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。     

原发性开角型青光眼与慢性原发性闭角型青光眼视网膜神经纤维层厚度与视野缺损的关系

目的 探讨原发性开角型青光眼(primary open-angle glaucoma,POAG)和慢性原发性闭角型青光眼(chronic primary angle-closure glaucoma,CPACG)患者频域光学相干断层扫描(optical coherence tomography,OCT)检测的视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度与视野平均缺损(mean defect,MD)的相关性.方法 采用RTVue100-2频域OCT和OCTO-PUS101视野计对POAG患者22例(22眼)及CPACG患者22例(22眼)进行检测,将两组患者RNFL厚度及视野MD值进行比较,应用Pearson积矩相关分析法确定RNFL厚度与视野MD值、上方和下方RNFL厚度与相对应半侧视野MD值的相关性.结果 POAG患者RNFL厚度、上方RNFL厚度及下方RNFL厚度分别为(91.19±15.85)μm、(94.93±18.76) μm、(87.82±15.65) μm,CPACG患者相应的RNFL厚度分别为(88.22±13.01) μm、(90.41±14.16)μm、(86.49±16.63) μm,两组患者各RNFL参数的比较差异均无统计学意义(均为P＞0.05).POAG组总MD值、上方半侧视野MD值、下方半侧视野MD值分别为(8.41±6.07)dB、(8.46±5.39)dB、(6.79±6.67) dB,CPACG组相应的MD值分别为(10.69±3.76) dB、(11.17±3.52) dB、(9.71±5.86)dB,两组患者各MD参数比较,差异均无统计学意义(均为P＞0.05).POAG组总RNFL厚度、上方RNFL厚度及下方RNFL厚度与视野相对应区域MD值呈中度负相关(r分别为:-0.574、-0.464、-0.600,均为P＜0.05),CPACG组总RNFL厚度、上方RNFL厚度及下方RNFL厚度与视野相应区域MD值呈高度负相关(r分别为-0.819、-0.884、-0.812,均为P =0.000);两组患者RNFL厚度与MD的相关系数和下方RNFL厚度与上方半侧视野MD的相关系数的差异均无统计学意义(P＞0.05),两组患者上方RNFL厚度与下方半侧视野MD的相关系数的差异有统计学意义(P＜0.05).结论 POAG患者RNFL厚度与视野MD呈中度负相关,CPACG患者RNFL厚度与视野MD呈高度负相关;相对于POAG患者,CPACG患者上方RNFL厚度与下方半侧视野MD具有更好的相关性.     

早期青光眼不同类型视盘视网膜神经纤维层厚度分析

目的　探讨早期青光眼患者不同类型视盘的视网膜神经纤维层（ｒｅｔｉｎａｌｎｅｒｖｅｆｉｂｅｒｌａｙｅｒ,ＲＮＦＬ）厚度,以了解不同类型视盘的早期青光眼患者的ＲＮＦＬ厚度的特点。方法　应用光学相干断层扫描（ｏｐｔｉｃａｌｃｏｈｅｒｅｎｃｅｔｏｍｏｇｒａｐｈｙ,ＯＣＴ）技术检查视盘ＲＮ-ＦＬ厚度,将收集到的ＯＣＴ视盘检查结果分为６组:对照组大视盘组、中视盘组、小视盘组,每组各２０眼,早期青光眼大视盘组、中视盘组、小视盘组各２０眼。ＯＣＴ测量１２０眼各钟点平均ＲＮＦＬ厚度。检测对照组和早期青光眼患者１２个钟位的视盘ＲＮＦＬ厚度。结果　对照组不同类型视盘组的ＲＮＦＬ厚度曲线均在下方和上方形成双峰,在鼻侧和颞侧形成波谷,各组下方峰均高于上方峰。其中大视盘组患者ＲＮＦＬ厚度（１０５．６０±５．８７）μｍ,其次是中视盘组（１０７．０５±７．２９）μｍ和小视盘组（１０８．４０±７．２７）μｍ。对照组大、中、小视盘组的ＲＮＦＬ厚度差异无统计学意义（Ｐ＞０．０５）。早期青光眼ＲＮＦＬ厚度曲线的上或下方峰值降低,但仍然具备上、下方的双峰特征,各组的下方峰皆高于上方峰。其中大视盘组患者ＲＮＦＬ厚度最薄（７０．２５±１４．７１）μｍ,其次是中视盘组（８５. ５５±１５．３９）μｍ和小视盘组（８７．５５±９．４６）μｍ,大视盘组与中视盘组、小视盘组的视盘ＲＮＦＬ厚度的差异有统计学意义（均为Ｐ＜０．０５）,中视盘组与小视盘组的ＲＮＦＬ厚度差异无统计学意义（Ｐ＞０．０５）。早期青光眼患者与对照组不同类型视盘的ＲＮＦＬ均为厚度差异均有统计学意义（均为Ｐ＜０．０５）。结论　对照组不同大小的视盘并不影响ＲＮＦＬ厚度,早期青光眼患者视盘的ＲＮＦＬ厚度明显变薄,但仍然具备上、下方的双峰特征,各组的下方峰皆高于上方峰,其中大视盘患者的ＲＮＦＬ比中、小视盘受损更严重。     

原发性开角型青光眼患者视网膜神经纤维层厚度与视野缺损的相关性研究

目的　探讨原发性开角型青光眼（ｐｒｉｍａｒｙｏｐｅｎａｎｇｌｅｇｌａｕｃｏｍａ,ＰＯＡＧ）患者视网膜神经纤维层（ｒｅｔｉｎａｌｎｅｒｖｅｆｉｂｅｒｌａｙｅｒ,ＲＮＦＬ）厚度与视野缺损的相关性。方法　选取２０１３年４月至２０１４年５月我院收治的３０例（３０眼）ＰＯＡＧ患者作为观察组,另选取同期于我院体检的３０名健康者作为对照组,检测两组受试者的ＲＮＦＬ厚度及视野缺损情况。结果　观察组上方、下方、颞侧、鼻侧四个象限的ＲＮＦＬ厚度分别为（９２．５３±１０．７２）μｍ、（９１．４８±１１．４５）μｍ、（７４．６８±８．３３）μｍ、（７１．４５±９．１５）μｍ,对照组分别为（１４１．６７±１９．４５）μｍ、（１３７．６１±１８．４６）μｍ、（９４．５５±１１．６４）μｍ、（９０．４９±１０．４８）μｍ,差异均有统计学意义（均为Ｐ＜０．０５）;观察组上方、下方、颞侧、鼻侧四个象限的视野缺损值分别为（６．４９±０．８４）ｄＢ、（５．９１±０．６９）ｄＢ、（８．４２±０．９５）ｄＢ、（７．２９±０．９４）ｄＢ。相关性分析显示,观察组ＲＮＦＬ厚度与各相应视野内的视野缺损呈负相关,回归系数ｂ的差异均有统计学意义（均为Ｐ＜０．０５）。结论　ＰＯＡＧ患者存在ＲＮＦＬ损伤及视野缺损,且二者具有负相关性,能够准确判断病情。     

剥脱性青光眼患者视网膜神经纤维层厚度变化分析

目的：比较维吾尔族假性剥脱综合征(PEX)患者、剥脱性青光眼(PEXG)患者视网膜神经纤维层(RNFL)厚度,为早期诊断剥脱性青光眼提供理论依据。

方法：回顾性病例对照研究。选取2018-04/ 2020-06在我院就诊治疗的维吾尔族假性剥脱综合征患者70例70 眼,剥脱性青光眼患者 80例80 眼,按照视野缺损分期分为早中期剥脱性青光眼患者56眼、晚期剥脱性青光眼患者24眼,选取同期本院收治的维吾尔族年龄相关性白内障病例60例60 眼作为对照组。比较四组患者视盘不同位置RNFL厚度。

结果：对照组、假性剥脱综合征组及剥脱性青光眼组患者视野缺损(MD)逐渐加重且剥脱性青光眼组患者MD显著高于假性剥脱综合征组(P<0.01); 假性剥脱综合征组、早中期剥脱性青光眼组及晚期剥脱性青光眼组视盘不同位置RNFL厚度较对照组均变薄(均P<0.01); 假性剥脱综合征组患者视盘平均RNFL、下方、上方RNFL厚度均低于对照组(均P<0.01)); 晚期剥脱性青光眼组患者视盘各个位置RNFL厚度明显低于早中期剥脱性青光眼患者(均P<0.01)。

结论：维吾尔族假性剥脱综合征患者早期RNFL厚度较未患有剥脱综合征人群开始变薄,早期对于假性剥脱综合征患者RNFL进行检测有助于剥脱性青光眼疾病诊断并进行治疗。     

OCT检测青光眼视网膜神经纤维层局部缺损的临床研究

背景传统眼底照相的方法诊断视网膜神经纤维层（RNFL）局部缺损依赖于检查者的主观经验,而光学相干断层扫描（OCT）可以客观判断RNFL的局部缺损,新的频域OCT对RNFI,缺损的显示更直观。目的评价频域OCT、时域OCT对青光眼RNFL局部缺损的诊断价值及其与眼底彩色照相的一致性。方法由2位青光跟专家通过眼底彩色照相一致确认存在RNFL局部缺损的青光眼患者55例55眼和正常对照41名41眼纳入研究,分析眼底彩色照相、频域CirrusHD-OCT、时域Stratus OCT分别检测的RNFL局部缺损的位置和宽度,进行三者检测结果的一致性和相关性研究,评价OCT对RNFL局部缺损的诊断价值。结果确认青光眼患者55眼中共有RNFL局部缺损75处,分别位于颞上和颞下象限。CirrusHD-OCT和Stratus OCT检测RNFL损害的灵敏度分别是88．O％和69．3％,特异度分别是927％和97．6％。CirrusHD-OCT和Stratus OCT检测RNFL缺损的位置均与眼底彩色照相结果的检测值呈高度正相关（r=0．993、r=0．992,P〈0．01）;二者检测的RNFL缺损宽度与眼底彩色照相结果的检测值呈正相关（r=0．420、r=0．432,P=0．019、P=0．002）,CirrusHD-OCT和Stratus OCT检测RNFL缺损宽度与眼底彩色照相的检测值比较差异均无统计学意义（CirrusHD-OCT：P=0．114;Stratus OCT：P：0．074）。CirrusHD-OCT和Stratus-OCT检测RNFL缺损宽度值差异有统计学意义（P：0．002）。结论频域OCT和时域OCT均具有较好的诊断RNFL局部缺损的价值,与眼底彩色照相检测值有较好的一致性。     

糖尿病患者早期视盘周围视网膜神经纤维层厚度及全视野闪光视网膜电图观察

目的 探讨无明显糖尿病视网膜病变(NDR)及轻、中度非增生性糖尿病视网膜病变患者(NPDR)视盘周围视网膜神经纤维层(RNFL)厚度及全视野闪光视网膜电图(ERG)的变化及其之间的关系.方法 选择在河北沧州眼科医院门诊普查的2型糖尿病(DM)患者128例(256只眼),依据检查结果按照糖尿病视网膜病变国际分期标准分为NDR组及轻、中度NPDR共3组,选择年龄相匹配的正常人38名(76只眼)作为对照组,所有受检者瞳孔散大后均行全视野闪光ERG检查判断视网膜功能并用光学相干断层扫描(OCT)对视盘周围RNFL厚度进行扫描.结果 与对照组相比,暗适应3.0反应DM各组振荡电位反应,轻、中度NPDR组b波振幅,中度NPDR组a波振幅及明适应3.0反应中度NPDR组b波振幅均下降(P＜0.05),各组明、暗适应3.0反应b波及轻、中度NPDR组暗适应3.0反应a波潜伏期均延迟(P＜0.05);DM患者视盘周围RNFL厚度较正常对照组均较薄,NDR组上方象限,轻度NPDR组上、下象限和中度NPDR组各象限及全周平均RNFL厚度与正常对照组差异有统计学意义(P＜0.05).结论 随着DM患者视网膜病变程度的增加,视网膜功能受损逐渐加重,视盘周围RNFL厚度逐渐降低,ERG与OCT两者相结合,为判断视网膜功能及预后、定量检测RNFL厚度变化提供可靠的检测依据.     

OCT检测视网膜神经纤维层厚度与视盘大小的相关性研究

目的探讨光学相干断层扫描(OCT)技术常规扫描模式检测视网膜神经纤维层(RNFL)厚度是否受视盘大小的影响,为其准确客观地应用于临床提供理论依据。方法对年龄在18～30岁的正常人118名(118眼)应用OCT常规扫描模式对盘周RNFL厚度进行检测。应用眼底照相检测视盘面积、水平及垂直直径。分析RNFL厚度与视盘大小的相关性。结果全周平均RNFL厚度值,上方、下方、鼻侧、颞侧象限RNFL厚度值分别为(112.02±10.13)、(135.16±19.04)、(138.56±16.46)、(71.56±14.91)、(97.43±17.98)μm。视盘垂直、水平直径及面积分别为(1.88±0.25)mm2、(1.79±0.19)mm2及(2.67±0.44)mm2。RNFL厚度值与视盘面积有正相关性(P<0.05)。结论OCT常规扫描模式检测RNFL厚度受视盘大小的影响。     

视网膜神经纤维层厚度与糖尿病视网膜病变程度的相关性研究

目的通过光学相干断层扫描(optical coherence tomography,OCT)仪观察具有不同视网膜病变程度的2型糖尿病患者及正常人视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度,探讨RNFL厚度与糖尿病视网膜病变(diabetic retinopathy,DR)的程度是否有相关性。方法正常对照组50人89眼,2型糖尿病患者75例130眼,按DR国际临床分型标准分为无糖尿病视网膜病变(non-diabetic retinopathy,NDR)组37例70眼、非增生性糖尿病视网膜病变(non-proliferative diabetic retinopathy,NPDR)组21例33眼、增生性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)组17例27眼,所有患者均行眼科常规检查和OCT检查;OCT测量数据包括:视盘周围360°平均及上方、下方、鼻侧和颞侧平均RNFL厚度。结果正常对照组RNFL厚度视盘360°平均为(106.80±9.28)μm、上方(130.24±16.13)μm、下方(137.50±14.12)μm、鼻侧(75.02±8.90)μm、颞侧(84.20±12.39)μm;NDR组RNFL厚度360°平均为(104.20±7.12)μm、上方(120.46±20.40)μm、下方(137.63±11.18)μm、鼻侧(74.42±6.50)μm、颞侧(84.38±12.58)μm;NPDR组RNFL厚度360°平均为(86.67±4.22)μm、上方(105.97±7.22)μm、下方(114.97±5.29)μm、鼻侧(52.93±7.86)μm、颞侧(72.81±6.91)μm;PDR组RNFL厚度360°平均为(127.92±6.44)μm、上方(154.48±9.28)μm、下方(167.22±9.59)μm、鼻侧(83.33±9.83)μm、颞侧(106.63±10.40)μm。与正常对照组相比,NPDR、PDR组各方位RNFL厚度差异均有统计学意义(均为P<0.05),NPDR组变薄而PDR组变厚;NDR组与正常对照组比较,只有360°平均及上方有统计学意义(均为P<0.05);NDR、NPDR、PDR三组间两两比较,差异均有统计学意义(均为P<0.05)。结论糖尿病患者RNFL厚度的变化与DR的程度具有相关性,NDR及NPDR患者RNFL厚度变薄提示眼底开始出现神经节细胞凋亡的可能,当RNFL厚度由薄转为增厚则提示出病变的进行性加重,对临床早期诊断及治疗具有指导意义。     

青光眼的视网膜神经纤维层缺损及视盘参数改变

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。     

Correlation of Peripapillary Choroidal Thickness and Retinal Nerve Fiber Layer Thickness in Normal Subjects and in Patients with Glaucoma

Purpose: This study was designed to compare the normal and glaucomatous eyes regarding retinal nerve fiber layer (RNFL) thickness and peripapillary choroidal thickness (PCT), and to investigate the correlation of RNFL thickness and PCT. Subjects and Methods: Subjects were selected as a convenience sample of those from a tertiary referral practice of glaucoma. Thirty-two glaucomatous eyes were accepted as group 1; 30 normal eyes were accepted as group 2. Groups were compared for RNFL thickness and PCT. Correlations of RNFL thickness and PCT were assessed for each peripapillary location. Results: Mean inferior and superior RNFL thickness in group 1 were significantly lower than the control group; mean thicknesses of temporal and nasal quadrants were not different in the two groups. Mean PCT at 500 µm distance in the inferior, at 1500 µm distance in the superior, at 500, 1000, and 1500 µm distance in the temporal, and at 1000 and 1500 µm distance in nasal quadrants were found to be significantly thinner in the glaucoma group compared with the control group. Retinal nerve fiber thickness was strongly correlated with PCT at all points of inferior quadrants at 500 µm distance in the superior. There was no correlation between RNFL thickness and PCT at any point in the control group. Conclusion: Peripapillary choroidal thickness was thinner in glaucomatous eyes compared with normal eyes. Correlation of PCT and RNFL thickness found in patients with glaucoma did not exist in normal subjects.     

近视儿童青少年盘周神经纤维层厚度的研究

目的：通过测量6～18 岁正视和近视儿童青少年盘周神经纤维层（RNFL）厚度,分析盘周平均RNFL厚度及相关的影响因素,研究不同屈光状态下盘周RNFL厚度分布地形图特点。方法：横断面研究。采用频域光学相干断层扫描仪测量6～18岁正视和近视儿童青少年盘周RNFL厚度,测量眼部及全身生物学指标（包括身高、体质量、体质量指数、头围、胸围、腰围、血压等）。根据等效球镜度（SE）分为不同的屈光组（包括正视组、低度近视组、中度近视组和高度近视组）,分析不同屈光状态下盘周不同区域RNFL厚度和地形图及厚度变化的影响因素。盘周RNFL厚度与各测量指标之间的相关性采用一元和多元逐步回归,各个组之间的差异采用单因素方差分析。结果：1 056 名正视和近视儿童青少年盘周各区域平均RNFL厚度为（104 ± 10）μm,正视组为（107 ± 9）μm,低度近视组为（105 ± 9）μm,中度近视组为（101 ±10）μm,高度近视组为（95 ± 8）μm。不同屈光组之间RNFL厚度差异均具有统计学意义（P < 0.01）。多元逐步回归显示RNFL平均厚度与SE（r=0.25,P < 0.001）、眼轴长度（AL）（ r=-0.18,P < 0.001）和晶状体厚度（LT）（ r=0.10,P =0.033）有相关性,与SE和LT呈正相关,与AL呈负相关;与性别、年龄等其他因素无相关性。不同屈光组,盘周RNFL厚度分布地形图不同。所有参与者的颞下象限最厚,为（162 ± 23）μm,鼻侧象限最薄,为（61 ± 10）μm。正视组和不同程度近视组中RNFL厚度均为颞下象限最厚,鼻侧象限最薄,其他区域的厚度地形图在不同的屈光组是不同的。颞侧盘周RNFL厚度随近视程度增加而增加,低度近视组为（87 ± 14）μm,高度近视组为（98 ± 21）μm;而其他区域的RNFL厚度则随着近视度数的增加而降低,尤其是鼻下象限。结论：盘周RNFL平均厚度与SE和LT呈正相关,与AL呈负相关;近视程度不同,盘周各区域RNFL厚度分布不同;颞侧RNFL随近视程度增加而逐渐变厚,其余象限则变薄。     

Comparison of the Diagnostic Ability of Retinal Nerve Fiber Layer Thickness Measured using Time Domain and Spectral Domain Optical Coherence Tomography in Primary Open Angle Glaucoma

 Purpose: To evaluate and compare the diagnostic ability of retinal nerve fiber layer (RNFL) thickness measurements using time domain (Stratus) and spectral domain (Cirrus HD) optical coherence tomography (OCT) in preperimetric and early primary open angle glaucoma (POAG). Methods: A total 62 eyes of 62 normal subjects, 47 eyes of 47 early perimetric damage POAG patients and 30 eyes of 30 preperimetric glaucoma patients were chosen in the study. All the subjects underwent peripapillary RNFL thickness measurements using Stratus OCT and Cirrus HD-OCT on the same day by a single trained operator. The RNFL thickness measured by Stratus OCT and Cirrus HD-OCT was statistically compared using paired t-tests. The relationship between RNFL thickness measured by two OCT instruments was evaluated using Pearson’s correlation coefficient. Areas under the receiver operating characteristic curves (AROC) were calculated and compared. Results: RNFL thickness measured using Stratus OCT was generally thicker than that using Cirrus HD-OCT(P＜0.05). A highly significant correlation between the two OCT instruments measurements was found in four quadrants and average RNFL thickness measurements (P＜0.001). The average RNFL thickness of Cirrus HD-OCT had significantly (P = 0.006) higher diagnostic ability (AROC = 0.951) than that of Stratus OCT (AROC = 0.881) in preperimetric glaucoma. There were no significant differences between the AROCs for other RNFL thickness parameters from Cirrus HD-OCT and Stratus OCT in preperimetric and early glaucoma (P＞0.05). Conclusion: Significant differences and an excellent correlation were noted in terms of RNFL thickness measurements using Stratus OCT and Cirrus HD-OCT. Cirrus HD-OCT presented higher diagnostic ability for preperimetric glaucoma.     

剥脱性青光眼与剥脱综合征黄斑厚度及体积比较

目的：对比分析剥脱性青光眼（PXG）、剥脱综合征（PEX）患者及正常人(CON)黄斑厚度及体积的差异。方法：病例对照研究。连续性选取2014 年5 月至2017 年5 月在石家庄市第一医院住院治疗的PXG病例31例（31眼）,PEX病例16例（16眼）及性别、年龄相匹配的CON 34例（34眼）分别作为PXG组、PEX组、CON组。3 组纳入人员均进行黄斑区OCT-3D模式扫描,并对黄斑各区厚度及体积进行单因素方差分析。结果：CON组、PEX组、PXG组黄斑平均厚度分别为（305±15）μm、（299±12）μm、（289±18）μm,黄斑平均体积分别为（0.94±0.05）μm3、（0.92±0.03）μm3、（0.89±0.06）μm3。3组间黄斑厚度总体差异在鼻内环（NIM）、上内环（SIM）、颞内环（TIM）、下内环（IIM）、上外环（SOM）、颞外环（TOM）、下外环（IOM）区有统计学意义（F=4.887、8.987、7.889、9.489、6.462、6.464、7.964,P < 0.05）,在中心凹厚度（CMT）、中央区（CSF）、鼻外环（NOM）区差异无统计学意义;3组间体积总体差异在NIM、SIM、TIM、IIM、SOM、TOM、IOM区有统计学意义（F=4.352、8.697、7.920、8.513、6.185、6.411、9.095,P < 0.05）,在CSF、NOM区差异无统计学意义。进一步两两比较显示,PXG组与CON组相比,黄斑厚度在NIM、SIM、TIM、IIM、NOM、SOM、TOM、IOM区变薄（P < 0.05）;黄斑体积在NIM、SIM、TIM、IIM、NOM、SOM、IOM区变小（P < 0.05）。PXG组与PEX组相比,黄斑厚度及 体积在SIM、IIM、SOM区变薄（P < 0.05）。结论：与PEX患者及正常人相比,PXG患者黄斑厚度变薄、体积变小,监测黄斑厚度的变化对PXG的临床诊治具有重要意义。     

近视快速增长儿童眼底神经纤维层厚度和血流参数特征

目的：利用光学相干断层扫描血管成像技术（OCTA）研究近视快速增长儿童的眼底黄斑区和视乳头区微细结构和血流灌注等临床特征。方法：病例对照研究。纳入7～14岁快速增长（1年近视增长 >1.00 D）的近视患儿40例（快速增长组）,同时选取39例增长缓慢（1年近视增长≤0.50 D）的近视患 儿作为对照（稳定增长组）,分别测量其屈光度和最佳矫正视力,通过LenStar测量眼轴,OCTA测量 黄斑区和视乳头区血流参数和神经纤维层（RNFL）厚度。2组间血流参数和RNFL厚度比较采用协方 差分析,眼轴、屈光度、视网膜厚度、血流密度之间相关性采用Pearson相关。结果：快速增长组和 稳定增长组眼轴分别为（24.7±0.9）mm和（24.5±0.8）mm,2组差异无统计学意义。黄斑区3 mm早 期糖尿病视网膜病变研究（ETDRS）分区视网膜深层和浅层以及视乳头4.5 mm GH（Garway heath）分 区的毛细血管血流密度的比较,2组在各局部区域的差异均无统计学意义,但在视乳头旁平均RNFL 厚度和视乳头鼻侧区域,快速增长组明显较缓慢增长组薄（P<0.05）。近视增长量和眼底血流参数不 相关,但与视乳头鼻侧区域RNFL厚度呈负相关。结论：儿童近视快速增长未伴有眼底血流密度的异常,但可伴有视乳头旁鼻侧、鼻上方和鼻下方RNFL厚度变薄,眼底血流参数对近视发展速度的 预估作用尚需进一步研究。     

Peripapillary Retinal Nerve Fibre Layer Thinning Secondary to Nutritional Folic Acid Deficiency

Folic acid has a fundamental role in central nervous system (CNS) function at all ages, especially the methionine synthase–mediated conversion of homocysteine to methionine, which is essential for nucleotide synthesis and genomic and non-genomic methylation. Folic acid and vitamin B12 may have roles in the prevention of disorders of CNS development, mood disorders, and dementias, including Alzheimer disease and vascular dementia in elderly people. The authors examined the peripapillary retinal nerve fibre layer thickness (RNFLT) in patients with nutritional folic acid deficiency using optical coherence tomography (OCT). Patients were divided into two groups according to blood folic acid levels: blood folic acid <7 nmol/L as Group 1 and >7 nmol/L as Group 2. Peripapillary RNFL measurements were performed. There were significant positive correlations between serum folate levels and RNFLT in all quadrants (p < 0.05), except for the temportal quadrant (p = 0.41).     

Peripapillary Retinal Nerve Fiber Layer Thickening Associated with Vitreopapillary Traction

Abstract

Purpose: To report two cases of retinal nerve fiber layer (RNFL) thickening as measured by Cirrus high-definition spectral-domain optical coherence tomography (OCT) associated with vitreopapillary traction. Methods: Consecutive peripapillary RNFL thickness assessments were performed using OCT in eyes with glaucoma and ocular hypertension. Results: OCT measurements revealed RNFL thickening when compared with the prior examination. A vitreopapillary traction to the thickened side of the RNFL was noted in a cross-sectional image of the optic nerve head obtained by OCT. Conclusion: Given that RNFL thickening can mask glaucomatous changes of the RNFL, caution is needed in glaucoma evaluation in eyes with vitreopapillary traction to the RNFL.     

Measurement of Retinal Nerve Fiber Layer Thickness and Macular Volume for Glaucoma Detection Using Optical Coherence Tomography

Purpose

To evaluate retinal nerve fiber layer (RNFL) thickness and macular volume in normal eyes and in the eyes of patients with glaucoma, and to compare the usefulness of these measurements in diagnosing glaucomatous eyes.

Methods

Eighty-one eyes were divided into three groups: normal control (n = 31), early glaucoma [n = 31, mean deviation (MD) ≥ ?6?dB], and advanced glaucoma (n = 19, MD < ?6?dB). The RNFL thickness and macular volume were measured using Stratus OCT (optical coherence tomography). Then, the diagnostic power of these parameters was evaluated.

Results

In eyes with early glaucoma, RNFL thickness was decreased significantly in eight of the 12 peripapillary sectors, and macular volume was decreased significantly in six of the nine macular sectors, compared with normal eyes. In the advanced glaucoma eyes, RNFL and macular volume were decreased throughout, except in RNFL thickness in the papillomacular region, and in retinal thickness in the foveal region. The area under the receiver-operating characteristic curve (AUROC) of the average RNFL (0.963) was larger than the macular volume (0.919).

Conclusions

Both peripapillary RNFL thickness and macular volume were decreased even in the early stage of glaucoma. Average RNFL thickness had greater diagnostic power than macular volume.?Jpn J Ophthalmol 2007;51:197–203 © Japanese Ophthalmological Society 2007

     

Reduced Retinal Nerve Fiber Layer Thickness of the Papillomacular Bundle and Congenital Pit of the Optic Nerve Head

A 32-year-old healthy woman with a history of poor visual acuity of the left eye was found to have a temporal optic nerve head pit, with no leakage on fluorescein angiography. Visual field showed a caecocentral scotoma, more profound at the location related to the pit. Optical coherence tomography showed the characteristics of the optic pit and excluded signs of previous macular detachment; Moreover, it disclosed a significantly reduced retinal nerve fiber layer thickness at the papillomacular bundle. Thus, reduction of the papillomacular bundle is an additional cause of poor visual acuity in cases of optic pit.     

Comparison of Ganglion Cell and Retinal Nerve Fiber Layer Thickness in Pigment Dispersion Syndrome,Pigmentary Glaucoma,and Healthy Subjects with Spectral-domain OCT

Purpose: To evaluate the ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL) thickness in pigment dispersion syndrome (PDS) and pigmentary glaucoma (PG) with RTVue spectral domain optical coherence tomography (SD-OCT). Methods: A total of 102 subjects were enrolled: 29 with PDS, 18 with PG, and 55 normal subjects. Full ophthalmic examination including visual field analysis was performed. SD-OCT was used to analyze GCC superior, GCC inferior, and average RNFL thickness. To compare the discrimination capabilities, the areas under the receiver operating characteristic curves were assessed. Results: Superior GCC, inferior GCC, and RNFL thickness values of patients with PG were statistically signicantly lower than those of patients with PDS (p?p?p?>?0.05). Conclusions: The SD-OCT-derived GCC and RNFL thickness parameters can be useful to discriminate PG from both PDS and normal subjects.