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1.
目的观察正常眼压性青光眼视盘出血与局限性视网膜神经纤维层 缺损(RNFLD)的关系。方法回顾性分析83例正常眼压性青光眼患者视盘 出血的累计发生频度及其在视盘上的分布,观察彩色立体眼底像中同一象限内的视盘出血和 视盘旁局限性RNFLD的毗邻关系及视盘出血发生之后视网膜神经纤维层的变化。结果(1)视盘出血在视盘上分布:83人中29人(34.94%),33只眼有出血的记录, 累计58眼次,其中颞下方39眼次、颞上方14眼次、其他象限5眼次。(2)立体眼底像中同一 象限内视盘出血与视盘旁RNFLD的毗邻关系:在可获得的立体眼底像中有23眼次(15人16只 眼)视盘出血在同一象限内存在楔形RNFLD,其中22眼次出血位于视盘旁楔形RNFLD的边界附近。(3)视盘出血发生后相对应的视网膜神经纤维层的变化:24眼次出血(20人21只眼) 出血当时及出血2年以后的眼底像保存完整。随访像中原19眼次视盘出血(均位于颞下或颞上)相对应处视网膜神经纤维层发生变化,其中由无缺损到出现宽窄不一的楔形缺损者7眼次,原视盘出血毗邻的局限性RNFLD扩展者12眼次。其它5眼次视盘出血(颞上、颞下各1眼次,其他象限3眼次)随访中相对应处无明显局限性RNFLD出现。结论正常眼压性青光眼患者的视盘出血多分布于颞下,其次为颞上,视盘出血的出现常预示着其邻近部位局限性RNFLD的发生或进展。(中华眼底病杂志,2004,20:339-342)  相似文献   

2.
眼底视网膜神经纤维层图像的增强处理   总被引:1,自引:0,他引:1  
赵梅生 《眼科研究》1998,16(3):190-192
目的利用眼底图像处理系统探索对眼底视网膜神经纤维层(RNFL)图像的处理。方法对正常眼组35只眼,高眼压组28只眼,开角型青光眼组67只眼的RNFL进行图像处理。结果所采用的图像处理方法能有效地增强各种类型的RNFL缺损图像和因屈光间质混浊而模糊不清的眼底图像。结论眼底图像处理系统可用于青光眼的早期诊断及定量分析由视神经疾病引起的RNFL缺损  相似文献   

3.
青光眼的视网膜神经纤维层缺损及视盘参数改变   总被引:1,自引:0,他引:1  
李杨  徐亮 《眼科》1997,6(1):24-26
青龙眼的主要病理过程是视网膜神经纤维及视乳头盘沿的丢失。青光眼的视网膜神经纤维层缺损可分为局部缺损和弥漫缺损,这两作缺损的存在可能预示着存在两种或多种造成青光眼视神经损害的机制。本文总结分析了75例开角型青光眼及慢性闭角型青光眼病人131只眼的彩色立体眼底象.根据视网膜神经纤维层损害形态的不同,将131只限分为局限性RNFLD;弥漫性RNFLD;混合性RNFLD三组。对各组眼的视盘参数进行定最测量并参照Airaksinen法对视网膜神经纤维层进行半定量评估,根据视杯扩大的形态及盘沿面积的大小将各组中的病眼分为0、Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ几个阶段,采用SYSTAT统计软件对三组病人的c/D、沿盘面积比进行对比分析;且对各级RNFLD的半定量值与盘沿面积进行直线相关及回归分析。结果表明三组间的C/D及沿盘面积比存在着相当显著性差异(P=0.000),且局部缺损组主要处于青光眼的早期和中期,混合缺损组主要分布于中期,弥漫缺损组主要分布于中晚期。视网膜神经纤维层缺损的半定量值与盘沿面积低度相关。青光眼视网膜纤维层缺损的不同形态表现,不同缺损形态组的视盘参数的差异及视杯扩大形式的差异,可能预示着存在多种造成青光眼视神经损害的机制。  相似文献   

4.
目的探讨原发性开角型青光眼(primaryopen-angleglaucoma,POAG)和低压性青光眼(lowtensionglaucoma,LTG)早期视野损害及视网膜神经纤维层缺损的特点。方法应用QZS-2型自动视野计全阈值程序对26例(41只眼)早期POAG和13例(15只眼)早期LTG进行定量视野测定,所有患者散瞳做视盘和视网膜神经纤维层照像,分析视网膜神经纤维层缺损的类型和程度。结果早期POAG和LTG视野损害多表现为局限性视网膜光敏感度下降,少数表现为弥漫性光敏感度下降,视野损害主要位于中心视野,少数可合并周边视野损害。中心视野平均光敏感度和短期波动与正常对照组之间差异有显著性,两型青光眼早期视野损害和视网膜神经纤维层缺损的类型及损害部位分布差异无显著性。结论早期POAG和LTG视野损害特征及视网膜神经纤维层缺损形态一致  相似文献   

5.
许贺  徐丽 《临床眼科杂志》2010,18(4):321-322
目的探讨对急性玻璃体后脱离眼进行详细眼底检查的必要性并评价欧堡全景200激光扫描检眼镜在其眼底病变检查中的应用价值。方法对我院329例(329只眼)玻璃体后脱离患者进行欧堡全景200激光扫描检眼镜与三面镜检查,统计眼底病变的发生率并对两种检查方法的结果进行比较。结果 329例(329只眼)受检患者中,三面镜检出有临床意义的眼底病变59只眼(17.9%),其中视网膜裂孔34只眼(10.33%),裂孔性视网膜脱离4只眼(1.22%),视网膜格子样变性21只眼(7.9%),视网膜出血18只眼(5.47%)。全景200激光扫描检眼镜对眼底病变的检查结果与三面镜检查结果无差异。结论急性玻璃体后脱离眼进行详细眼底检查是非常必要的,欧堡全景200激光扫描检眼镜为玻璃体后脱离患者眼底疾病的筛查提供了一条简便、高效的方法。  相似文献   

6.
前部缺血性视神经病变视网膜神经纤维层损害的初步观察   总被引:3,自引:0,他引:3  
用无赤光眼底照相法结合眼底荧光血管造影及定理视野分析,对23例(25眼)前部缺血性视神经病变患者的视网膜神经纤维层进行观察。有23眼(92%)检出RNFL缺损并伴有相应的视野缺损。视盘荧光充盈缺损与PNFL缺损及视野缺损三者之间有高度的对应关系,表明AION可造成RNFL缺损,并导致相应的视功能损害。  相似文献   

7.
高度近视合并原发性开角型青光眼的临床分析   总被引:7,自引:0,他引:7  
Fu P  Liu L  Li M  Yuan Y  Cui Y 《中华眼科杂志》2002,38(8):480-483,W002
目的 探讨高度近视合并原发性开角型青光眼(primary open-angle glaucoma,POAG)的早期诊断依据。方法 (1)将存档的21例(40只眼)高度近视合并POAG患者资料(A组)与随机抽取的21例(40只眼)中度近视合并POAG患者的资料(B组)及21例(42只眼)低度近视合并POAG患者的资料(C组)进行对照,比较初次就诊时3组患者间视野缺损,视网膜神经纤维层缺损(retinal nerve fibre layer defect,RNFLD),最高眼压值及最佳矫正视力等指标的差异;(2)观察A组患者的三维眼底照片,分析其临床特点。结果 (1)初诊时,A组患者中,重度视野缺损和RNFLD的比例明显高于B,C组,矫正视力低于B,C组;(2)高度近视患者视乳头,视网膜的特异性变化及视乳头周围病变等,直接干扰对青光眼的早期诊断;(3)散瞳检查或立体眼底拍片是提高青光眼检出率的重要手段。结论 认识高度近视本身及合并POAG时的临床特点,有利于提高临床医师对该病的警觉性及早期诊断水平。  相似文献   

8.
目的:评价欧堡全景200激光扫描检眼镜在青光眼患者眼底检查的应用价值。方法:对100例125眼的青光眼患者术前行全景200激光扫描眼底检查,其中男34例,女66例,平均年龄58.5岁,对眼底进行评估,术后3d散瞳行间接眼底镜检查,进行对比分析。结果:欧堡全景200激光扫描检眼镜检查发现黄斑视网膜前膜1例,明显眼底动脉硬化4例,糖尿病视网膜病变3例,色素变性1例,脉络膜萎缩3例,黄斑变性2例,分支静脉栓塞2例,静脉周围炎1例,青光眼眼底疾病检出率为13.6%;术后散瞳间接眼底镜检查均得到证实。结论:欧堡全景200激光扫描检眼镜可快速、有效的发现青光眼眼底病变。  相似文献   

9.
用谱域OCT检测青光眼局限性视网膜神经纤维层缺损   总被引:4,自引:2,他引:2  
吴西施  徐亮  张莉  杨桦  陈长喜 《眼科》2010,19(1):14-18
目的评价新一代谱域OCT(SD—OCT)对青光眼局限性视网膜神经纤维层缺损(RNFLD)的识别能力。设计前瞻性病例系列。研究对象眼底立体像存在局限性RNFLD的青光眼患者44例(53眼),非青光眼对照者53例(53眼)。方法采用SD-OCT以视盘为中心环形扫描检查,扫描直径3.46mm。Kappa检验分析眼底立体像与SD—OCT两种方法对局限RNFLD部位检测一致性,并比较两种方法所检测局限RNFLD的位置及宽度对应关系。主要指标敏感性与特异性,k值,Pearson相关系数。结果自带数据库的SD-OCT显示局限性RNFLD的敏感性为92.8%,特异性为96.4%。它与眼底立体像显示局限RNFLD总体一致率94.39%(101/107),K值为0.912(P=0.000)。两种方法检测的局限性RNFLD位置Pearson相关系数r=0.987(P=0.000),宽度Pearson相关系数r=0.932(P=0.000)。结论SD—OCT具有较好的发现局限性RNFLD的能力,且与眼底立体像有很好的检测一致性。在临床上可作为青光眼RNFLD的有效检测手段,对青光跟RNFLD的进展随诊观察具有潜在价值。  相似文献   

10.
目的:探讨青光眼的视网膜神经纤维层缺损特征,评价激光偏振光扫描测量仪(GDxVCC)在青光眼早期诊断方面的应用价值。方法:采用激光偏振光扫描测量仪(GDxVCC,美国)对60例110眼正常人及46例85眼青光眼患者视网膜后极部水平方向40°、垂直方向20°范围进行激光偏振光扫描测量视网膜神经纤维层厚度(RNFL),同时进行中央30°视网膜光阈值检查(Humphrey视野分析仪,Central30-2thresholdtest,美国),并对结果进行统计分析。结果:正常眼RNFL厚度与性别、眼别无关,而与年龄呈负相关;各期青光眼患者的RNFL均值显著低于正常对照组(年龄匹配,P<0.01);早期、进展期、晚期青光眼患者的RNFL厚度均值比较也有显著性差异(P<0.001)。GDxVCC检测RNFL厚度值与Humphrey视野检查指数平均缺损值(MD)具显著正相关性(r=0.795,P<0.001)。青光眼的视网膜神经纤维层图像可表现为局限性变薄或缺损(85.2%)、弥漫性变薄(6.6%)、弥漫性变薄并局限性缺损(8.2%),以鼻上方的局限性变薄或缺损最常见(56.7%)。有23.3%的早期青光眼患者视野检测正常而GDxVCC检测发现有不同程度的视网膜神经纤维层缺损。结论:GDxVCC能准确定量检测RNFL厚度值,视网膜神经纤维层的检测能比视野检测更早地发现青光眼的视神经的损害,因而可作为青光眼患者早期诊断的重要指标之一。随着青光眼患者病情的发展,RNFL厚度逐渐变薄,视野的平均缺损值逐渐增加。GDxVCC联合视野检查对于追踪青光眼患者的病情变化,确立靶眼压的水平,制定个性化的治疗方案有着重要的价值。  相似文献   

11.
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.  相似文献   

12.
Background: To evaluate the agreement and repeatability between operator‐dependent centring and automatic centring retinal nerve fibre layer thickness measurement patterns (RNFL3.45 and NHM4) of RTvue optical coherence tomography in normal and glaucomatous eyes. Design: Cross‐sectional observational study. Participants: A total of 153 eyes from 149 normal subjects and subjects with glaucoma were analysed. Methods: The retinal nerve fibre layer thickness was measured using RNFL3.45 and NHM4 three times on the same day to determine the repeatability and agreement between the two scan patterns. Main Outcome Measures: Student's paired t‐testing, intra‐class correlation coefficient, coefficient of variation, test–retest viability, Pearson's correlation coefficient and Bland–Altman analysis of retinal nerve fibre layer thickness measurements. Results: The difference between RNFL3.45 and NHM4 measurements was statistically significant by paired t‐testing (P = 0.003) only in severe glaucoma group. The Pearson's correlation test showed a high degree of correlation of the mean retinal nerve fibre layer thickness (r = 0.949). Bland–Altman plots showed that the differences between RNFL3.45 and NHM4 were smaller at thicker retinal nerve fibre layer values, but larger at thinner retinal nerve fibre layer values. The intra‐class correlation coefficient for RNFL3.45 (and lower 95% confidence interval) in normal and glaucomatous eyes was 0.990 (0.985 confidence interval) and 0.997 (0.995 confidence interval), respectively. The intra‐class correlation coefficient for NHM4 in normal and glaucomatous eyes was 0.989 (0.983 confidence interval) and 0.995 (0.992 confidence interval), respectively. The test–retest variability for RNFL3.45 and NHM4 ranged from 3.98 to 9.75 µm in normal eyes, and from 4.10 to 13.34 µm in glaucomatous eyes. Conclusion: Measurements of retinal nerve fibre layer thickness by RNFL3.45 and NHM4 are in good agreement.  相似文献   

13.
Sugiyama K 《Nippon Ganka Gakkai zasshi》2012,116(3):233-67; discussion 268
Primary open-angle glaucoma (POAG), including normal-tension glaucoma (NTG), is reported by the Tajimi Study to afflict 3.9% of the total population, and this represents about 80% of all total glaucoma cases which, in total, afflict 5.0% of the population. We tried to analyze the clinical problems relating to POAG by looking at the pathogenesis, intraocular pressure (IOP), therapy, neuroprotection and surgery of the disease. To elucidate the pathogenesis of glaucoma progression, we measured retinal nerve fiber layer defect (RNFLD) angles', and divided the NTG cases into 2 groups, enlarged RNFLD and stable RNFLD. Disc hemorrhages were found to be significantly more frequent in the enlarged group than in the stable group. RNFLD was enlarged in the direction of disc hemorrhage in over 80% of the eyes. In the majority of the eyes of the enlarged group, the enlargement of RNFLD was toward the fovea. The enlargement of RNFLD in NTG was closely associated with disc hemorrhage and the deterioration of the visual field. We developed a simultaneous structure and function evaluation technique combining spectral-domain (SD) optical coherence tomography (OCT) and fundus-oriented perimeters for the detection of visual field abnormalities in the RNFLD area. We superimposed the ganglion cell complex map obtained by SD-OCT on the fundus-oriented perimeter image. We observed very early or preperimetric normal pressure glaucoma as well as disc hemorrhage adjacent to the borders of the RNFLD. The borderline of the RNFLD seemed to be the thinnest RNFL and had the lowest retinal sensitivity (Active site for RNFLD progression). To clarify the role of the circadian clock genes in the generation of a 24-hour IOP rhythm, we used the microneedle method to measure the IOP at eight time points daily, both in wild type mice and Cry-deficient (Cry 1-/-Cry 2-/-) mice. In the wild-type mice living in light-dark conditions, the pressure measured in the light phase was significantly lower than in the dark phase. This biphasic daily rhythm was maintained under dark-dark conditions. In contrast, the Cry-deficient mice did not show significant circadian changes in their IOP, regardless of the environmental light conditions. These findings demonstrate that clock genes are essential for the generation of the circadian rhythm of IOP. We evaluated the relationship between the genetic polymorphisms of the adrenergic receptor (ADR) and the diurnal IOP in untreated NTG patients. For Del 301-303 in α2B-ADR, De1322-325 in α2C-ADR, and S 49G (A/G) in βl-ADR, the major homozygotes and minor carriers had parallel diurnal IOP curves, but significantly different diurnal IOP levels. Polymorphisms of the ADR gene may predict the diurnal IOP level of patients with NTG. Looking toward the future, tailor-made medicine in glaucoma therapy, we evaluated the relationship between the polymorphisms of the prostaglandin F2α, receptor (FP receptor) gene and the effectiveness of topical latanoprost treatment in 100 normal volunteers. One SNP(rs3753380) was located in the promoter region of the FP receptor gene and was significantly correlated with % IOP reduction. Two SNPs, rs3753380 and rs3766355 (an SNP in intron 1), were associated with the degree of response to latanoprost. The genotype of these SNPs may be an important determinant of variability in response to latanoprost. To investigate the predictability of IOP response of the fellow eye in a one-eye trials, we compared the correlation of the fellow-eye's IOP response in one-eye trials performed separately for each eye with that of bilateral treatment in 41 normal subjects. Correlation of mean diurnal IOP reduction between 2 one-eye trials was poor (r2 = 0.102), even after subtracting the nontreated eye IOP fluctuations from the treated eye IOPs (r2 = 0.097), but that between fellow eyes in bilateral treatment was excellent (r2 = 0.849). Therefore, we examined the effects of multiple IOP measurements on the correlation of response to glaucoma medication between fellow eyes. Latanoprost was applied to the first eye and then to both eyes of POAG or ocular hypertension patients. IOP measurements were performed twice on different days at baseline, during treatment of the first eye only and for both eyes. No significant correlations of ΔIOP 1 (IOP at baseline-IOP after treatment) between fellow eyes were found. ΔIOP 2 (ΔIOP 1-IOP fluctuation of the contralateral eye) was significantly correlated between the fellow eyes using two post-treatment IOP measurements. Using multiple IOP measurements may improve the prediction of a fellow eye's response to glaucoma medication in one-eye trials. We used a scanning laser ophthalmoscope (SLO) for in vivo imaging and counting of rat retinal ganglion cells (RGCs). RGC survival decreased gradually after crushing the optic nerve. RGC counts by SLO were comparable to those in retinal flat mounts. We developed OCT system for rat eyes. The mean retinal nerve fiber layer (RNFL) thicknesses in the circumpapillary OCT scans were unchanged 1 week after crushing the optic nerve, but then decreased significantly and progressively after the second week. RNFL thicknesses in OCT images correlated significantly with thicknesses determined histologically. SLO and OCT will be useful for evaluating the effects of neuroprotective drugs. We developed a new glaucoma filtration surgery system using a thin honeycomb-patterned biodegradable film in rabbits. The film had a honeycomb-patterned surface that faced the subconjunctival Tenon tissue, while the other side was smooth. Postoperative IOPs of the film-treated eyes were significantly lower than those of the control eyes, but were not significantly different from those of the MMC-treated eyes. The thin honeycomb-patterned film that was attached to the inner bleb wall worked as an adhesion barrier in glaucoma filtration surgery in rabbits.  相似文献   

14.
目的 探讨高分辨率三维OCT在开角型青光眼中的诊断价值.方法 采用CirrusHD-OCT对正常组94人188只眼和试验组46例92只眼进行视网膜神经纤维层厚度的检测,对比分析视盘形态和视网膜神经纤维层厚度改变.结果 正常组各部位神经纤维层厚度与性别、眼别无相关(P>0.05).正常对照组各部位神经纤维纤维层厚度明显高于实验组,经过独立样本t检验得出差异有统计学意义(P<0.05).根据OCT结果,并根据视野、眼压等将试验组46例92只眼诊断为青光眼的24例48只眼,大视杯22例44只眼,两个亚组各部位RNFL厚度和正常对照组相比较,视网膜神经纤维层厚度均变薄,差异有统计学意义(P<0.05);但大视杯亚组各部RNFL厚度均高于青光眼亚组,差别有统计学意义(P<0.05).结论 OCT可以清晰显示视网膜神经纤维层变薄的范围和区域,再配合其他检查,即可较准确、快捷鉴别原发性开角型青光眼患者,大大提高开角型青光眼的早期诊断水平,是诊断早期青光眼的不可缺少的重要检查方法之一.
Abstract:
Objective To evaluate the diagnostic value of of high-resolution three-dimensional OCT in early primary open-angle glaucoma.Methods The retinal nerve fiber layer thickness in the normal group of 94 cases (188 eyes) and experimental group (glaucoma suspect group) of 46 cases (92 eyes) were detected using the Cirrus HD-OCT,and the comparative analysis of optic disc and retinal nerve fiber layer thickness were taken.The OCT performance of normal and suspected glaucoma image features was compared.Results There was no relationship in different parts of nerve fiber layer thickness (RNFL) with gender and eyes (P <0.05).The thickness of nerve fiber layer of normal control group was higher than experimental group,there was statistically significant difference (P <0.05) by independent sample t test.Based on the measured thickness of retinal nerve fiber layer,the image features and characteristics of OCT images,vision and intraocular pressure,48 eyes of 24 patients were diagnosed with glaucoma,and 44 eyes of 22 cases were diagnosed with large cup in experimental group.RNFL thickness of different parts of the two sub-group were thinning compared with the control group,the difference was statistically significant (P <0.05);but large cup group showed thicker RNFL than glaucoma group,and there was the statistically significant difference (P <0.05).Conclusions Cirrus HD-OCT has important diagnostic value in early primary open-angle glaucoma;also can greatly increase early diagnosis in primary open-angle glaucoma.It is an important and indispensable check method.  相似文献   

15.
目的 比较正常人和不同程度青光眼患者GDxVCC系统检测RNFL参数的不同,评价GDx各参数的敏感性、特异性,探讨GDxVCC系统检测视网膜神经纤维层在青光眼早期诊断中的价值.方法 对35例(35只眼)原发性开角型青光眼、33例(33只眼)慢性闭角型青光眼、27例(27只眼)急性闭角型青光眼以及年龄相匹配的36人(36只眼)正常人进行GDxVCC系统和静态视野检查.GDxVCC系统检查,视盘周围视网膜神经纤维层(retinal nerve fiber layer,RNFL)任一参数与系统内所附中国正常人数据库对比概率<5%或NFI>30或视网膜神经纤维标准偏差图上连续有10个超级像素概率<5%定义为具有青光眼性视网膜神经纤维层结构损害,并判断为青光眼.结果 22只正常眼被判断为非青光眼(61.1%),82只青光眼被判断为青光眼(86.3%),RNFL参数椭圆平均值、上方平均值、下方平均值、TSNIT标准偏差、神经纤维指数,标准偏差图诊断青光眼的敏感性分别为48.4%、56.8%、48.4%、50.5%、62.1%,特异性分别为97.2%、100%、97.2%、94.4%、97.2%、61.1%.GDxVCC系统诊断早期、中期、晚期青光眼的敏感性分别为77.36%、95.83%、100%.结论 GDxVCC系统诊断早期青光眼的敏感性和特异性均高,而且RNFL参数中神经纤维指数的敏感性最高.
Abstract:
Objective To evaluate the usefulness of the scanning laser polarimeter with variable corneal compensation (GDxVCC) for glaucoma detection in a Chinese population,and to investigate the retinal nerve fiber layer (RNFL) thickness difference between normal subjects and glaucoma patients.Methods Thirty-six eyes of 36 normal subjects,33 eyes of 33 primary chronic angle-closure glaucoma patients,27 eyes of 27 primary acute angle-closure glaucoma and 35 eyes of 35 primary open-angle glaucoma patients were studied.The glaucoma patients were age-matched with the normal.The thickness of retinal nerve fiber layer was measured with GDxVCC.An eye was diagnosed as glaucoma,ifone of the parameters showed P<0.05 on the results of the examination reports including four TSNIT parameters (the average of TSNIT,superior,inferior,and TSNIT Std.Dev.),nerve fiber indicator (NFI) > 30,and at least 10 consecutive defects of superpels showed in deviation map (P <0.05).Results Of 22 normal eyes (61.1%) were diagnosed as non-glaucoma and 82 glaucomatous eyes (86.3%) were diagnosed as glaucoma by GDxVCC.Sensitivity of the average of TSNIT,superior,inferior,TSNIT Std.Dev.,NFI and the deviation map were 48.4%,56.8%,48.4%,50.5%,62.1% respectively and specificity were 97.2%,100%,97.2%,94.4%,97.2% and 61.1% respectively.Sensitivity of detection early,moderate and progression glaucoma by GDxVCC were 77.36%,95.83%,100% respectively.Conclusions GDxVCC is a valuable technology to detect retinal nerve fiber layer defect in early glaucoma.It is shown that the NFI has highest sensitivity.  相似文献   

16.
目的 探讨正常眼压性青光眼 (normal-tension glaucoma, NTG)与高眼压性青光眼(high-tension glaucoma, HTG)视盘和视神经纤维层(retinal nerve fiber layer, RNFL)损害的差异。 方法 选择具有青光眼性视神经损害或RNFL缺损、相应的视野缺损的青光眼患者,NTG至少2次24 h眼压曲线和多次眼压测量均≤21 mm Hg(1 mm Hg =0.133 kPa),HTG的眼压至少2次测量≥25 mm Hg。患者进行详细的眼科检查,同时用扫描激光偏振仪(scanning laser polarimetry, SLP)、光学相干断层扫描(optical coherence tomography, OCT)和海德堡视网膜成像仪(Heidelberg retinal tomography, HRT)定量测定视盘形态和RNFL厚度。比较两组视盘总体和相同象限测量参数。 结果 30例 NTG和 19例 HTG (共49只眼)患者的平均年龄分别为(59.6±8.6)岁(39~71岁)和(59.2±12.3)岁(36~75岁)。两组间视野缺损的平均偏差(mean deviation, MD)差异不显著(P>0.05)。HRT测量的视盘 C/D面积比,除鼻侧象限外,NTG者视盘总体和上、下、颞侧3个象限均显著大于HTG者(P<0.05 ),而盘缘面积小于HTG者(P<0.05);两组间其他视盘参数差异不显著。3种激光扫描技术所测定的总体和象限RNFL厚度,两组间差异不显著。 结论 NTG趋向大 C/D面积比和窄盘缘面积。RNFL缺损的形态分布须更精细和节段性分析。 (中华眼底病杂志, 2002, 18: 109-112)  相似文献   

17.
低眼压性青光眼的眼底血管荧光造影与视网膜神经...   总被引:1,自引:0,他引:1  
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18.
PURPOSE: To evaluate the capability of the GDx VCC nerve fiber analyzer to detect preperimetric glaucoma across 12 retinal nerve fiber layer (RNFL) peripapillary sectors. METHODS: Data were obtained in a cross-sectional, hospital clinic-based study; 699 eyes from 699 glaucoma suspects were enrolled in this protocol. All subjects underwent ophthalmologic examination, static automated perimetry [Humphrey 24-2 Swedish interactive threshold algorithm (SITA) Standard], optic nerve stereoscopic photographs, red-free digital RNFL photographs and GDx VCC examination. Group S included 283 normal eyes and 39 preperimetric glaucoma eyes with RNFL superior or diffuse defects in the fiber layer photographs. Group I included 324 normal subjects and 24 with preperimetric glaucoma eyes with RNFL inferior or diffuse defects in fiber layer photographs. RESULTS: Mean values of the area under the curve (AUC) for receiver operating characteristic analysis for inferior average (Inf Avg), temporal-superior-nasal-inferior temporal average (TSNIT Avg), superior average (Sup Avg), and the nerve fiber indicator were significantly less in the eyes with RNFL defects than the control group compared with the AUC for thickness at hour 12 and at hour 6 calculated from the RNFL sector density. The AUC for receiver operating characteristic analysis of the new parameters improved by 12% with respect to the best GDx VCC standard values. CONCLUSIONS: Our results confirm that the 12 sector divisions of the GDx VCC have better diagnostic reliability in preperimetric glaucoma, and are able to improve the discrimination capability between normal and early damaged RNFLs.  相似文献   

19.
Atrophy of the optic nerve is associated with changes of the retinal fiber layer (RNFL). Using red-free photographs the authors examined the RNFL of 398 eyes with chronic primary open-angle glaucoma and compared it with the RNFL of 234 normal eyes. The glaucoma group was divided into five stages and the fundus into four sectors. Differences between the normal and glaucoma eyes were: (1) The sequence of the sectors, with regard to the best visibility of the retinal nerve fiber bundles, was changed. In the normal eyes the nerve fiber bundles were most often best visible in the inferior temporal sector, followed by the superior temporal sector, the temporal horizontal area and finally the nasal region. In the glaucoma group the nerve fiber bundles were significantly more often best detectable in the superior temporal sector and the temporal horizontal area. (2) The degree of visibility of the retinal nerve fibers decreased significantly with increasing glaucoma stage. (3) Localized defects were seen in 15% of the eyes with glaucoma and none of the normal eyes. The specificity of this qualitative parameter was, therefore, 100%. The defects were found most often in the superior and inferior temporal regions. These differences between normal and glaucomatous eyes were also significant for the first glaucoma stage of this study. The localization of the foveola below the optic disk center (0.53 +/- 0.34 mm in the glaucoma group and 0.55 +/- 0.29 mm in the normal eyes) was not significantly different.  相似文献   

20.
PURPOSE: To evaluate the relationship between visual field and retinal nerve fiber layer (RNFL) thickness measured by optical coherent tomography (OCT) and to assess the diagnostic ability of OCT to distinguish between early glaucomatous or glaucoma-suspect eyes from normal eyes. DESIGN: Retrospective, non-randomized, cross-sectional study. METHODS: A total of 160 eyes of 120 normal Japanese adults, 23 eyes of 16 patients with ocular hypertension, 38 eyes of 35 glaucoma-suspect patients, and 237 glaucomatous eyes of 140 glaucoma patients were enrolled in the study. The glaucoma group included 89 early glaucomatous eyes. Thickness of the RNFL around the optic disk was determined with three 3.4-mm diameter circle OCT scans. Average and segmental RNFL thickness values were compared among all groups. The correlation between mean deviation and RNFL thickness in glaucomatous eyes was also analyzed. Receiver operating characteristic (ROC) curve area was calculated to discriminate normal eyes from early glaucomatous or glaucoma-suspect eyes. RESULTS: A significant relationship existed between the mean deviation and RNFL thickness in all parameters excluding the 3-o'clock area. The average RNFL thickness had the strongest correlation in all parameters (r = -0.729, P <.001). Retinal nerve fiber layer thickness at the 7-o'clock inferotemporal segment had the widest areas under the ROC curves in all parameters for early glaucomatous eyes (0.873). CONCLUSIONS: Measurement of RNFL thickness by OCT is useful in detecting early RNFL damage. Furthermore, OCT measurements of RNFL thickness may provide clinically relevant information in monitoring glaucomatous changes.  相似文献   

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