Comparison of retinal nerve fiber layer measured by time domain and spectral domain optical coherence tomography in optic neuritis

Purpose

To study the relationship between retinal nerve fiber layer (RNFL) thickness measurements from time domain (Stratus) and spectral domain (Cirrus HD) optical coherence tomography (OCT) in subjects with optic neuritis.

Methods

A total of 18 patients who had suffered monocular acute optic neuritis were imaged by a single trained operator using the Stratus-OCT (fast RNFL scan mode) and Cirrus HD-OCT (optic disc cube mode) on the same day. The relationship between RNFL thickness measurements of the two OCTs (overall and by quadrants) were evaluated using intraclass correlation coefficient (ICC) and Bland–Altman plots. Comparisons between eyes having optic neuritis (ON-group) and fellow eyes (fellow-group) were assessed by a generalized estimating equation (GEE) regression model.

Results

For Stratus-OCT, the median average RNFL was 86.3 and 102 μ in the ON-group and in the fellow-group, respectively. For Cirrus-OCT, the corresponding measurements were 81 and 93 μ. Average RNFL thickness as determined by the two OCT devices was well correlated in the ON-group (ρ=0.906, P<0.001) and in the fellow-group (ρ=0.702, P=0.001). The median signal strength was significantly higher with Cirrus-OCT. Bland–Altman plots showed that Stratus RNFL measurements were larger than Cirrus-OCT, but smaller when average RNFL thickness was very thin (≤56 μ).

Conclusions

Although the Cirrus-OCT and Stratus-OCT RNFL thickness measurements are well correlated in patients with optic neuritis, RNFL measurements cannot be directly compared. Clinicians should be aware that measurements are generally higher with Stratus- than with Cirrus-OCT.     

Frequency doubling technique perimetry and spectral domain optical coherence tomography in patients with early glaucoma

Purpose

To assess the combined diagnostic power of frequency-doubling technique (FDT)-perimetry and retinal nerve fibre layer (RNFL) thickness measurements with spectral domain optical coherence tomography (SDOCT).

Methods

The study included 330 experienced participants in five age-related groups: 77 ‘preperimetric'' open-angle glaucoma (OAG) patients, 52 ‘early'' OAG, 50 ‘moderate'' OAG, 54 ocular hypertensivepatients, and 97 healthy subjects. For glaucoma assessment in all subjects conventional perimetry, evaluation of fundus photographs, FDT-perimetry and RNFL thickness measurement with SDOCT was done. Glaucomatous visual field defects were classified using the Glaucoma Staging System. FDT evaluation used a published method with casewise calculation of an ‘FDT-score'', including all missed localized probability levels. SDOCT evaluation used mean RNFL thickness and a new individual SDOCT-score considering normal confidence limits in 32 sectors of a peripapillary circular scan. To examine the joined value of both methods a combined score was introduced. Significance of the difference between Receiver-operating-characteristic (ROC) curves was calculated for a specificity of 96%.

Results

Sensitivity in the preperimetric glaucoma group was 44% for SDOCT-score, 25% for FDT-score, and 44% for combined score, in the early glaucoma group 83, 81, and 89%, respectively, and in the moderate glaucoma group 94, 94, and 98%, respectively, all at a specificity of 96%. ROC performance of the newly developed combined score is significantly above single ROC curves of FDT-score in preperimetric and early OAG and above RNFL thickness in moderate OAG.

Conclusion

Combination of function and morphology by using the FDT-score and the SDOCT-score performs equal or even better than each single method alone.     

Agreement of angle closure assessments between gonioscopy, anterior segment optical coherence tomography and spectral domain optical coherence tomography

AIM: To determine angle closure agreements between gonioscopy and anterior segment optical coherence tomography (AS-OCT), as well as gonioscopy and spectral domain OCT (SD-OCT). A secondary objective was to quantify inter-observer agreements of AS-OCT and SD-OCT assessments. METHODS: Seventeen consecutive subjects (33 eyes) were recruited from the study hospital’s Glaucoma clinic. Gonioscopy was performed by a glaucomatologist masked to OCT results. OCT images were read independently by 2 other glaucomatologists masked to gonioscopy findings as well as each other’s analyses of OCT images. RESULTS: Totally 84.8% and 45.5% of scleral spurs were visualized in AS-OCT and SD-OCT images respectively (P<0.01). The agreement for angle closure between AS-OCT and gonioscopy was fair at k=0.31 (95% confidence interval, CI: 0.03-0.59) and k=0.35 (95% CI: 0.07-0.63) for reader 1 and 2 respectively. The agreement for angle closure between SD-OCT and gonioscopy was fair at k=0.21 (95% CI: 0.07-0.49) and slight at k=0.17 (95% CI: 0.08-0.42) for reader 1 and 2 respectively. The inter-reader agreement for angle closure in AS-OCT images was moderate at 0.51 (95% CI: 0.13-0.88). The inter-reader agreement for angle closure in SD-OCT images was slight at 0.18 (95% CI: 0.08-0.45). CONCLUSION: Significant proportion of scleral spurs were not visualised with SD-OCT imaging resulting in weaker inter-reader agreements. Identifying other angle landmarks in SD-OCT images will allow more consistent angle closure assessments. Gonioscopy and OCT imaging do not always agree in angle closure assessments but have their own advantages, and should be used together and not exclusively.     

频域OCT检查对黄斑水肿特点的分析

目的 通过频域OCT对黄斑水肿形态进行观察,了解水肿程度及分布情况,并分析水肿与视力的相关性.方法 选取患黄斑水肿患者25例29只眼,病例包括视网膜中央静脉阻塞所致为8例8只眼,视网膜分支静脉阻塞7例7只眼,葡萄膜炎4例4只眼,糖尿病性视网膜病变6例10只眼.年龄52-83(64.76±8.30)岁.最佳矫正视力(BCVA)0.05～1.0(0.35±0.12).利用最新一代频域RTVueFD-OCT对黄斑区进行扫描.结果 黄斑区15°范围内神经上皮厚度(453.00±103.12)μm,其中各区域神经上皮层厚度为:中心凹(533.10±115.23)μm,旁中心区(488.93±89.71)μm,中心凹边缘区(397.05±83.52)μm.不同区域神经上皮层厚度比较差异有统计学意义(F=2.937,P<0.01),黄斑区中心凹区神经上皮层厚度与中心凹边缘区神经上皮层厚度比较差异有统计学意义(与上、下、鼻、颞侧比较结果P<0.01,以中心凹区最厚,依次为下、上、颞、鼻侧边缘区).而中心凹神经上皮层厚度与旁中心凹区神经上皮层厚度比较差异无统计学意义与上、下、鼻、颞侧比较结果P>0.05.患者BCVA与中心凹神经上皮层厚度间存在负相关关系(r=-0.784,P<0.01),与旁中心凹区神经上皮层厚度间无相关关系(r=-0.134,P>0.05),与中心凹边缘区神经上皮层厚度间无相关关系(r=.275,P>0.05).结论 频域OCT能够精确地对黄斑水肿进行活体组织学成像,具有简便、非侵入性、重复性好等特点.     

Comparison of choroidal thickness in systemic hypertensive subjects with healthy individuals by spectral domain optical coherence tomography

Purpose:The purpose of the study was to compare the choroidal thickness in normal population and hypertensive patients and to assess the possible effect of hypertension on choroidal thickness using Spectral Domain Optical Coherence Tomography (SD-OCT).Methods:This was a comparative cross-sectional study. A total of 68 eyes of 34 individuals in the age group of 40–60 years were included in both the hypertensive group and control group. Individuals with refractive error beyond ± 3 D and posterior segment pathology were excluded. The choroidal thickness was measured at the sub-foveal region, 500 μm nasal and 500 μm temporal to the fovea on SD-OCT with enhanced depth imaging (EDI) mode. Systolic blood pressure (SBP), Diastolic blood pressure (DBP), and Mean arterial pressure (MAP) were recorded in all individuals. Duration of hypertension was also noted in hypertensive individuals.Results:The choroidal thickness at all locations was significantly lower in the hypertensive group (subfoveal, nasal, temporal and mean choroidal thickness 253.24 ± 63.96 μm, 249.35 ± 63.57 μm, 250.01 ± 63.37 μm, 250.87 ± 63.38 μm, respectively) as compared to the control group (subfoveal, nasal, temporal and mean choroidal thickness 301.25 ± 55.79 μm, 298.97 ± 57.07 μm, 299.49 ± 55.06 μm, 299.90 ± 55.50 μm, respectively). The choroidal thickness in the hypertensive group also had a significant negative correlation with the SBP (Spearman correlation coefficient, rho = –0.35, P = 0.003) and the duration of hypertension (rho = -0.25, P = 0.037).Conclusion:The study demonstrated decreased choroidal thickness in systemic hypertensive subjects as compared to age-matched healthy individuals. The choroidal thickness in hypertensive subjects also had a significant but weak negative correlation with SBP and duration of hypertension.     

频域OCT对正常中青年人黄斑区视网膜厚度的测量研究

目的研究频域Cirrus HD-OCT测量中青年人黄斑区视网膜厚度正常值。设计横断面研究。研究对象18～36岁的正常人98例196眼。方法用Cirrus HD-OCT的512×128及200×200两种扫描模式对受试者双眼黄斑区进行检测。主要指标黄斑中心区视网膜厚度,黄斑区视网膜体积,黄斑区平均视网膜厚度。结果采用512×128扫描模式,黄斑中心区视网膜厚度为(242.41±20.02)μm,黄斑区视网膜体积为(10.01±0.60)mm3,黄斑区平均视网膜厚度为(280.71±12.41)μm。九个分区视网膜平均厚度之间除了内环上方与内环鼻侧及内环颞侧与外环鼻侧之间无显著性差异外,其余各区之间均有显著性差异。左右眼之间差异无统计学意义。采用512×128及200×200两种扫描模式所测结果差异无统计学意义。结论频域Cirrus HD-OCT测量的正常中青年人黄斑区视网膜厚度较文献报告的Stratus OCT约厚50μm,在临床上进行比较时应注意仪器差异。     

Spectral domain anterior segment optical coherence tomography assessment of pterygium and pinguecula

Purpose: To study the morphological patterns of pterygia and pingueculae using high‐resolution anterior segment spectral domain optical coherence tomography (SD‐OCT). Methods: Prospective cross‐sectional study of 25 eyes presented with pterygia and pingueculae was conducted, and the eyes were examined by anterior segment SD‐OCT. Results: We examined 25 eyes, including 13 eyes with primary pterygia, six eyes with recurrent pterygia, one case with a pseudopterygium and five eyes with pingueculae. Primary pterygia revealed elevation of the corneal epithelium by a wedge‐shaped mass of tissue separating the corneal epithelium from the underlying Bowman’s membrane, which became wavy and interrupted. We found satellite masses of pterygium tissue advanced under the epithelium beyond the clinically seen pterygium margins. In recurrent pterygia, we detected that the central tip of the pterygium was more advanced and creeping beneath the basal corneal epithelium than the primary pterygium. In pseudopterygium, the SD‐OCT images showed that the overgrowing membrane was not really attached to the underlying cornea. In cases of pingueculae, SD‐OCT revealed a wedge‐shaped mass that was nearly similar in pattern to that of the pterygia but stopped at the limbal region. Immediately after removal of pterygia, we noticed many remnants of the pterygia masses over the corneal stroma in spite of the clinically clear appearance of cornea. Conclusions: SD‐OCT provided us with high‐resolution images of the pterygium and the pinguecula and showed clearly the anatomical relationship between the corneal tissues and these lesions. The use of this new modality of imaging may help to decrease the current recurrence rates after pterygium excision through using the anterior segment SD‐OCT in the evaluation of these lesions.     

Morphological and functional changes in spectral domain optical coherence tomography and microperimetry in macular microhole variants: spectral domain optical coherence tomography and microperimetry correlation

Purpose:

To evaluate the relationship between the morphology and retinal function of macular microhole (MMH) variants.

Materials and Methods:

We evaluated 12 eyes of 11 patients with defects in the IS/OS junction of photoreceptor layer with SD-OCT. All patients underwent comprehensive ophthalmic examination including spectral domain optical coherence tomography (SD-OCT) and microperimetry.

Results:

The mean logMAR visual acuity in the affected eye was 0.15 ± 0.17 (range 0.00–0.5). Mean horizontal diameter of the MMH was 163 ± 99 μm; the mean retinal sensitivity in the area corresponding to the MMH was 13.79 ± 4.6 dB. Negative correlation was found between the MMH diameter and the retinal sensitivity (r = -0.65, p = 0.02). Three morphological patterns of MMH variants were recognized on SD-OCT, which did not differ in retinal sensitivities.

Conclusion:

We described and classified the MMH variants and made an assessment on the physiological functions using microperimeter.     

Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as inflammation markers in patients with papilledema due to idiopathic intracranial hypertension

Purpose:The aim of this study was to investigate the role of inflammation in the pathogenesis of idiopathic intracranial hypertension (IIH) using the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as inflammation markers.Methods:The files of 33 IIH patients and 33 controls were screened for this retrospective study. For each patient, the NLR and PLR values were calculated using a single fasting blood sample. For both eyes, papilledema (PE) grades, best-corrected visual acuity (BCVA), retinal nerve fiber layer thickness (RNFLT), and ganglion cell layer thickness (GCLT) measurements were recorded along with the demographic data, including body mass index (BMI), and complete neurological and ophthalmological findings. Comparisons between the two groups and between the IIH patients with and without PE were made. The associations of NLR and PLR with all other parameters were analyzed independently from age, gender, and BMI.Results:NLR and PLR were higher in patients with IIH than controls (P < 0.05). They were also higher in patients with PE (P < 0.05) in the IIH group. NLR and PLR were found to be associated with BCVA (P < 0.001 and P = 0.023, respectively), global RNFLT (P = 0.004 and 0.012, respectively), RNFLT of the temporal quadrant (P < 0.001 and P = 0.042, respectively) and PE grade (P < 0.001 and P = 0.035, respectively).Conclusion:The NLR and PLR values and their associations with BCVA, RNFLT, and PE support the hypothesis that inflammation is a very important component of the pathogenesis of IIH.     

20MHz B型超声与频域光学相干断层扫描在黄斑病变诊断中的对比观察

背景 黄斑区病变的形态学检查在疾病的早期诊断中发挥着重要作用.频域光学相干断层扫描(OCT)在屈光间质混浊眼的检查受到限制,传统的10 MHz B型超声检查对黄斑病变的分辨率较低,20 MHzB型超声检查在黄斑区疾病中的应用是一种新的方法. 目的 应用频域OCT和20 MHz B型超声对黄斑病变进行形态学对比观察,探讨20 MHz B型超声对黄斑疾病的临床诊断价值.方法 收集在天津医科大学眼科中心确诊的黄斑病变患者51例51眼,患眼均行频域OCT扫描,然后行20 MHz B型超声检查.黄斑病变按频域OCT检查的形态学改变进行分类,分析20 MHz B型超声的声像学特征,探讨病因. 结果 根据频域OCT检查检出黄斑裂孔 10眼,B型超声显示黄斑区实性圆顶状回声表浅隆起,病变中央呈孔状凹陷.频域OCT检出的黄斑水肿16眼、神经上皮层脱离6眼和视网膜劈裂4眼,B型超声均显示黄斑区球壁表面的局限性带状表浅隆起,其下见液性无回声间隙.频域OCT检出的视网膜色素上皮(RPE)层脱离15眼,B型超声检查显示黄斑区球壁表面局限带状强回声表浅隆起,光带较厚,其下见液性无回声间隙. 结论 20 MHz B型超声能对几种常见的黄斑病变进行初步鉴别,与频域OCT相比,黄斑病变B型超声表现的识别能力稍欠,但在屈光间质混浊的情况下,B型超声的诊断作用优于频域OCT.     

频域OCT测量正常学龄期儿童黄斑区视网膜厚度

目的　应用频域ＯＣＴ测量正常学龄期儿童的黄斑区视网膜厚度。方法　选取６～１２岁儿童１０８人,以最佳矫正远视力≥１．０、最佳矫正近视力Ｊｒ１、球镜屈光度范围（－１．００～＋１．００Ｄ）、柱镜屈光度范围（－１．００～＋１．００Ｄ）为纳入标准,最终选取２１３眼。应用ＣｉｒｒｕｓＨＤ-ＯＣＴ的２００×２００扫描模式和５１２×２１８扫描模式对受试者双眼黄斑区视网膜进行检查,测量黄斑中心视网膜厚度（ｃｅｎｔｒａｌｓｕｂｆｉｅｌｄｔｈｉｃｋｎｅｓｓ,ＣＳＴ）、黄斑区视网膜容积（ｍａｃｕｌａｒｖｏｌｕｍｅ,ＭＶ）、黄斑区平均视网膜厚度（ａｖｅｒａｇｅｍａｃｕｌａｒｔｈｉｃｋｎｅｓｓ,ＡＭＴ）及九分区模式视网膜厚度。结果　两种扫描模式下黄斑区视网膜厚度值差异均无统计学意义（均为Ｐ＞０．０５）。左右眼差异无统计学意义（均为Ｐ＞０．０５）。男童ＣＳＴ（２４０．６８±１６．５７）μｍ厚于女童（２３４．５１±１８．６５）μｍ（Ｐ＝０．０４０）,且男童内环各分区视网膜厚度均厚于女童（均为Ｐ＜０．０５）。结论　本研究应用ＨＤ-ＯＣＴ测量正常儿童ＡＭＴ,为确定国人学龄期儿童ＡＭＴ正常值及疾病诊断提供参考,提示临床注意性别差异。     

Corneal and corneal epithelial thickness distribution characteristics in healthy North Indian eyes using spectral domain optical coherence tomography

Purpose:To determine the pattern of corneal thickness and epithelial thickness distribution in healthy North Indian eyes by using spectral domain optical coherence tomography (SD-OCT).Methods:The observational study measured total corneal and epithelial thickness in the central 2 mm zone and eight sectors each in paracentral 2–5 mm (ring 1) and midperipheral 5–7 mm (ring 2) zones on SD-OCT.Results:The study included 67 eyes of 67 subjects with a male:female ratio of 32:35 and mean age of 25.04 ± 4.54 years. The mean central corneal and epithelial thicknesses were 505.97 ± 30.12 mm and 60.48 ± 8.37 mm, respectively. The epithelium of inferior and infero-nasal sectors in ring 1 and inferior sector in ring 2 was significantly thicker than the radially opposite sectors of the respective rings (P = 0.001; P = 0.01 and P = 0.02, respectively). Sector-wise analysis did not reveal any significant correlation between the total corneal thickness and epithelial thickness (all P > 0.05) except in the outer superior sector where there was a weak positive correlation (r = 0.28, P = 0.02). Central epithelial thickness in males (60.59 ± 9.28 mm) and females (60.37 ± 7.58 mm) was comparable (P = 0.91). Pachymetry was thinnest in the inferior, inferonasal, and inferotemporal sectors in 44.79% of eyes (n = 30), while thinnest epithelium was seen in the superior, superonasal, and superotemporal quadrants in 50.75% of eyes (n = 34)Conclusion:The epithelial thickness distribution in this sample of topographically normal healthy North Indian eyes was nonuniform and independent of the underlying corneal thickness. Epithelium was thinner in the superior cornea, whereas total corneal thickness was minimum in the inferior part.     

Comparison of peripapillary capillary plexus using optical coherence tomography angiography and retinal nerve fibre layer analysis using spectral domain optical coherence tomography in glaucoma patients,glaucoma suspects,and healthy subjects

Purpose:To assess the association between radial peripapillary capillary (RPC) plexus using optical coherence tomography angiography (OCTA) and retinal nerve fibre layer (RNFL) thickness using spectral domain OCT (SD-OCT) in primary open-angle glaucoma (POAG) patients, glaucoma suspects, and healthy subjects.Methods:In this single-centre cross-sectional observational study, POAG, glaucoma suspects, and healthy patients underwent OCT-RNFL and optic nerve head angiography scans. The RNFL thickness and the vascular parameters obtained from RPC plexus, including perfusion density (PD), flux index (FI), and vessel density (VD), were analysed.Results:In all, 120 eyes of 120 patients, including 40 POAG patients, 40 glaucoma suspects, and 40 healthy subjects, were included. The pairwise comparison of mean RNFL thickness, FI, and VD showed significant difference (P < 0.001) in all sectors between POAG, glaucoma suspects, and healthy eyes. However, PD showed no significant difference between glaucoma suspects and healthy eyes. The average RNFL thickness was found to have a better diagnostic ability than VD to distinguish POAG eyes from healthy eyes and glaucoma suspects based on receiver operating characteristics curve and area under the curve. VD had better diagnostic accuracy than RNFL when glaucoma suspects and healthy were compared.Conclusion:OCT-RNFL has better diagnostic capability in differentiating glaucoma from healthy eyes compared to OCTA. However, OCTA was found to be better in screening out glaucoma suspects from healthy eyes. The VD is a better OCTA parameter than FI and PD to differentiate POAG and glaucoma suspects from healthy eyes.     

频域OCT检测青光眼视网膜神经节细胞复合体厚度的研究

背景 青光眼以视网膜神经节细胞( RGCs)丢失为主要的病理特征,频域光学相干断层扫描(SD-OCT)可以检测黄斑区视网膜神经节细胞复合体(GCC)厚度. 目的 探讨黄斑区视网膜GCC厚度在原发性开角型青光眼(POAG)人群的分布特征. 方法 采用系列病例对照研究设计.利用SD-OCT( RTVue100)和时域OCT(TD-OCT)技术分别检测POAG患者101例101眼和年龄、屈光度相匹配的正常对照者41例41眼视网膜的黄斑区整体平均GCC厚度(GCC-Avg)、上方平均GCC厚度(GCC-Sup)和下方平均GCC厚度(GCC-Inf)及对应区域视盘旁视网膜神经纤维层(RNFL)厚度,按照POAG的程度分为视野损害前POAG组、早期POAG组、进展期POAG组和晚期POAG组,比较各POAG组与正常对照组间上述3个GCC参数的差异,分析GCC厚度和RNFL厚度的相关性以及青光眼患者视野平均缺损值(MD)与GCC厚度的相关性. 结果 视野损害前POAG组、早期POAG组GCC-Avg、GCC-Sup和GCC-Inf值均明显低于正常对照组,差异均有统计学意义( GCC-Avg:t=5.411、10.247,P＜0.01:GCC-Sup:t=6.171、9.484,P＜0.01; GCC-Inf:t=5.281、8.592,P＜0.01).进展期POAG组GCC-Avg、GCC-Sup和GCC-Inf值均明显低于早期POAG组,差异均有统计学意义(GCC-Avg:t =4.246,P＜0.01;GCC-Sup:t=2.419,P=0.019;GCC-Inf:t=4.636,P＜0.01),而晚期POAG组GCC-Avg、GCC-Sup和GCC-Inf值均明显低于进展期POAG组,差异均有统计学意义(GCC-Avg:t=2.095,P=0.040;GCC-Sup:t=2.756,P＜0.01;GCC-Inf:t=2.018,P=0.040).GCC-Sup、GCC-Inf和GCC-Avg值与对应区域平均RNFL厚度值均呈高度正相关(r=0.802、0.825、0.856,P＜0.01),青光眼患者的视野MD值与GCC-Avg值呈正相关( r=0.601,P＜0.01). 结论 SD-OCT能够定量测量并区分青光眼患者与正常人群的黄斑区GCC厚度,GCC厚度随青光眼病情的进展而逐渐变薄,并与RNFL和视野的损害有较好的相关性.     

Anterior-segment spectral domain optical coherence tomography in epidermolysis bullosa

PurposeAssess epidermolysis bullosa (EB)-related corneal pathology using anterior segment optical coherence tomography (AS-OCT) and correlate imaging with clinical metrics in EB patients versus age-matched controls.MethodsEB patients and controls were recruited during an EB conference (July 2018) and at Tufts Medical Center (June–August 2019). Subjects completed a questionnaire, had best corrected visual acuity (BCVA) tested, and underwent AS-OCT scanning. Stromal and epithelial thickness were measured. Depth, length, and type of the three largest lesions were assessed by a masked examiner using a novel pathology grading system. Multivariate analysis of AS-OCT findings and clinical metrics was performed.Results62 EB patients and 60 age-matched controls were enrolled. Mean BCVA was 1.8 lines worse in patients (p < 0.001). Vision loss was associated with increased stromal thickness. Discrete lesions were seen in 60.2% of patient eyes, averaging 1.71 ± 1.75 lesions in patients and 0.14 ± 0.42 in controls (p < 0.001). Mean primary lesion depth was 151.88 ± 97.49 μm in patients. Patients showed significant stromal thickening versus controls and lesions were most common in the periphery and inferiorly. Differences in frequency and duration of abrasions and severity of pain were all statistically and clinically significant in patients versus controls (p < 0.001).ConclusionsAS-OCT can visualize and quantify differences in the corneas of EB patients compared with age-matched controls. Novel findings include quantification of average depth, length, and severity of discrete lesions, and sparing of the superior quadrant from stromal thickening in EB patients. These results support use of AS-OCT and a questionnaire in clinical trials for new EB therapies.     

Analysis of spectral domain optical coherence tomography findings in occult macular dystrophy

Acta Ophthalmol. 2011: 89: e52–e56

Abstract.

Purpose: To describe findings of spectral domain optical coherence tomography (SD‐OCT) in the diagnosis of occult macular dystrophy (OMD). Materials and Methods: Five visually disturbed patients who had shown normal findings in full field electroretinogram (ERG), fundus photography and fluorescein angiography but abnormal findings in multifocal ERG had undergone SD‐OCT. The morphologic changes in retina and macular thickness were detected and imaged by SD‐OCT. We analysed the results of SD‐OCT including macular thickness, inner segment and outer segment (IS/OS) boundary and external limiting membrane (ELM). Results: Mean age was 41.6 (22–63) in three male and two female patients in this study. Mean central foveal thickness was 142.9 (76–161) μm. All patients had shown decreased bowing of IS/OS boundary, and five of nine eyes were noted with disrupted IS/OS boundary of the photoreceptors according to SD‐OCT. The interruption of external limiting membrane was noted in three of nine eyes. Conclusions: Spectral domain optical coherence tomography findings are useful in diagnosing OMD. Morphologic changes of the retina including deformity of the OS/IS boundary of the photoreceptors, disruption of the ELM and decreased foveal thickness may be important characteristics to consider when determining the pathophysiology and diagnosing criteria of OMD.     

三维光学相干断层扫描在特发性黄斑前膜诊治中的应用

目的:应用三维光学相干断层扫描(3D-OCT)观察特发性黄斑前膜(idiopathic epiretinal membrane,IERM)的形态特征和临床应用。方法:应用3D-OCT观察IERM患者59例71眼,分析中心凹形态及感光细胞(IS/OS)情况。结果:IERM的3D-OCT图像表现为视网膜表面薄厚不一的高反光带,或紧贴于黄斑表面或与其部分相连。绝大多数黄斑中心凹变浅,厚度增加;术后黄斑区视网膜前膜消失。在59例71眼中合并板层裂孔者18眼、假性黄斑裂孔者17眼、弥漫水肿者15眼、中心凹正常者5眼、囊肿者16眼。结论:3D-OCT可以直接客观地显示IERM及手术前后黄斑部各种组织结构的改变,为IERM的临床诊断、手术效果及治疗评价提供了更加准确可靠的信息。     

频域光学相干断层扫描在视网膜神经纤维层厚度测量中的应用

目的应用频域光学相干断层扫描（OCT）测量非青光眼受试者和青光眼患者的视盘周视网膜神经纤维层（RNFL）厚度,并对测量结果进行重复性检验。方法非青光眼受试者和青光眼患者各30例纳入研究,随机选取受试者一侧眼的数据进行统计分析。应用Spectralis OCT对每位受试者进行视盘周RNFL厚度测量,应用“随诊”模式进行3次扫描。计算出受试者内部标准筹（Sw）、变异系数（CV）和同类相关系数（ICC）,以评价该仪器测量的可重复性。应用Spearman秩相关系数分析评估每位受试者RNFL厚度平均数值与其3次测量的标准差之间的天系。结果非青光眼受试者的CV数值范围为1．44％（全周厚度平均值）～2．58％（颞侧象限）,青光眼患者的CV为1．73％（全周）～3．24％（颞侧象限）;非青光眼受试者的ICC数值范围为0．977（颞侧象限）～0．990（鼻下45。扇形区）,青光眼患者的ICC数值范围为0．981（颞侧象限）～0．997（下方象限）;非青光眼受试者的Sw为1．33μm（全周）～2．36μm（颞上45°扇形区）,青光眼患者的Sw为1．13μm（全周）～2．26μm（鼻上45。扇形区）;RNFL厚度数值与测量变异性间无明显相关性（P〉0．05）。结论高速扫描和眼跟踪系统使Spectralis OCT在测量非青光眼受试者和青光眼患者的视盘周RNFL厚度均有良好的可重复性,是青光眼长期随诊中对于其结构性损害可信赖的影像学检查技术。