原发性开角型青光眼与可疑青光眼患者后极部视网膜厚度分析的比较研究

目的 观察后极部视网膜厚度分析参数在原发性开角型青光眼与可疑青光眼患者间的差异。 方法 应用新型视网膜厚度分析仪对12例原发性开角型青光眼及11例可疑青光眼患者的后极部视网膜厚度进行了分析，对每一个球形指数进行了比较。 结果 中心凹形态偏差、中心凹校正厚度偏差、中心凹固视校正厚度偏差、中心凹中心厚度偏差、校正的中心凹中心厚度偏差、中心凹周围异常变薄区、后极部异常变薄区及后极部异常模式偏差在原发性开角型青光眼及可疑青光眼患者间差异有显著性的意义(P<0.05)。 结论 原发性开角型青光眼与可疑青光眼患者间存在后极部视网膜厚度形态参数的差异。 (中华眼底病杂志, 2002, 18: 113-115)     

光学相干断层扫描血管造影在翼状胬肉患者角膜厚度测量中的应用

目的　通过光学相干断层扫描血管造影（optical coherence tomography angiography，OCTA）技术检测翼状胬肉患者翼状胬肉周边角膜各区域厚度及上皮厚度的变化。方法　选取翼状胬肉女性患者（右眼，翼状胬肉组）和正常女性（右眼，正常组）各44人。用OCTA技术分别对翼状胬肉组和正常组角膜各区域全层厚度及上皮厚度进行测量。对角膜进行25分区，中央区（M2）为角膜中央2 mm区域，内环、中环、外环直径范围分别为距角膜中央5 mm、7 mm和9 mm。将角膜的内环、中环和外环的每个区域划分为下方(I)、颞下(IT)、颞侧(T)、颞上(ST)、上(S)、鼻上(SN)、鼻侧(N)以及鼻下(IN)8个方位。翼状胬肉组各区域(除翼状胬肉区域SN、N、IN区外)与正常组角膜对应区域全层厚度及上皮厚度进行两两比较。结果　翼状胬肉组角膜的上方（S5、S7、S9区），下方（I5、I7、I9区）角膜全层及上皮厚度均较正常组角膜厚（均为 P<0.05），中央区及其他区域角膜全层厚度差异均无统计学意义（均为P>0.05）。角膜的S5、S7、S9区为翼状胬肉组各环中角膜上皮所占角膜总厚度比例最大的区域，角膜的IT5、IT7、IT9区为所占比例最小的区域。IT5、T7、T9区为正常组各环角膜上皮所占角膜总厚度比例最大的区域，S5、S7、S9区为所占比例最小的区域。中央区（M2）角膜上皮占各角膜全层厚度的比例最大，从内到外逐渐下降。结论　OCTA技术可以发现翼状胬肉患者上下方角膜厚度和角膜上皮厚度明显增厚。     

Multimodal ocular evaluation in hemodialysis patients

International Ophthalmology - To evaluate choroidal thickness, intraocular pressure (IOP), axial length, central corneal thickness (CCT), lens thickness, anterior chamber depth, and ocular pulse...     

Early detection of thinning of retinal nerve fiber layer in glaucomatous eyes by optical coherence tomography 3000: analysis of retinal nerve fiber layer corresponding to the preserved hemivisual field

The retinal nerve fiber layer (RNFL) thickness was measured with the optical coherence tomography using version 3.0 software (OCT3000) in 153 eyes of 153 normal subjects. The mean of the average RNFL thickness over the entire 360 degrees in the control group was 92.5 +/- 12.9 microm which was significantly thinner than the normative data of 95.9 +/- 11.4 microm included with the OCT3000 (p < 0.01). The RNFL thickness decreased with increasing age (p < 0.01, r = -0.395). The RNFL thickness was also measured in 53 eyes of 53 patients with glaucoma whose superior (13 eyes) or inferior (40 eyes) perimetric hemifields were normal. Only the RNFL thickness corresponding to the preserved perimetric hemifields were measured by OCT3000 and scanning laser ophthalmoscopy (SLO). The RNFL thickness in the superior and inferior 30 degrees sectors, the maximum and average RNFL thickness in the superior (S(max) and S(avg)), and inferior quadrants (I(max) and I(avg)) were analyzed.The S(max), S(avg), I(max), I(avg), and the RNFL thickness in the superior (p < 0.05), superotemporal and inferotemporal sectors (p < 0.01) in the glaucoma patients without a nerve fiber layer defect (SLO) were significantly thinner than in the control subjects in same age. OCT3000 measurements showed that the RNFL thickness in glaucomatous eyes with normal perimetric visual fields and SLO was significantly thinner than the RNFL thickness in normal eyes.     

睡眠呼吸障碍患者黄斑区神经节细胞复合体厚度研究

目的:比较不同程度睡眠呼吸障碍患者黄斑区神经节细胞复合体(GCC)的厚度变化。方法:采用横断面研究,收集2015-06/2018-06间于我校附属医院诊断为阻塞性睡眠呼吸障碍综合征的患者和健康体检者,将呼吸暂停低通气指数(AHI)≥5的58例患者纳入睡眠呼吸障碍组,根据AHI值将其分为轻、中、重度三个亚组,将AHI<5的50例健康体检者纳入对照组。采用RTVUE 100-2型相干光断层扫描检查仪对黄斑区视网膜进行扫描,测量黄斑区GCC总体平均厚度(GCC-Avg)、上方平均厚度(GCC-Sup)、下方平均厚度(GCC-Inf)、局部丢失容积(FLV)与整体丢失容积(GLV)。分析比较各组间GCC厚度的差异。结果:不同程度睡眠呼吸障碍组各区GCC厚度均较对照组变薄(P<0.05),但FLV和GLV均较对照组增加(P<0.05),不同程度睡眠呼吸障碍组组间FLV比较无差异(P>0.05),不同程度睡眠呼吸障碍组组间GLV比较有差异(P<0.05)。结论:随着睡眠呼吸障碍程度的加重黄斑区GCC厚度变薄。     

Influence of birth parameters on peripapillary nerve fiber layer and macular thickness in six-year-old children

PURPOSE: To examine influences of gestational age and birth parameters on peripapillary nerve fiber layer (NFL) and macular thickness at age six. DESIGN: Cross-sectional study. METHODS: The Sydney Childhood Eye Study examined a random-cluster sample of 1765 six-year-old Sydney school children. Peripapillary NFL and macular thickness were measured (StratusOCT, Zeiss, Dublin, California, USA). Birth parameters were extracted from health records. Multivariate analyses were performed. RESULTS: Higher birth weight children had greater peripapillary NFL, inner and outer (all P(trend) < 0.03), but not central or average macular thickness (both P(trend) > 0.1). Peripapillary NFL (P(trend) = 0.001), inner (P(trend) = 0.01), outer (P(trend) = 0.002), and average macular thickness (P(trend) = 0.02), but not central macular thickness (P(trend) = 0.5) was greater in children with larger head circumference at birth. The central macula was thicker in prematurely (<37 weeks) born children (195.0 microm) than those born at term (191.2 microm), P = 0.04. CONCLUSION: Birth weight and head circumference predicted peripapillary NFL and macular thickness. Prematurity was weakly associated with central macular thickness.     

三岁龄恒河猴眼球生物学参数研究

目的通过对3岁龄恒河猴的角膜、视网膜、屈光参数、眼压（IOP）、视觉电生理5个方面的眼球参数进行测量,获取该年龄段恒河猴眼球相关参数值。方法描述性研究。选择3岁龄恒河猴8只作为实验对象。使用回弹氏眼压计、带状光检影镜、A型超声测厚仪、光学相干断层扫描（OCT）、视觉电生理仪检测猴眼IOP、等效球镜度（SE）、前房深度（ACD）、晶状体厚度（LT）、玻璃体腔长度（VCD）、眼轴长度（AL）、中央角膜厚度（CCT）、视网膜厚度、脉络膜厚度（黄斑中心小凹处以及距黄斑中心小凹鼻、颞侧各500、1 000、1 500 µm处）、闪光视网膜电图（f-ERG）的生物学参数。对所有眼部参数左右眼的比较采用配对t检验,黄斑中心小凹处与鼻、颞侧各部位脉络膜厚度的比较采用重复测量资料的方差分析。结果3岁龄恒河猴的IOP为（16.9±3.1）mmHg,SE为（+0.6±1.0）D,ACD为（3.4±0.4）mm,LT为（3.8±0.2）mm,VCD为（12.3±0.5）mm,AL为（19.5±0.6）mm,CCT为（537.6±50.8）µm,黄斑中心小凹处视网膜平均厚度为（206.8±16.0）µm,黄斑中心小凹处脉络膜平均厚度为（186.6±17.2）µm,脉络膜各部位厚度差异具有统计学意义（F=10.966,P＜0.001）,进一步进行Bonferroni检验,黄斑中心小凹处脉络膜厚度与鼻、颞侧各部位脉络膜厚度比较差异具有统计学意义（P＜0.05）。暗适应视杆细胞反应b波振幅（170.3±41.7）µV,暗适应最大混合反应a波振幅（195.4±37.4）µV、b波振幅（373.0±70.1）µV,明适应视锥细胞反应a波振幅（26.1±6.6）µV、b波振幅（105.4±35.7）µV。左右眼各生物学参数差异均无统计学意义。结论本研究获取了完整可靠的3岁龄恒河猴眼部生物学参数,为恒河猴眼部疾病模型的制作奠定基础。     

Can optical coherence tomography predict the outcome of laser photocoagulation for diabetic macular edema?

BACKGROUND AND OBJECTIVE: To assess the outcome of laser photocoagulation in patients with diabetic macular edema. PATIENTS AND METHODS: Forty-seven patients (51 eyes) with clinically significant macular edema (CSME) undergoing grid laser photocoagulation were included. Clinical examination and optical coherence tomography (OCT) were performed at baseline and 3 to 4 months after treatment. The central foveal thickness, mean inner macular thickness (average retinal thickness in fovea and inner macular circle), and mean macular thickness were calculated. Based on the greatest OCT thickness at baseline, patients were grouped according to mild (< 300 microm; Group 1), moderate (300 to 399 microm; Group 2), and severe (> or = 400 microm; Group 3) macular edema. RESULTS: Group 2 showed significant reductions in central foveal thickness (23 microm, P = .02), mean inner macular thickness (18 microm, P = .02), and mean macular thickness (9 microm, P = .04) with slight improvement in visual acuity. Groups 1 and 3 did not show any significant change in macular thickness values and there was a statistically insignificant worsening of visual acuity in these groups. CONCLUSIONS: Patients with moderate macular thickening of 300 to 400 microm benefit most from laser treatment. OCT may help in choosing the appropriate treatment for CSME based on the degree of macular thickening. Long-term studies are warranted to confirm these findings.     

OCT快速和重复扫描法在青光眼诊断中的可重复性研究

目的：评价应用光学相干断层成像术(OCT)快速和重复法测量视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度在诊断青光眼中的可重复性意义。

方法：应用Stratus OCT测量38例正常人和42例原发性开角型青光眼患者的RNFL厚度,分别应用快速和重复扫描两种方案来测量正常人和原发性开角型青光眼患者RNFL厚度,通过统计各组视盘区域中颞区、上区、下区和鼻区共四个象限的总体平均RNFL厚度的组内相关系数和变异性系数来进行重复性评估。

结果：在正常人和原发性开角型青光眼患者中,总体平均RNFL厚度和颞侧、上方、鼻侧、下方RNFL厚度,两组均未显示出差异; 而重复扫描方案较之快速扫描在视盘周围测出的平均RNFL厚度具有更高的ICC和更低的CV值,在颞区存在统计学差异(P=0.042),在颞区、鼻区、上区和下区中得出的RNFL厚度的ICC(CV值)如下：快速扫描分别为0.918(7.2%),0.831(6.82%),0.856(5.12%),0.911(7.19%); 而重复扫描的分别为0.927(3.21%),0.962(5.01%),0.909(6.02)%,0.869(4.67%),0.918(6.89%)。

结论：OCT测量RNFL厚度中应用快速和重复扫描在正常人和原发性开角型青光眼中均具有可重复性的价值,而重复扫描方案在评估RNFL厚度方面更为精确。     

【In Press】 Correlation between macular ganglion cell-inner plexiform layer thickness and visual acuity after resolution of the macular edema secondary to central retinal vein occlusion

AIM: To investigate the thickness of the ganglion cell-inner plexiform layer (GCIPL) in eyes with resolved macular edema (ME) in non-ischemic central retinal vein occlusion (CRVO), using spectral-domain optical coherence tomography (SD-OCT), and its relationship with visual acuity. METHODS: The retrospective observational case-control study included 30 eyes of non-ischemic CRVO patients with resolved ME (ME eyes) after treatment, and 30 eyes of non-ischemic CRVO patients without ME (non-ME eyes). The macular GCIPL thickness, peripapillary retinal nerve fiber layer (pRNFL) thickness and central macular thickness (CMT) were measured on a SD-OCT scan. Linear regression analyses were performed to determine the correlation between the thickness of each and the visual acuity (VA). RESULTS: No significant difference in average GCIPL thickness, mean pRNFL thickness and CMT was observed between ME group and non-ME group (P=0.296, 0.183, 0.846). But, minimum GCIPL thickness was reduced in ME eyes compared with non-ME eyes (P=0.022). Final VA significantly correlated with the minimum GCIPL thickness in ME eyes (r=-0.482, P=0.007), whereas no correlation was found with average GCIPL thickness, average pRNFL thickness and mean CMT. CONCLUSION: Minimum GCIPL thickness is reduced in ME eyes compared with non-ME eyes, and correlated with the VA in non-ischemic CRVO. These results suggest that inner retinal damage occurring in patients with ME secondary to non-ischemic CRVO may lead to permanent visual defect after treatment.     

Correlation between macular ganglion cell-inner plexiform layer thickness and visual acuity after resolution of the macular edema secondary to central retinal vein occlusion

AIM: To examine the thickness of the ganglion cell-inner plexiform layer (GCIPL) in eyes with resolved macular edema (ME) in non-ischemic central retinal vein occlusion (CRVO), applying spectral-domain optical coherence tomography (SD-OCT), and its relationship with visual acuity. METHODS: The retrospective observational case-control study included 30 eyes of non-ischemic CRVO patients with resolved ME (ME eyes) after treatment, and 30 eyes of non-ischemic CRVO patients without ME (non-ME eyes). The macular GCIPL thickness, peripapillary retinal nerve fiber layer (pRNFL) thickness and central macular thickness (CMT) were measured on a SD-OCT scan. Linear regression analyses were performed to determine the correlation between the thickness of each and the visual acuity (VA). RESULTS: No significant difference in average GCIPL thickness, mean pRNFL thickness and CMT were observed between ME group and non-ME group (P=0.296, 0.183, 0.846). But, minimum GCIPL thickness was reduced in ME eyes compared with non-ME eyes (P=0.022). Final VA significantly correlated with the minimum GCIPL thickness in ME eyes (r=-0.482, P=0.007), whereas no correlation was found with average GCIPL thickness, average pRNFL thickness and mean CMT. CONCLUSION: Minimum GCIPL thickness is reduced in ME eyes compared with non-ME eyes, and correlated with the VA in non-ischemic CRVO. These results propose that inner retinal damage occurring in patients with ME secondary to non-ischemic CRVO may lead to permanent visual defect after treatment.     

不同的降血糖治疗方案对无眼底并发症的糖尿病患者黄斑部视网膜厚度的影响

目的：观察不同的降血糖治疗方案对于无眼底并发症的糖尿病患者的黄斑部视网膜厚度的影响。方法：通过频域光相干断层扫描仪检测患者的黄斑部视网膜的厚度,以黄斑为中心进行容积扫描,生成1、3、6 mm三个环九个区域的平均厚度数据,并进行统计学分析。结果：研究纳入健康对照组、口服降血糖药物组、胰岛素治疗组三组患者,各组均为22例22眼。健康对照组黄斑区各环视网膜厚度分别为：第1环268．09±17．97μm,第2环340．41±22．25μm,第3环298．14±12．90μm。口服降血糖药物治疗组黄斑区各环视网膜厚度分别为：第1环260．00±18．17μm,第2环335．44±21．12μm,第3环295．63±15.92μm。胰岛素治疗组黄斑区各环视网膜厚度分别为：第1环271．01±26．09μm,第2环340．86±17．10μm,第3环298．57±12．14μm。三组黄斑区第1环视网膜厚度的差异无统计学意义（F＝1．21,P＝0．31）,第2环的差异无统计学意义（F＝0．35,P＝0．71）,第3环的差异亦无统计学意义（F＝0．22,P＝0．81）。结论：与健康者相比,口服降糖药物和胰岛素治疗均未改变无眼底并发症的糖尿病患者的黄斑区视网膜厚度。     

In-vitro comparison of morphology of current microkeratomes for LASIK

BACKGROUND: We have performed an in-vitro examination of the morphology of flap thickness and stromal bed after LASIK in porcine eyes. MATERIALS AND METHODS: Freshly enucleated porcine eyes and synthetic eye models were used for cutting flaps with the microkeratomes Hansatome-Excellus (Bausch&Lomb), M2 single use (Moria), Amadeus (AMO), MK-2000 (Nidek) and Carriazo-Pendular (Schwind). The flap thickness of porcine eyes was determined using a non-contact, confocal optical distance measuring device (CHR 150N, Jurca), in the eye models a mechanical thickness measuring device (K?fler) was used. The morphology of the stromal bed was examined by photography, histology, scanning electron microscopy and confocal optical distance measurements. RESULTS: The optical/mechanical flap thickness measurements showed an average difference compared to the adjusted thickness of - 3/+ 90 microm (Hansatome-Excellus), + 7/+ 100 microm (M2 single use), - 35/+ 40 microm (Amadeus), - 4/+ 80 microm (MK-2000) and + 11/+ 0 microm (Carriazo-Pendular). Histology showed no mechanical damage and smooth, slightly undulating surfaces with all microkeratomes. In the scanning electron microscopic examination, the stromal surface was found to be homogeneous and smooth for all of the microkeratomes. Average roughness of the ablation surface was 0.27 microm (Hansatome-Excellus), 0.23 microm (M2 single use), 0.21 microm (Amadeus), 0.23 microm (MK-2000) and 0.29 microm (Carriazo-Pendular). CONCLUSION: The stromal bed showed in all cases only a slightly roughness, which seems to be acceptable for the clinical outcome. However, the more critical point is the large variations in flap thickness compared to the intended thickness.     

23G玻璃体切除术治疗特发性黄斑前膜后视力与黄斑区结构变化的关系

目的 评估23G玻璃体切除联合黄斑前膜剥离术治疗特发性黄斑前膜后视力与黄斑区结构变化的关系。设计 回顾性病例系列。研究对象 2015年至2017年在武汉大学人民医院接受23G玻璃体切除联合黄斑前膜剥离的特发性黄斑前膜患者78例（82眼）。方法 根据患者术前OCT的黄斑形态，分为以下四组：中心凹结构基本正常组（24眼）、黄斑区弥漫性水肿组（39眼）、黄斑区囊样水肿组（9眼）、黄斑裂孔组（10眼）。观察并记录患者的临床特征、手术方式，手术前、术后7天的最佳矫正视力（LogMar）、黄斑区中心凹厚度、旁中心凹区厚度、中心凹周厚度及术后并发症。并随防至术后1个月。主要指标 最佳矫正视力、黄斑区中心凹厚度、旁中心凹区厚度、中心凹周厚度。结果 特发性黄斑前膜患者在行玻璃体切除手术后7天，最佳矫正视力由术前0.26±0.16提高到0.36±0.16（P=0.000），黄斑区中心凹厚度由术前（506.41±112.67）μm降低到（442.39±82.10）μm（P=0.000），旁中心凹厚度由术前（453.66±79.36）μm 恢复至（409.95±61.63）μm（P=0.000），中心凹周厚度从（365.93±50.84）μm降低至（356.76±54.20）μm（P=0.092）；四组患者术后的最佳矫正视力均明显提高（P均<0.05），其中中心凹结构基本正常组患者术后视力的提高较其它组更佳（F=3.118, P=0.031）。与术后7天相比，术后1个月的黄斑区厚度降低，但视力变化不显著。术后BCVA与术前BCVA（r=0.850，P=0.000）、术前中心凹厚度（r=0.7386，P=0.000）、旁中心凹区厚度（r=0.811，P=0.000）、中心凹周厚度（r=0.799，P=0.000）均呈正相关；与术后中心凹厚度（r＝-0.335，P＝0.035）、旁中心凹区（r＝-0.376，P＝0.017）具有明显相关性，但与中心凹周厚度（r＝-0.310，P＝0.052）无明显相关性。结论 23G玻璃体切除手术剥除黄斑前膜可显著提高患者的视功能，同时改善黄斑区结构。术后中心凹厚度变化与视力恢复程度有关，且术后1周的变化即可决定预后；术前黄斑结构正常者视力预后较好。     

糖尿病患者短期内血糖变化对黄斑区视网膜厚度的影响

目的 探讨糖尿病患者短时间内血糖下降对黄斑区视网膜厚度的影响.方法 35例血糖控制不良的糖尿病患者纳入研究.受试者入院后第2天清晨即测量空腹血糖,同时行光学相干断层扫描(opticalcoherence tomography,OCT)检查获得黄斑区视网膜厚度后,予胰岛素注射降血糖治疗第2天清晨测量空腹血糖后,再行OCT检查获得黄斑区视网膜厚度.将视网膜厚度变化情况与血糖变化情况进行pearson相关分析.结果 患者治疗前血糖(168.2±31.6)mg·dL-1、黄斑中心凹厚度(237.95±24.20)μm、黄斑部体积(10.17±0.60)mm3、黄斑凹厚度(282.41±16.43)μm.降血糖治疗后患者血糖(117.0±21.2)mg·dL-1、黄斑中心区厚度(238.86±22.41)μm、黄斑部体积(10.17±0.63)mm3、黄斑区厚度(282.32±17.65)μm.治疗前后血糖变化差异显著,差异有统计学意义(P＜0.05);而黄斑区视网膜厚度的变化差异均无统计学意义(均为P＞0.05).短时间内血糖变化与黄斑区视网膜厚度变化无显著相关(P＞0.05).结论 短期内血糖降低不会对黄斑区视网膜厚度产生影响.     

Evaluation of spectral domain optical coherence tomography parameters in discriminating preperimetric glaucoma from high myopia

AIM: To evaluate the diagnostic ability of macular ganglion cell-inner plexiform layer (GCIPL) thickness obtained by spectral-domain optical coherence tomography (SD-OCT) in discriminating non-highly myopic eyes with preperimetric glaucoma (PPG) from highly myopic healthy eyes. METHODS: A total of 254 eyes, including 76 normal controls (NC), 116 eyes with high myopia (HM) and 62 non-highly myopic eyes with PPG were enrolled. The diagnostic ability of OCT parameters was accessed by the areas under the receiver operating characteristic (AUROC) curve in two distinguishing groups: PPG eyes with non-glaucomatous eyes including NC and HM (Group 1), and PPG eyes with HM eyes (Group 2). Differences in diagnostic performance between GCIPL and RNFL parameters were evaluated. RESULTS: The minimum (AUROC curve of 0.782), inferotemporal (0.758) and inferior (0.705) GCIPL thickness were the top three GCIPL parameters in discriminating PPG from non-glaucomatous eyes, all of which had statistically significant lower diagnostic ability than average RNFL thickness (0.847). In discriminating PPG from HM, the best GCIPL parameter was minimum (0.689), statistically significant lower in diagnostic ability than average RNFL thickness (0.789) and three other RNFL thickness parameters of temporal and inferotemporal clock-hour sectors. CONCLUSION: The minimum GCIPL thickness is the best GCIPL parameter to detect non-highly myopic PPG from highly myopic eyes, whose diagnostic ability is inferior to that of average RNFL thickness and RNFL thickness of several temporal and inferotemporal clock-hour sectors. The average RNFL thickness is recommended for discriminating PPG from highly myopic healthy eyes in current clinical practice in a Chinese population.     

不同程度近视眼黄斑区OCT的观察

目的了解不同程度近视眼黄斑区各区域视网膜厚度及其变化特征。方法收集我院屈光门诊18～32岁的近视患者68例(101眼),受试者分为中低度近视组23例(40眼)、高度近视组24例(40眼)、正常对照组正视眼21例(21眼)。分别进行Zeiss-Humphrey光学相干断层成像仪(Cirrus Hd-OCT4000)测量,对被检眼的黄斑区进行OCT快速扫描,将黄斑区分为9个区域:中心凹区(A1)、上方内圈(A2)、颞侧内圈(A3)、下方内圈(A4)、鼻侧内圈(A5)、上方外圈(A6)、颞侧外圈(A7)、下方外圈(A8)、鼻侧外圈(A9),分别测定各区域的视网膜厚度,再比较三组之间的差别。结果 A1、A5区视网膜厚度在三组之间差异均无统计学意义(均为P>0.05);A2、A3区视网膜厚度正常对照组[(322.48±18.90)μm、(306.43±14.98)μm]、中低度近视组[(320.80±15.67)μm、(305.50±15.71)μm]分别与高度近视组[(311.98±16.14)μm、(296.85±18.32)μm]之间比较,差异均有统计学意义(均为P<0.05);正常对照组、中低度近视组A4、A6、A7、A8、A9区视网膜厚度分别与高度近视组之间比较差异均有显著统计学意义(均为P<0.01)。正常对照组与中低度近视组各值差异均无统计学意义(均为P>0.05)。结论黄斑区域视网膜厚度分布存在区域特异性,随屈光度的增加出现区域选择性变薄,高度近视眼的视网膜变薄是确实存在的,主要在旁中心凹区。     

早期糖尿病患者黄斑区厚度与相关生化指标的关系

目的：研究早期糖尿病患者黄斑区视网膜厚度与相关生化指标的关系。 方法：糖尿病组40例40眼（男、女各20例）,对照组40例40眼（男、女各20例）,应用OCT测量黄斑区视网膜厚度,应用相关生化仪检测糖尿病组的尿微量白蛋白(mAlb)、糖化血红蛋白比(HbA1c)、C-肽(C-PR)、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）的值。比较两组黄斑区视网膜的厚度,分析糖尿病组黄斑区厚度与相关生化指标的关系。 结果：糖尿病组所选患者黄斑区厚度比正常组大（P＜001),黄斑区视网膜厚度与尿微量白蛋白(mAlb)、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL）呈正相关（P＜0.05);与高密度脂蛋白（HDL）呈负相关（P＜005);与糖化血红蛋白比(HbA1c)和C-肽(C-PR)无相关性（P＞0.05)。 结论：对于早期糖尿病患者,检测黄斑区厚度和尿微量白蛋白(mAlb)、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）的变化,有利于糖尿病早期并发症的预测。     

Diurnal variation of retina thickness measured with time domain and spectral domain optical coherence tomography in healthy subjects

PURPOSE. To investigate diurnal variations in macular thickness and total macular volume using time domain optical coherence tomography (TD-OCT) and spectral domain OCT (SD-OCT) in healthy subjects. METHODS. Data were derived from 52 eyes of 52 healthy subjects. Macular thickness, macular volume was measured by using TD-OCT and SD-OCT at 8 AM and 6 PM. RESULTS. Comparing TD-OCT measurements, retinal thickness was significantly greater in the afternoon than in the morning in 3 of 9 grid subfields: central macular thickness (CMT) (194 vs. 190 μm; P = 0.006), superior inner area (276 vs. 273 μm; P = 0.010), and temporal inner area (261 vs. 258 μm; P = 0.006). In SD-OCT measurements, CMT, pericentral macular thickness, and macular volume did not differ significantly between the morning and the afternoon. Comparing the absolute variation in the parameters measured by the two devices, central macular thickness and temporal inner area thickness differed significantly (P = 0.015, P = 0.029), whereas other area thicknesses and macular volumes did not. Comparing the relative variation of the two devices, CMT and temporal inner area thickness differed significantly (P = 0.014, P = 0.027), whereas other area thicknesses and macular volume showed no significant difference. The moduli of variations for CMT, macular volume, and pericentral macular thickness were significantly lower using SD-OCT than using TD-OCT. CONCLUSIONS. The diurnal variation of the TD-OCT measurements was likely due to the limited repeatability of the device rather than to tissue variation. Diurnal variation was not found using SD-OCT, which has better repeatability.     

Optic nerve compression: the role of the lamina cribrosa and translaminar pressure

AIM: To describe the morphological changes of the lamina cribrosa (LC) in patients with optic nerve compression. METHODS: Cross-sectional study. Twenty eyes with optic nerve compression, affected by Graves'' ophthalmopathy (GO) were compared with 18 refractive error-matched healthy eyes. The following examinations were performed: best-corrected visual acuity (BCVA), intraocular pressure, optic nerve echography, visual field, SD-OCT including the retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), and LC thickness and extent. RESULTS: A-scan revealed significant differences in the subarachnoid space (SAS) between the affected and control groups. LC thickness and LC area were 233 µm (SD 23) and 0.41 mm2 (SD 0.19), respectively. Average GCC thickness (P=0.0005), LC thickness (P=0.001), MD (P=0.001) and PSD (P=0.001) differed significantly between the two groups; whereas LC area (P=0.2) and average RFNL (P=0.1) did not. CONCLUSION: Optic nerve compression reduces the SAS thereby altering the morphology of LC thickness and causing GCC damage.