
TAng
"S5"
mk I Ty Id (Fisher's)
Kit qud bdng 1 eho thIy 94,1% mit spo typ 1 (16/17 mit) vd 100% m i t spo typ II (19/19 mit) c i NA <
21mmHg. Trong khi dd ty l i m i t d NA £ 21mmHg ehilm khd cao d nhdm spo dgng typ 111 (12/28 mit - 42.9%) vd typ IV (1/3 m i t - 33,3%) Sy khde biit v l m i i lidn quan giiia d c hinh thdi spo ndy vd NA ed y nghTa thing kd vdi p < 0,05. Hai hinh thdi spo typ I vd typ II Id nhirng spo d d i r e ndng thIm Ipe tit. Spo typ HI. typ IV Id nhO'ng hinh thdi spo d chac ndng thim Ipe kdm han vi vdy de gdy tinh trgng mit kilm sodt eua NA sau PT.
Nhgn (^nh ndy d a chung toi cQng tyang ty vdi k i t ludn cua tdc gia Kronfeld [4]
Bang 2. Lien quan giO'a hinh thdi spo bpng trin OCT yd nhdn dp
Trin Visante OCT trong nhdm NA < 21 mmHg, ty l | bpng t i a Ian vd bpng dgng nang d i l m 96,6% (28/29 mit) vd 84,6% (11/13 mit). eao han bpng dgng v6 bao (47,1%) vd bpng dgng dpt (75,0%). Ngype Igi trong nhdm NA £ 21 mmHg sgo dgng v6 bao vd spo dgng dgt chilm ty l i 52.9% (9/17 mit) vd 25% (2/8 mit), cao han so vdi ty l | spo dgng tda Ian (3.4%) vd dgng nang (15,4%%). M i i liin quan vd s y khde bi|t ndy d d y nghTa thing k i vdi p < 0,05 (Fisher's Exact Tost). Nhy vdy spo bpng tda Ian vd dgng nang thydng d NA < 21 mmHg vd Id d c spo bpng d chirc ndng thIm tit. Cdc sgo bpng dgng v i bao vd dgng dpt thi thudng d NA tren 21 mmHg vd Id d c spo bpng d chirc ndng thIm kdm han. K i t qua nghiin ciiu ciia chiing t i i cOng tyang ty ket qua nghiin ciru cua d c tdc gid khdc trin t h i gidi [7,8,10].
Phan logi theo ldm sdng (mk)
T y p I (Dgng nang) Typ II (Tod Ian)
Typ III (dgng det) T^p IV (vd bao)
Tdnq
Phdn logi theo OCT (mdt) T y p e
(dgng nang) 6 4 2 1 13
T y p D (tda Ian) 11 12 6 0 29
T J p E (vd bao)
0 2 13 2 17
T y p F (dgng dgt)
0 1 7 0 6
T6ng 17 19 28 3 67 K s c o r e ' 0 5; S p e a r m a n ' 0 6 Pearson Chi-Square: P<0 0 1 , Fisher's Exact Test. P<0 01
Hinh ttidi 5$0
Bgng toa Ian Bpng dgng
nanq Bpng dgng
vd bao Bpng dgng
T i n g
Nhan dp
<21 mmHq S i mic 28 11
e
6 53
T y l $ 96,6%
84,6%
4 7 , 1 % 75,0%
7 9 , 1 % a 21 mmHq
S i mat
1 2 g 2 14
T y l $ 3,4%
15,4
%
52,9 25.0
%
20.9
%
%
T i n g S l mat 29 13 17 6 67
T y l $ 100
%
100
%
100
%
100 100
%
%
P (Fisher's)
P<0 05
Bdng 3 cho thIy ed s y liin quan vd phii hpp giCra 2 ky thudt ddnh gid sgo bpng theo l i m sdng (Slit-lamp) va OCT. K i t qud ddnh gid spo bpng sau m i theo nhdm ehire ndng thIm t i t thi d e dgng spo bpng tda Ian (typ D) vd dgng nang (typ C) chilm ty l i cao trin mdyVisante OCT tyang u-ng ty l i cao d c typ I vd II trdn khdm d6n khe. Tuang ty nhy t h i d s y tyang i>ng vd phii hpp 6 nhdm spo chire ndng thIm kdm han, giO'a cde bpng dgng vd bao vd dgng dpt phdn logi theo OCT vd typ III vd IV phdn logi theo ISm sdng (Slit-lamp). M i l liin quan gi{ra 2 phyang phdp tdm sdng vd Visante OCT cd y nghTa thing k§ vdi p <0.01 ( d Pearson Chi-Square test vd Fisher's Exact test), Sy phii hpp d mirc tmng binh khd giO'a 2 phyang phdp ddnh gid spo bpng nay vdi du s i K = 0,5 vd chi s i Spearman = 0.6
Tuy nhiin n l u x i t d i tilt v l d u tnJc ndi tgi cua sgo tipng chiing t i i v3n thIy d sy khdc nhau gioa d c hinh thdt spo bpng theo phdn k)gi bing khdm den khe tr€n SHV vd OCT. Trong 17 m i t spo dgng nang tren khdm ddn khe thi d i d 6 m i t spo dgng nang (typ C) trdn OCT, d n 11 m i t d sgo dgng tda tan (typ D). Cung tyong tv nha vdy vdi d c hinh thdi khde. Chung tdi d o ring 66 ^ do d c h i thing phdn logi spo bpng dya theo dde dilm bin ngodi d a spo quan sdt dope bing khdm ddn khe trdn SHV hiin nay d a d c tdc gia Indiana (IBAGS) [2], Kronfeld [4] vd Moorfields (MBGS) [9], d i u h d n todn mang tinh d I t d i i quan, djnh tinh md khing bao hdm tinh djnh lypng. Kha ndng ddnh gid d u tnie nil tgi cua sgo tipng trgn mdy Visante OCT chinh xde han nhirng nhdn xdt quan sdt dyp'c bing d i n khe trin SHV nen khing phdi d c hinh thdi sgo bpng thIm phdn logi tren Visante OCT vd Idm sdng hodn todn giing nhau. Theo Singh M [6], d i i u ddy thdnh spo d i n h Id d i e u ddy lop KM-thypng CM, Id m i t t i i u d u l n vdng d l ddnh gid cli(rc ndng thim d a sgo bpng. Tinh trgng Idp KM-thypng CM ddy duvc d o Id phdn anh ciia ding thuy d j d day qua khoang KM-thypng CM {1]. Cdc spo bpng d mirc W dilu dfnh < 21 mmHg d l y cd thdnh spo ddy hode xuat hiin d c khe, IS d d i phdn dm thIp vdi d c hinh dgng khdc nhau n i m phia dydi KM. Ngyp'c Igi, da so d e seo bpng d mire NA khing diiu <^inh thydng bilu hiin c6 sy kit dinh giCra KM vd vgt CM, dO phan dm eao, thSnti sgo khing ddy vd d c khe ha nOi tgi spo bpng bj tac nghSn, Idp KM mdng, d b l day chi giing nhy KM mat binh thydng. Trin mdy visante OCT 6 cua bpng thIm U hiin b&I m i t viing giam phan quang rd r^t, n i m ngay
Y HOC THVC H A N H (810) - S 6 3/2013
dudi KM. O nhieu spo bpng dgng nang nlu quan sdt bing den khe thi d m nhdn nhy ehiing dnira dyng mit i Idn nam d bdn dudi Idp KM mdng. Nhyng trdn mdy Visante OCT thi Igi thay cdc spo bpng dgng nang ndy ed nhieu khoang giam phan quang khu tru ngay trong thdnh ciia spo bpng, vdi mpt 6 nhd d bin trong bpng, han Id hinh thanh mpt 6 duy nhlt d trung tam bpng Trong trudng hpp d c spo bpng ed chilu eao thIp <1mm, niu ehi quan sat bang den khe thi d l bj nh$n djnh nhIm Id cdc spo dgng dgt. Chung tdi cd dong quan diem vdi d c tac gia Mulier M [5], Singh M [6], Zhang Yi [10] ring ddnh gid sgo bpng sau mo bdng OCT cd nhieu au dilm vi de SLP dyng, khdng xam hgi, cho d i chinh xdc eao, ed t h i ddnh gid vd dya ra hinh anh cdc dde dilm khdc nhu chilu cao, dp day, va cac khoang dich ciia seo
,fe3r
Theo bang 1, bang 2 vd bieu do 1 giaa lam sdng va OCT d i u d sy tyang dyang ve ty Ip NA d cdc mire, trong do nhdm mit d NA < 21mmHg d i i m 79.1%
(53/67 mat) Ngupc lai, nhdm mat NA > 21 mmHg cd ty Ip thIp han, chilm 20.9% (14/67 mdt). Sy khdc biit ndy cd y nghTa thing ke vdi p < 0,05. Nhdn xet nay cua ehiing tdi cung phii hpp vdi k i t qua nghien eiru eua mpt so tac gia khde rang ca hai phuang phap tren deu cho phep ddnh gia sy hinh thdnh seo bpng vd tien lypng ve kha nang dilu chinh NA sau phdu thugt [3].
K^T LUAN
GiO'a 2 phyang phdp ddnh gid dgc dilm spo bpng theo Idm sdng (Slit-lamp) vd theo OCTcd mii liin quan vd phii hpp d mire trung binh khd. Hinh thai typ I vd II tren kham Idm sdng taang irng vd phii hpp vdi dgng spo bong tda Ian va dang nang tren OCT. Taang ty, typ III va IV trdn lam sang tuang ang vdi bpng dgng vd bao vd dgng dpt theo OCT. Ca hai phyang phap deu cho phep ddnh gid sy hinh thdnh sgo bpng va tien lypng v l
kha ndng diiu ehinh NA sau phiu thudt. Tuy nhien ddnh gid spo bpng thIm bang OCT e i nhieu yu diem han vi d l sy dyng, khing xdm hgi, eho s l do ehinh xac vd lau giir Igi hinh anh v l ede dde dilm eua spo bpng sau m l .
T A I LIEU THAM K H A O
1. Addicke EM, Quigley HA, Green WR, Robin AL (19S3), "Histologic charactersistic blebs in glaucomatuous eyes", Arch Ophthalmol 101, pp 795-798
2- Cantor LB, Mantravadi A, WuDunn D, Swamynathan K, Cortes A (2003). "Morphologic classification of flltenng blebs after glaucoma filtration surgery the Indiana Bleb Appearance Grading Scale", J Gfaucoma 12, pp 266-271.
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