青光眼视网膜神经纤维层厚度变化及其与视野缺损的相关性

目的　利用光学相干断层扫描（ｏｐｔｉｃａｌｃｏｈｅｒｅｎｃｅｔｏｍｏｇｒａｐｈｙ,ＯＣＴ）检测早期原发性开角型青光眼和可疑青光眼患者视网膜神经纤维层（ｒｅｔｉｎａｌｎｅｒｖｅｆｉｂｅｒｌａｙｅｒ,ＲＮＦＬ）厚度的变化,并分析其与视野缺损的相关性。方法　收集来我院就诊的可疑青光眼患者３５例（６３眼）为Ａ组,早期原发性开角型青光眼患者４１例（７２眼）为Ｂ组,对照组３４例（６６眼）为Ｃ组,采用ＯＣＴ仪和Ｈｕｍｐｈｒｅｙ７４０ｉ全自动视野计分别对３组受检者进行视盘周围ＲＮ-ＦＬ厚度和视野检测,比较３组患者的ＲＮＦＬ厚度,分析青光眼组ＲＮＦＬ厚度与视野缺损间的关系。结果　Ａ组的上方、下方象限及平均ＲＮＦＬ厚度与Ｃ组对应象限比较,差异均有统计学意义（均为Ｐ＜０．０５）;Ｂ组与Ｃ组比较平均及各象限ＲＮＦＬ厚度差异均有统计学意义（均为Ｐ＜０．０５）;Ａ组与Ｂ组比较上方、下方、鼻侧象限及平均ＲＮＦＬ厚度差异均有统计学意义（均为Ｐ＜０．０５）。三组受检者各象限及全周视野缺损两两比较,差异均有统计学意义（均为Ｐ＜０．０５）。Ｂ组平均及各象限ＲＮＦＬ厚度与视野缺损程度均呈负相关（均为Ｐ＜０．０５）。结论　青光眼患者ＲＮＦＬ厚度变薄,并且与视野缺损程度呈负相关。     

Pattern of retinal nerve fiber layer damage in Korean eyes with normal-tension glaucoma and hemifield visual field defect

PURPOSE: To evaluate quantitatively the pattern of retinal nerve fiber layer (RNFL) damage in eyes with normal-tension glaucoma (NTG) with hemifield dominant visual field defects using scanning laser polarimetry. METHODS: Prospectively, 40 consecutive eyes from 40 patients with NTG and hemifield defect based on the findings of examination using the Humphrey Field Analyzer underwent RNFL thickness measurements. Twenty normal eyes from 20 subjects matched in age and refractive error formed a control group. RESULTS: Symmetry, calculated as the ratio of superior to inferior RNFL thickness, showed no statistically significant difference between the study group and the control group ( P=0.50). Overall, 27.5% (11/40 eyes) showed an "abnormal" symmetry index that indicated focal RNFL change. The affected ratio, calculated as the ratio of RNFL thickness in the quadrant corresponding to the hemifield of visual field defect to that of the temporal quadrant was significantly lower in the study group than in the control group ( P<0.0001). A similar finding was noted for the unaffected ratio. CONCLUSION: Despite strict selection of the eyes with visual field defect confined to one hemifield, a mixture of both focal and diffuse RNFL damage was noted, with a common occurrence of symmetrical RNFL thinning in both upper and lower quadrants based on scanning laser polarimetry.     

Optical coherence tomography measurement of retinal nerve fiber layer after acute primary angle closure with normal visual field

PURPOSE: To detect retinal nerve fiber layer (RNFL) thickness after a single acute primary angle closure (APAC) attack with normal visual field. DESIGN: Prospective, observational case study. METHODS: Twenty-eight patients who had a single unilateral APAC attack associated with normal visual fields at three months after remission and 28 single eyes from normal controls were enrolled. Duration of APAC attack was 5.9 +/- 2.7 hours. Comparisons of average RNFL thickness and RNFL thickness in four quadrants and in 12-o'clock-hour segments of the attacked eyes, unaffected fellow eyes, and normal controls were made using fast RNFL thickness (3.4) of Stratus optical coherence tomography. RESULTS: Significant differences were demonstrated comparing the inferior-quadrant RNFL thicknesses for the attacked eyes with those of the normal controls (P = .02) and fellow eyes (P = .02) using one-way analysis of variance with Tukey's tests. CONCLUSIONS: Inferior region RNFL thickness was significantly decreased in the attacked eyes after an APAC episode associated with normal visual field.     

Retinal nerve fiber layer measures in high- and normal-tension glaucoma.

PURPOSE: To use optical coherence tomography (OCT) to investigate the qualitative and quantitative differences in the defects of the retinal nerve fiber layer (RNFL) in subjects with high tension primary open angle glaucoma and subjects with normal tension glaucoma. METHODS: RNFL was assessed with OCT in 21 eyes with high-tension glaucoma (HTG) and 20 eyes with normal-tension glaucoma (NTG). Regression analyses were performed to investigate the interaction of disease group and location for localized RNFL loss, and to predict diffuse and localized RNFL loss as a function of age, mean defect, spherical equivalent, disease group, and location. Local RNFL thicknesses for superior clock-hour regions were estimated after adjustment for the thicknesses of symmetrically opposed locations. RESULTS: There were no differences in mean age, visual field defect mean deviation, and refractive error between subjects in HTG and NTG groups. Diffuse RNFL thickness was not significantly different between the two groups [mean RNFL for NTG > HTG by 3.48 mum, 95% confidence interval (CI) -3.9 to 10.9 microm, p = 0.092]. There was no significant interaction of group and location for localized RNFL loss (p = 0.916). Local RNFL thickness at superior regions was not significantly different in the two groups, after adjustment for RNFL thickness at corresponding inferior locations (mean RNFL for NTG > HTG by 6.30 microm, 95% CI -1.08 to 13.7 microm, p = 0.34). RNFL thickness decreased, on average (1.88 microm/dB mean deviation, 95% CI 1.21 to 2.55 microm, p < 0.0001) and locally (1.37 microm/dB mean deviation, 95% CI 0.79 to 1.96 microm, p < 0.0001), with increasing severity of glaucoma. CONCLUSION: There is no difference in the spatial pattern of RNFL defects, as assessed by the OCT, between HTG and NTG.     

Retinal nerve fibre layer of perimetrically unaffected eyes of glaucoma patients: an optical coherence tomography study

Purpose:  The aim of this study is to evaluate whether optical coherence tomography (StratusOCT) may detect early changes in perimetrically unaffected (PU) fellow eyes of glaucomatous patients by assessing retinal nerve fibre layer (RNFL) thickness parameters.
Methods:  Thirty-seven glaucomatous patients with unilateral field loss and 34 age-matched controls were recruited. In glaucoma patients, PU and perimetrically affected fellow eyes were analysed separately. For each group, mean values (±SD) of RNFL thickness parameters were calculated and comparisons between fellow eyes of glaucoma patients and between healthy and PU eyes of glaucoma patients conducted with paired t -test and Mann–Whitney U -test, respectively. Proportion of clock-hour sectors flagged with probability <5% or <1% was collected and differences between healthy and PU eyes were evaluated on Fisher exact test.
Results:  Global (Average Thickness) and sectoral parameters (Inferior and Nasal Average), Maximum thickness–minimum thickness (Max-min), as well as 2-o'clock (nasal side) and 6-o'clock sectors resulted significantly thinner in PU eyes than in control group. Proportion of eyes with clock-hour position flagged with probability <5% or <1% was not significantly different between healthy and PU eyes.
Conclusion:  Despite a standard automated perimetry within normal limits, the StratusOCT detected both localized and diffuse RNFL thinning in PU eyes of glaucoma patients. These eyes should be considered at risk of developing functional damage over time and consequently require thorough monitoring for detecting any sign of progression.     

维吾尔族青光眼OCT3检测RNFL厚度与视野缺损的相关性研究

目的:研究OCT3检测青光眼视网膜神经纤维层厚度与Humphrey750型视野计检测视野缺损的相关性。方法:维吾尔族青光眼47例79眼,汉族青光眼对照组21例38眼,维吾尔族正常对照组15例30眼,分别对各组进行OCT3和视野检测,比较各组指标差异,并进行视网膜神经纤维层厚度与视野相关性分析以及维族青光眼组分层分析。结果:维族青光眼组与维族正常组间的比较结果为两组的OCT1∶00,11∶00及上象限、全自动视野的MD和PSD差异具有极显著性(P<0.01),OCT6∶00,7∶00,12∶00和下象限差异具有显著性(P<0.05),维族青光眼组与汉族青光眼组间的OCT参数差异没有显著性。维族青光眼组OCT指标与视野指标相关且随着青光眼分期相关性加强。结论:OCT在青光眼的诊断中有较好的诊断价值,OCT在青光眼的视网膜神经纤维层厚度检测与视野相关,OCT检测能够验证视野的检测,为青光眼的诊断提供了量化标准。     

OCT检测视网膜神经纤维层厚度及视盘参数在青光眼早期诊断应用

目的 通过光学相干断层成像术(OCT)检测视网膜神经纤维层(RNFL)厚度及视盘结构参数,结合视野改变,探讨OCT在青光眼早期诊断中的应用价值.方法 采用OCT对34只眼疑似闭角型青光眼(SG)患者、36只眼慢性闭角型青光眼(CACG)早中期患者、10只眼正常人行RNFL及视盘扫描,观察各组的RNFL厚度及视盘结构的图像特征;将各象限RNFL厚度和平均RNFL厚度的均数进行总体比较及任意两组间比较;将视乳头水平、垂直杯盘比及杯/盘面积比的均数进行比较;将平均RNFL厚度与视野指数进行相关分析.结果 三组间各象限RNFL厚度、平均RNFL厚度、视盘参数差异有统计学意义(P<0.05);正常人与SG组下方、上方及平均RNFL厚度差异有统计学意义(P<0.05);正常人与CACG早中期组各象限RNFL厚度及平均RNFL厚度差异均有统计学意义(P<0.05);CACG早中期组与SG组上方、下方、鼻侧及平均RNFL厚度差异有统计学意义(P相似文献   

薄角膜正常眼压性青光眼OCT检测与分析

目的 探讨薄角膜正常眼压性青光眼(NTG)患者视盘周围视网膜神经纤维层(RNFL)厚度及视盘结构的OCT特征.方法 采用OCT对21例(42只眼)中央角膜厚度(CCT)低于正常人群范围(＜500μm)的正常眼压性青光眼患者进行RNFL及视盘扫描,并根据其CCT值分为:组1(480μm≤CCT＜500μm)和组2(460μm≤CCT＜480μm),比较分析两组RNFL厚度、视盘参数及30.中心视野指数.结果 两组患者的OCT检测参数包括Avg.Thick、Savg、Iavg、Navg、Tavg差异无统计学意义(P＞0.05),Max-Min值差异有统计学意义(P＜0.05);视盘参数(垂直盘沿容积值等)、视野参数(MD、MS值)差异无统计学意义(P＞0.05).两组患者的RNFL平均厚度与视野平均缺损值MD呈强且负的直线关系(r=-0.602,P=0.000).结论 OCT能对NTG患者视盘及视网膜神经纤维层做出定量测量和分析,且与视野检测指标有良好的相关性,在NTG的早期诊断中有重要意义;薄角膜NTG患者的角膜厚度水平与视网膜神经纤维层缺损程度无明显相关.

Abstract：

Objective To investigate the thickness changes of peripapillary retinal nerve fiber layer (RNFL) in normal tension glaucoma (NTG) with thin cornea measured by optical coherence tomography (OCT).Methods Twenty-one NTG patients (42 eyes) with thin cornea were divided into two groups according to their central corneal thickness (CCT):group 1 (480μm≤CCT＜500μm) and group 2 (460μm≤CCT＜480μm),and analysis the different results of OCT scan and visual outcome in two groups.Results There were no significant differences in OCT parameters of Avg.,Thick,Savg,Iavg,Navg and Tavg among the two groups (P ＞0.05),while Max-Min was lower in group 2 (P ＜0.05);There were also no significant differences in the optic nerve head analysis results,visual field mean defect (MD) and mean sensitivity (MS) among two groups (P＞0.05).The average RNFL thickness and MD showed a strong and negative linear relationship(r =-0.602,P =0.000).Conclusions OCT can make quantitative measurement and analysis of optic disc and RNFL for NTG patients,and has a good correlation with vision field.It has important significance in the early diagnosis of NTG.For NTG patients with thin corneas,there is no significant correlation between the level of CCT and extent of retinal nerve fiber layer defect.     

Increasing scans per examination improves the reproducibility on retinal nerve fiber layer measurements by optical coherence tomography.

PURPOSE: To investigate whether increasing the number of scans per examination would improve the reproducibility of retinal nerve fiber layer (RNFL) measurements by optical coherence tomography (OCT) in healthy and glaucomatous eyes. METHODS: A total of 28 eyes of 28 healthy subjects and 20 eyes of 20 patients with primary chronic open-angle glaucoma were recruited. OCT RNFL assessments were obtained in one randomly selected eye. Each subject underwent seven scans on five separate occasions within a 1-month period. RESULTS: In the healthy group, the intervisit mean coefficient of variations (COV's) for the average RNFL thickness (100 sampling points) and the quadrant RNFL measurements (25 sampling points) were similar in a series of three, five, and seven scans per examination (p > 0.05), but COV's for the two clock-hour segment measurements (seven sampling points, superotemporal and inferotemporal) were significantly lower in a series of five and seven scans per examination than that of three scans per examinations (p < 0.01). In the glaucoma groups, COV's for the two quadrant (superior and inferior) and five clock-hour segment RNFL measurements (superior, superotemporal, temporal, inferotemporal, and superonasal) were significantly lower in a series of five and seven scans per examination than that of three scans per examination (p < 0.01). There was no statistical difference in the COV's between a series of five scans and that of seven scans per examination in all OCT RNFL thickness parameters in healthy and glaucomatous eyes (p > 0.05). Similar results were observed with intravisit COV comparisons. CONCLUSION: Increasing the number of scans per examination may improve the reproducibility of quadrant and clock-hour segment OCT RNFL measurements in healthy and glaucomatous eyes. A series of five scans per examination is recommended for OCT RNFL measurements.     

Longitudinal Changes in Retinal Nerve Fiber Layer Thickness after Intravitreal Anti-vascular Endothelial Growth Factor Therapy

PurposeTo determine the effects of intravitreal anti-vascular endothelial growth factor (VEGF) on thickness of the retinal nerve fiber layer (RNFL) in patients with age-related macular degeneration.MethodsTwenty eyes of 20 patients diagnosed with age-related macular degeneration who underwent intravitreal anti-VEGF injection were studied. Postinjection RNFL thickness was measured using optical coherence tomography. Average thickness, four-quadrant RNFL thicknesses, and intraocular pressure (IOP) in affected eyes were measured before and 6 and 12 months after anti-VEGF injection for comparison. RNFL thickness and IOP in affected and normal fellow eyes were also compared. Given that macular lesions can affect RNFL thickness, the changes in thickness were evaluated by dividing the 12 clock-hour RNFL into the pathologic areas adjacent to the lesion and the non-pathologic area.ResultsThe mean clock-hour segment in the pathologic area was 4.8 hours. A significantly thicker RNFL was exhibited in temporal quadrants and pathologic areas (p = 0.043 and 0.048, respectively) in affected eyes before injection compared to the baseline RNFL thickness in normal eyes. No significant differences were found in RNFL thickness or IOP between affected and normal eyes after injection. The changes over time in the temporal and pathologic areas were statistically significant at 6 and 12 months after injection compared to baseline data (p < 0.05). No significant differences were displayed in RNFL thickness in the other three quadrants or in non-pathologic areas in either affected or normal eyes. Sequential changes in RNFL thickness in affected eyes were not significant.ConclusionsRepeat intravitreal anti-VEGF treatment did not have a significant effect on RNFL thickness. RNFL thickness significantly decreased with time in the pathologic areas and in the temporal segment adjacent to exudative macular lesions. The reduction in RNFL thickness was most likely associated with changes in the macular lesion rather than with anti-VEGF injection.     

Longitudinal changes in retinal nerve fiber layer thickness after acute primary angle closure measured with optical coherence tomography

PURPOSE: Longitudinal follow-up of peripapillary retinal nerve fiber layer (RNFL) thickness after an episode of acute primary angle closure (APAC) using Stratus optical coherence tomography (OCT). METHODS: Seventeen patients who had experienced a single unilateral APAC episode (intraocular pressure, >50 mm Hg) were enrolled. The average and superior, temporal, inferior, and nasal quadrant RNFL thicknesses of the affected and fellow eyes at 1, 4, and 12 weeks after remission were compared by using StratusOCT. The relationship between average RNFL thickness and interval of follow-up were evaluated with regression analysis. RESULTS: The mean duration of the APAC episode was 13.8 hours (range, 3-40). Comparison of the average and four quadrant RNFL thicknesses in the affected eyes longitudinally showed significant differences between 1 and 4, and 1 and 12 weeks, but not between 4 and 12 weeks. The average and four-quadrant RNFL thicknesses for the affected eyes were greater than the analogous values for fellow eyes at 1 week. In contrast, the inferior- and superior-quadrant RNFL thicknesses for the affected eyes were lower at 4 and 12 weeks, whereas the average and nasal quadrant values for the affected eyes were lower than those in fellow eyes at 12 weeks. Average RNFL thickness for the affected eyes was correlated with the interval of follow-up by using inverse regression analysis (P < 0.001; R(2) = 0.60). Controlling for duration of APAC episode, the interval of follow-up on RNFL thickness reduction remained significant (P < 0.001, r = -0.69). CONCLUSIONS: This study demonstrated an initial increase in diffuse RNFL thickness after a single APAC episode, followed by a subsequent decrease.     

剥脱性青光眼视盘视网膜神经纤维层厚度与视野缺损的相关性

探讨不同时期剥脱性青光眼（PXG）患者视盘视网膜神经纤维层（RNFL）厚度与视野缺损的相关性。方法：病例对照研究。连续性选取2013年1月至2018年1月在石家庄市第一医院青光眼科住院治疗的PXG患者97例（97眼），并将其分为早期PXG组28例，中期PXG组27例，晚期PXG组42例。另选择与PXG组匹配的正常志愿者32例（32眼）作为正常对照组。所有纳入对象均采用SD-OCT对视盘各区RNFL厚度进行扫描，采用单因素方差分析比较4组受检者视盘各区RNFL厚度差异，采用 Pearson相关分析对视盘RNFL厚度与视野平均缺损相关性进行分析。结果：正常对照组及早、中、晚期PXG组平均视盘RNFL厚度分别为（104±11）μm，（92±14）μm，（82±12）μm，（54±18）μm。4组受检者鼻侧、鼻上方、颞上方、颞侧、颞下方、鼻下方及平均RNFL厚度总体差异均具有统计学意义（F=24.38、36.40、47.84、8.70、95.46、54.75、82.28，均P<0.001）。进一步两两比较发现，正常对照组与早期PXG组颞上方、颞下方、鼻下方及平均视盘RNFL厚度差异有统计学意义（均P<0.05）；正常对照组与中期PXG组鼻侧、鼻上方、颞上方、颞下方、鼻下方及平均RNFL厚度差异有统计学意义（均P<0.05）；正常对照组与晚期PXG组各区RNFL厚度差异均有统计学意义（均P<0.001）。中、晚期 PXG组视盘平均RNFL厚度与视野平均缺损呈正相关（r=0.404，P=0.037；r=0.582，P<0.001）。结论：中、晚期PXG眼视盘平均RNFL厚度与视野缺损呈正相关，SD-OCT监测视盘RNFL厚度变化可以作为PXG诊断分期和随访的重要参考指标。     

Comparison of retinal nerve fiber layer measurements between NTG and HTG using GDx-vCC

PURPOSE: To compare quantitative polarimetric measurements in eyes with NTG and HTG using GDx-VCC. Both groups were matched by age and glaucoma stage based on the Humphrey visual field test. METHODS: We retrospectively reviewed the records of 146 patients who underwent Humphrey field analysis (HFA) and GDx-VCC. We compared outcomes of retinal nerve fiber layer (RNFL) parameters among the three groups by ANOVA and between each pair of groups using the Tukey-Kramer Post-Hoc test. We also evaluated the sensitivity and specificity of GDx-VCC in detecting glaucoma in each group. RESULTS: The mean age and HFA mean deviation (MD) were 55.6 +/- 9.5 years and -0.8 +/- 1.5 dB in 47 control patients, 59.4 +/- 9.0 years and -5.77 +/- 4.38 dB in 49 NTG patients, and 59.4 +/- 11.7 years and -8.09 +/- 6.77 dB in 51 HTG patients, respectively. All thickness parameters were lower in HTG patients compared to NTG patients, but there were no significant differences in ratio parameters between age-matched early HTG and NTG patients. The sensitivity of GDx-VCC was significantly higher in both early and total HTG patients compared to the respective groups of NTG patients. CONCLUSIONS: Compared to eyes with NTG, eyes with HTG showed reduced RNFL thickness and ratio parameters when patients were age and visual field matched. GDx-VCC appeared to be more sensitive in detecting RNFL damage in HTG patients.     

高眼压性和正常眼压性原发性开角型青光眼视神经损害特征的比较

目的探讨高眼压性原发性开角型青光眼(POAG)和正常眼压性青光眼(NTG)患者视神经损害的不同特点。方法应用德国Heidelberg公司生产的视网膜断层扫描仪对高眼压性POAG39例(47只眼)和NTG32例(38只眼)进行定量视盘参数和神经纤维层检查,并行眼底立体照相观察视网膜神经纤维层(RNFL)缺损类型,检测静态定量视野,并对检查结果进行比较。结果(1)NTG组视盘总体参数和分区(除颞侧外)盘沿面积、沿/盘面积小于高眼压性POAG组,而C/D大于高眼压性POAG组;平均RNFL厚度和RNFL面积在颞下和颞上小于高眼压性POAG组;总体盘沿容积小于高眼压性POAG组,总体平均视杯深度和颞下视杯面积大于高眼压性POAG组,两组差异均有统计学意义(P<005)。两组颞侧视盘各参数比较,差异无统计学意义(P>005)。(2)RNFL缺损类型高眼压性POAG组RNFL弥漫性缺损占5319%,局限性缺损占426%;NTG组弥漫性缺损占2105%,局限性缺损占5526%。两组RNFL缺损类型构成比比较,差异有统计学意义(P<001)。结论NTG较高眼压性POAG具有较大的C/D值、C/D面积比和窄盘沿面积,RNFL丢失严重。高眼压性POAG患者的RNFL以弥漫性缺损为主,NTG患者的RNFL以局限性缺损为主。两者视神经损害具有不同特点,其损害机制可能不同。(中华眼科杂志,2005,41136140)     

视野缺损计分与OCT测量RNFL厚度的关系

目的:探讨视野缺损计分值与视网膜神经纤维层损害的关系。方法:收集开角型青光眼患者30例30眼,分别进行OCT视网膜神经纤维层厚度及视野检查。根据视野结果进行视野缺损计分并分组。组间分析各象限视网膜神经纤维层厚度值与视野缺损计分,平均缺损(MD)的关系和相关性。结果:根据视野缺损计分将患者分为四组,上侧、下侧,平均视网膜神经纤维层厚度在组间有显著性差异(P=0.010,P<0.01,P<0.01)。四组间随视野缺损程度加重,上侧、下侧,平均视网膜神经纤维层厚度变薄。在重度缺损组视网膜神经纤维层厚度最薄。视野缺损计分与上、下、鼻、颞侧及平均视网膜神经纤维层厚度均明显负相关(r=-0.610,P=0.001;r=-0.779,P<0.01;r=-0.463,P=0.015;r=-0.500,P=0.008;r=-0.782,P<0.01),视野指数MD与上侧,下侧及平均RNFL厚度明显正相关(r=0.557,P=0.003;r=0.431,P=0.025;r=0.532,P=0.004)。结论:视野缺损计分对视野缺损的客观评估,与OCT测得的视网膜神经纤维层厚度的结果负相关,是反应青光眼视神经损伤的可靠的观察指标。     

光学相干断层成像术对原发性开角型青光眼视网膜神经纤维层的定性和定量检测

OBJECTIVE: To study the characteristics of optical coherence tomography (OCT) of primary open angle glaucoma (POAG), the difference of retinal nerve fiber layer (RNFL) thickness between normal persons and patients with POAG and the correlation between RNLF and visual field index. METHODS: Eighty-three cases (149 eyes) with POAG and 83 normal persons (150 eyes) were tested by OCT with circular scans around the optic nerve head (diameter = 3.46 mm) to observe the features of OCT. Statistic analysis was taken to compare the difference of RNFL thickness in quadrants and means between normal and glaucomatous group, and the difference of the thickness among the stages in POAG. Linear correlation and regression analysis was used to show the correlation between RNFL thickness and visual field index of 115 eyes of glaucomatous patients. RESULTS: The RNFL thickness measured by OCT in normal subjects is the thickest in superior and inferior quadrants, less in thickness in temporal and the thinnest in nasal quadrant. The curve showed double peaks. The RNFL of glaucomatous patients showed local thinness or defect, diffuse thinness or combination of the above two types. The mean RNFL thickness of normal group was (90.1 +/- 10.8) microm, (140.4 +/- 10.5) microm, (85.2 +/- 14.0) microm, (140.4 +/- 9.7) microm and (114.2 +/- 6.0) microm, of glaucomatous group was (56.0 +/- 31.0) microm, (81.0 +/- 36.3) microm, (47.1 +/- 27.5) microm, (73.4 +/- 38.4) microm and (64.6 +/- 28.8) microm in temporal, superior, nasal, inferior quadrant and the whole area, respectively. There is significant difference of RNFL thickness between the normal and glaucomatous group (P < 0.000), and there are significant differences among the three stages (early, developing and late) of glaucomatous group (P < 0.000). There is a close negative relationship between RNFL thickness and visual field index (r = -0.796, P < 0.0001). The sensitivity and specificity of RNFL thickness measured by OCT were 93.3% and 92.0%, respectively. CONCLUSION: OCT can quantitatively measure the RNFL thickness and show the difference of RNFL between normal persons and glaucomatous patients. The RNFL thickness gradually decreases while visual field defect increases with the development of POAG.     

Study of retinal nerve fibre layer thickness in eyes with high tension glaucoma and hemifield defect

AIM: To quantitatively evaluate retinal nerve fibre layer (RNFL) difference in areas of apparently normal appearing visual field in eyes with high tension glaucoma (HTG) and hemifield defects using scanning laser polarimetry. METHODS: 40 eyes from 40 patients with HTG with superior or inferior hemifield defects based on the Humphrey field analyser (HFA) underwent RNFL thickness measurements. 20 normal eyes from 20 subjects matched in age and refractive error were selected as a control group. The RNFL thickness was measured with a scanning laser polarimeter. Mean RNFL thickness was evaluated in four quadrants (superior, inferior, nasal, and temporal). A superior or inferior quadrant in the defined ring of scanning laser polarimetry corresponds to inferior or superior hemifield in HFA. RESULTS: The mean RNFL thickness in the unaffected quadrant (the quadrant corresponding to the hemifield with apparently normal visual field based on HFA) of the HTG group was significantly thinner than the average RNFL thickness of the corresponding quadrant of the control eyes. The RNFL thickness of the unaffected quadrant in the eyes with HTG was reduced and statistically similar to that of the affected quadrant. Symmetry, calculated as the ratio of superior to inferior RNFL thickness, showed no statistical difference between the study and control group. CONCLUSION: Changes in RNFL are present in the apparently normal hemifield in the eyes with HTG. The thickness of the RNFL is reduced symmetrically in both superior and inferior quadrants based on the GDx parameters.     

Effect of luteolin on apoptosis and vascular endothelial growth factor in human choroidal melanoma cells

AIM:To investigate the effects of luteolin on apoptosis,the cell cycle,and the expression and secretion of vascular endothelial growth factor(VEGF)in human choroidal melanoma cells(C918 and OCM-1).METHODS:C918 and OCM-1 cells cultured in vitro were treated with various concentrations of luteolin(0,5,10,15μmol/L).Cell growth was observed with an inverted microscope,and cell cycle arrest was detected by propidium iodide(PI)staining using flow cytometry.Apoptosis was detected by Hoechst33342 staining,and apoptosis rate was determined by Annexin V-FITC/PI experiments using flow cytometry.The expression of apoptosis-related proteins Bcl-2,Bax and VEGF was analyzed using Western blots.The levels of VEGF secreted by the cells into the supernatant was analyzed using ELISA.RESULTS:After treating with 5 to 15μmol/L luteolin for 48 h,the fusion degree of C918 and OCM-1 cells decreased,and more floating apoptotic cells appeared.Luteolin treatment increased the G0-G1 phase ratio of the C918 and OCM-1 cells,blocked cell cycle progression,and increased the apoptosis rate of the C918 and OCM-1 cells.Western blot showed that luteolin decreased the expression of Bcl-2 and VEGF in the C918 and OCM-1 cells and increased the expression of Bax protein.The ELISA results showed that 10 to 15μmol/L luteolin decreased the cell secretion of VEGF.CONCLUSION:Luteolin may induce apoptosis by regulating the levels of apoptosis-related proteins in C918 and OCM-1 cells.Luteolin can induce cell cycle arrest,decrease the expression of VEGF.     

Optic disc rim area to retinal nerve fiber layer thickness correlation: comparison of diabetic and normal tension glaucoma eyes

Purpose

To compare the correlation between optic disc rim area and retinal nerve fiber layer thickness (rim-RNFL correlation) in diabetic eyes with non-progressive RNFL defects and normal tension glaucoma (NTG) eyes.

Methods

Seventy-three eyes of 73 patients with preperimetric or early NTG and 25 eyes of 25 type II diabetes patients with a non-progressive RNFL defect for ≥5 years were enrolled in this retrospective cohort study. Rim areas and RNFL thicknesses were measured by Heidelberg retina tomography (HRT II) and by optical coherence tomography (Cirrus OCT), in global and 12 clock-hour parameters. Diabetic eyes were evaluated whether they were above the 95 % prediction interval (PI) for the rim-RNFL correlation of NTG.

Results

A significant linear rim-RNFL correlation was observed in NTG eyes globally and at all clock-hours, except in the 4 and 9 o’clock areas, (0.08 < r ² < 0.56, P < 0.05). Eighty-four percent of the diabetic eyes were above the 95 % PI of the rim-RNFL correlation of NTG in ≥2 clock-hours, as compared with 36 % of the eyes in the global parameter.

Conclusions

The eyes of diabetic patients with non-progressive RNFL were well-differentiated from NTG eyes by the rim-RNFL correlation.     

垂体腺瘤视野表现的特征

目的　探讨垂体腺瘤视野表现特征。方法　收集于神经外科经病理确诊为垂体腺瘤的３７１例患者的视野及光学相干断层扫描（ｏｐｔｉｃａｌｃｏｈｅｒｅｎｃｅｔｏｍｏｇｒａｐｈｙ,ＯＣＴ）资料。将垂体腺瘤患者根据视野缺损改变分为颞侧象限性视野缺损组、颞侧垂直性偏盲组和管状视野组。分析视野缺损形态特征,通过线性相关分析及方差分析对视野缺损形态、视野平均光敏感度（ｍｅａｎｓｅｎｓｉｔｉｖｉｔｙ,ＭＳ）等指标与ＯＣＴ测量视网膜神经纤维层（ｒｅｔｉｎａｌｎｅｒｖｅｆｉｂｅｒｌａｙｅｒ,ＲＮＦＬ）厚度、肿瘤体积之间的关系进行分析。结果　颞侧象限性视野缺损组、颞侧垂直性偏盲组和管状视野组三组间ＲＮＦＬ厚度、ＭＳ值差异均具有统计学意义（均为Ｐ＝０．００）,垂体腺瘤体积差异无统计学意义（χ２ ＝０．５８,Ｐ＝０．７５）。颞侧垂直性偏盲组与管状视野组中,ＭＳ和对应眼鼻侧ＲＮＦＬ厚度有直线关系（Ｒ２ ＝０．１８６,ｔ＝４．７６,Ｐ＝０．００;Ｒ２＝０．１４６,ｔ＝２．６５,Ｐ＝０．０１）,ＲＮＦＬ厚度、ＭＳ与肿瘤体积均无直线关系（均为Ｐ＞０．０５）。结论　视野缺损类型与垂体腺瘤侵犯视交叉的位置有关。相应受累眼视野缺损程度与视网膜ＲＮＦＬ厚度、ＭＳ值有一致性。受累眼的ＭＳ值变化与ＲＮＦＬ厚度有一致性。视野缺损改变、ＲＮＦＬ厚度、ＭＳ与肿瘤体积单一因素无关。