相干光断层扫描测量正常人和青光眼患者黄斑厚度

目的 探讨相干光断层成像(optical coherence tomography,OCT)测量黄斑厚度对青光眼的诊断价值.设计 前瞻性对照研究.研究对象 62例(101眼)正常人和41例(64眼)青光眼患者.方法 应用Stratus OCT测量正常人和青光眼患者的黄斑厚度,观察正常人和青光眼患者的黄斑厚度地形图的图像特征;将正常人和青光眼患者黄斑厚度进行比较;用受试者工作特征曲线下面积(area under the receive operator characteristic curve,AROC)的分析方法找出青光眼早期诊断的最佳指标.主要指标 黄斑厚度地形图特征及各分区黄斑厚度、AROC.结果 正常人黄斑厚度地形图呈"马蹄形",青光眼患者的黄斑区视网膜呈局限性或弥漫性变薄.青光眼患者黄斑各分区视网膜厚度均比正常人减少,差异有统计学意义(P＜0.05),而早期青光眼患者仅黄斑外环各分区较正常人减少,差异有统计学意义(P＜0.05).无论是正常人和青光眼患者之间还是正常人和早期青光眼患者之间,黄斑下方外环区的AROC均最大(分别为0.876、0.728).结论 OCT测量正常人黄斑厚度地形图呈"马蹄形",青光眼患者黄斑厚度呈局限性或弥漫性变薄,黄斑下方外环区改变是较佳的早期诊断指标.(眼科,2008,17:25-28)     

高度近视眼黄斑体积的分区测定

目的:应用光学相干断层成像(OCT)技术研究高度近视眼黄斑部视网膜神经上皮层体积的变化。方法:将高度近视眼68例68眼和正常对照者59例59眼分为高度近视组和对照组,OCT测量黄斑中心凹最薄处神经上皮层厚度以及后极部视网膜地形图各个区域体积,比较两组结果的差异性。结果:高度近视眼组黄斑中心凹最薄处神经上皮层厚度145.7±20.2μm,正常对照组为151.9±26.7μm,两者差异无显著性(P=0.276)。高度近视眼组黄斑部视网膜神经上皮层体积为6.761±0.579mm3,正常对照组为7.262±0.508mm3,高度近视眼组黄斑体积明显小于正常组(P=0.006)。结论:OCT能够对黄斑部神经上皮层体积进行分区精确测量,可以作为研究高度近视眼后极部视网膜变化的手段之一。     

Comparison of glaucomatous parameters in normal, ocular hypertensive and glaucomatous eyes using optical coherence tomography 3000

This study was performed to evaluate optic disc appearance, retinal nerve fiber layer (RNFL) thickness, and macular thickness in normal, ocular hypertensive (OHT) and glaucomatous eyes using optical coherence tomography (OCT) 3000. One hundred fifty-eight eyes of 167 consecutive subjects were enrolled: 60 normal, 53 OHT, and 54 glaucomatous. OCT topographic parameters of cup diameter, cup area, rim area, and cup/disc area ratio were significantly less in OHT eyes than in normal eyes and were significantly less in glaucomatous eyes than in normal and OHT eyes. RNFL was significantly thinner in OHT eyes than in normal eyes in the inferior quadrant, and in glaucomatous eyes than in OHT and normal eyes in the mean and for all four quadrants. Macular thickness was significantly thinner in glaucomatous eyes than in OHT and normal eyes throughout all subdivisions. Optic disc parameters, and RNFL and macular thickness measurements made with OCT may be useful in the clinical assessment of glaucoma.     

Detection of progressive macular thickness loss using optical coherence tomography in glaucoma suspect and glaucomatous eyes

Aims

To examine the rate of macular thickness loss using time-domain optical coherence tomography (OCT) in functionally progressing versus non-progressing eyes, determined by standard automated perimetry (SAP).

Methods

Glaucoma suspects (GS) and glaucomatous (G) eyes underwent SAP and OCT imaging every 6 months. Functional progression was determined using pointwise linear regression, defined as 2 contiguous locations losing ≥1.0 dB/year at P<1.0% in the same hemifield. The annual rate of macular thickness loss was calculated from inner and outer regions of the macular map.

Results

72 eyes (43 GS and 29G) with ≥30 months of follow-up were enroled. Fourteen eyes demonstrated SAP progression. The annual rate of macular thickness loss (μm/year) in progressing eyes was faster (all P<0.05) than non-progressing eyes in temporal outer (−1.90±2.97 vs 0.33±2.77), nasal inner (−1.70±2.66 vs 0.14±2.76), superior inner (−2.15±4.57 vs 0.51±2.99), temporal inner quadrants (−2.58±5.05 vs −0.38±2.34), and the average of inner macular quadrants (−1.84±2.90 vs 0.03±2.10). The rate of loss in the nasal inner (P=0.02) and temporal outer (P=0.02) macular regions was associated with optic disc haemorrhage.

Conclusions

Eyes with SAP progression have significantly greater rates of macular thickness loss consistent with glaucomatous retinal ganglion cell atrophy, as compared with non-progressing eyes.     

Discrimination between normal and glaucomatous eyes using Stratus optical coherence tomography in Taiwan Chinese subjects

Background We differentiated between normal and glaucomatous eyes in the Taiwan Chinese population based solely on the quantitative assessment of summary data reports from Stratus optical coherence tomography (OCT) by comparing their area under the receiver operating characteristic (ROC) curve.Methods One randomly selected eye from each of the 62 patients with early glaucomatous damage (mean deviation –2.8 ± 1.8 dB) and from each of the 62 age- and sex-matched normal individuals were included in the study. Measurements of glaucoma variables (retinal nerve fiber layer thickness and optic nerve head analysis results) were obtained by Stratus OCT. Twenty-one OCT parameters were included in a linear discriminant analysis (LDA) using forward selection and backward elimination to determine the best combination of parameters for discriminating between glaucomatous and healthy eyes based on ROC curve area.Results The average RNFL thickness was the best individual parameter for differentiating between normal eyes and glaucomatous eyes (ROC curve area 0.793). The maximum area under the ROC curve of six input parameters (average RNFL thickness; 10, 11, and 12 oclock segment thicknesses; cup area; and vertical integrated rim area) generated by the forward selection method was 0.881. Whereas the maximum area under the ROC curve of 15 input parameters (average RNFL thickness; 1, 3, 4, 6, 8–10, 12 oclock segment thicknesses; vertical integrated rim area; horizontal integrated rim area; disc area; cup to disc area ratio; cup to disc horizontal ratio; and cup to disc vertical ratio) generated by backward elimination method was 0.929.Conclusions The performance of individual parameters obtained from Stratus OCT is fairly reliable for differentiating the early glaucomatous eyes from normal eyes. However, the discriminant power increases when LDA with forward selection and backward elimination methods is applied.     

Reliability of nerve fiber layer thickness measurements using optical coherence tomography in normal and glaucomatous eyes

OBJECTIVE: To evaluate the reliability of nerve fiber layer (NFL) thickness measurements by optical coherence tomography (OCT) in normal and glaucomatous eyes. DESIGN: Prospective, comparative, observational case series and instrument validation study. PARTICIPANTS: Twenty-four glaucomatous patients were compared with 24 gender- and age-matched normal subjects. METHODS: Each individual underwent OCT measurements of NFL thickness. Five repetitions of a series of scans on five separate occasions within a 0.5-month period were performed. Each eye was scanned at three different nerve head programs (1.5 radius [R], R = 1.73 mm, 2.0 R). For each option (1.5 R, R = 1.73 mm, and 2.0R) and region (superior, inferior, temporal, nasal, and overall mean), variance components and intraclass correlation coefficients were determined using repeated measures regression. In these models, NFL thickness, as measured by OCT, was assumed to have three variance components: intersubject, intervisit (within-subject between-dates), and intravisit (within-subject within-date). The intraclass correlation coefficient (intersubject variance/total variance) was used as a measure of reliability. MAIN OUTCOME MEASURES: Measurements of NFL thickness using OCT were performed. RESULTS: Reliability values, as measured by intraclass correlation coefficients, resulted as follows: 1.5 R, 0.54/0.52 (normal/glaucoma); R = 1.73 mm, 0.50/0.50; 2.0 R, 0.49/0.50. CONCLUSIONS: Our results indicate that the recent commercially available OCT provides reliable NFL thickness measurements in both healthy and glaucomatous eyes with each circle radius tested. The greatest amount of variability can be attributed to intersubject differences.     

Assessment of macular retinal thickness and volume in normal eyes and highly myopic eyes with third-generation optical coherence tomography

PURPOSE: To compare the macular retinal thickness and macular volume between subjects with high myopia and non-myopia. METHODS: This prospective nonrandomized, comparative study recruited healthy subjects with high myopia subjects, defined as a spherical equivalence (SE) over -6 dioptres (D) or AXL>or=26.5 mm and the best corrected visual acuity better than 20/25, and subjects with non-myopia, defined as an with SE between 1.5D and -1.5 D and the BCVA better than 20/25. Optical coherence tomography was performed in each eye. RESULTS: Eighty high myopic eyes and 40 non-myopic eyes were included. The mean age of the high myopic group and non-myopia group was 29.6 and 27.5 years old, respectively. The mean refraction was -9.27 D in the high myopia group and -0.22 D in the non-myopia group. The high myopia group had significantly greater mean retinal thickness in the foveola and fovea 1 mm area than the non-myopia group (166 vs149 microm, P<0.0001, 199 vs188 microm, P=0.0063, respectively). However, the mean retinal thickness in the inner and outer macular area (superior, nasal, inferior, or temporal) of the high myopia group was significantly less than in the non-myopia group. In addition, the high myopia group had significantly smaller macular volume than the non-myopia group (P<0.0001). CONCLUSION: This study demonstrated that the retinal thickness in individuals with high myopia is thicker in the foveola and fovea, but thinner in the inner and the outer macular region. The retina of individuals with high myopia had smaller macular volume than those with non-myopia.     

Comparative evaluation of optical coherence tomography in glaucomatous, ocular hypertensive and normal eyes

BACKGROUND: To correlate the findings of optical coherence tomography (OCT) evaluation of retinal nerve fiber layer (RNFL) thickness with visual field changes in glaucomatous, ocular hypertensive and normal eyes. MATERIALS AND METHODS: Thirty consecutive normal, 30 consecutive ocular hypertensive and 30 consecutive glaucomatous eyes underwent a complete ophthalmic examination, including applanation tonometry, disc evaluation, (30-2) Humphrey field analyzer white on white (W/W) perimetry and short- wavelength automated perimetry. Thickness of the RNFL around the optic disc was determined with 3.4 mm diameter-wide OCT scans. Average and segmental RNFL thickness values were compared among all groups. A correlation was sought between global indices of perimetry and RNFL thickness. RESULTS: Of the 90 eyes enrolled (mean age of patients 52.32+/-10.11 years), the mean RNFL thickness was significantly less in ocular hypertensive (82.87+/-17.21 mm; P =0.008 and glaucomatous eyes (52.95+/-31.10 microm; P < 0.001), than in normals (94.26+/-12.36 microm). The RNFL was significantly thinner inferiorly in glaucomatous eyes (64.41+/-43.68 microm; P<0.001). than in normals (120.15+/-14.32 microm) and ocular hypertensives (107.87+/-25.79 microm; P<0.001). Ocular hypertensives had thinner RNFL in the nasal, inferior and temporal quadrants (P<0.001) when compared to normals. Global indices in ocular hypertensives on SWAP showed Mean Deviation (MD) of 5.32+/-4.49, Pattern Standard Deviation (PSD) 3.83+/-1.59 and Corrected Pattern Standard Deviation (CPSD) 2.84+/-1.85. The RNFL thickness could not be significantly correlated with global indices of visual fields in ocular hypertensives. CONCLUSION: Optical coherence tomography is capable of detecting changes at the level of RNFL in ocular hypertensive eyes with normal appearance of discs and W/W perimetry fields.     

Heidelberg retina tomography and optical coherence tomography in normal, ocular-hypertensive, and glaucomatous eyes.

PURPOSE: To evaluate optic disc and retinal nerve fiber layer (RNFL) appearance in normal, ocular-hypertensive, and glaucomatous eyes undergoing confocal scanning laser ophthalmoscopy and optical coherence tomography (OCT). DESIGN: Prospective, cross-sectional study. PARTICIPANTS: Seventy-eight eyes of 78 consecutive normal (n = 17), ocular-hypertensive (n = 23), and glaucomatous subjects (n = 38) were enrolled. METHODS: Each patient underwent complete ophthalmic examination, achromatic automated perimetry, confocal scanning laser ophthalmoscopy (Heidelberg Retinal Tomography [HRT]), and OCT. Topographic HRT parameters (disc area, cup-disc ratio, rim area, rim volume, cup shape measure, mean RNFL thickness, and cross-sectional area) and mean OCT-generated RNFL thickness were evaluated in each group. MAIN OUTCOME MEASURES: OCT and HRT assessment of optic disc and RNFL anatomy. RESULTS: OCT RNFL thickness showed no difference between normal and ocular-hypertensive eyes (P = 0.15) but was significantly less in glaucomatous eyes (P < 0.001). HRT measurements of rim area, cup-disc ratio, cup shape measure, RNFL thickness, and RNFL cross-sectional area were significantly less in glaucomatous eyes (all P < 0.005) and were correlated with mean OCT RNFL thickness (all P < 0.02). RNFL thickness using OCT or HRT was highly correlated with visual field mean defect during achromatic perimetry (P < 0.0001). CONCLUSION: Both HRT and OCT can differentiate glaucomatous from nonglaucomatous eyes. RNFL thickness measurements using OCT correspond to disc topographic parameters using HRT.     

Effect of pupil dilation on macular choroidal thickness measured with spectral domain optical coherence tomography in normal and glaucomatous eyes

To compare choroidal thickness before and after pupil dilation. Macular subfoveal, nasal, temporal and average choroidal thicknesses were measured in one eye of 17 healthy individuals and 40 glaucoma patients using enhanced depth imaging optical coherence tomography before and after pupil dilation. Comparisons were made between pre- and post-dilation measurements, and between normal and glaucomatous eyes. No statistically significant differences were found between pre- and post-dilation choroidal thickness measurements both in normal (p = 0.361 for subfoveal, 0.760 for nasal, 0.941 for temporal, 0.881 for average) and glaucomatous eyes (p = 0.687 for subfoveal, 0.340 for nasal, 0.913 for temporal, and 0.642 for average). After adjusting for age, the comparison between normal and glaucomatous eyes showed no significant differences in measurements both before (p = 0.701–0.907) and after pupil dilation (p = 0.757–0.988). Similar results were obtained for measurements unadjusted for age. Measurements obtained under the two conditions correlated well in normal (r = 0.92–0.97, p < 0.001) and in glaucomatous eyes (r = 0.84–0.98, p < 0.001). Bland–Altman analyses showed good agreements between them in both groups of eyes, with mean difference ranges of 0.43–2.86 and 0.39–3.08 μm between pre- and post-dilation measurements in normal and glaucomatous eyes, respectively. Subfoveal and average choroidal thickness decreased significantly by 2 μm/year. Each millimeter increase in axial length decreased subfoveal choroidal thickness by 16.5 μm and average thickness by 14.1 μm. Macular choroidal thicknesses measured before and after pupil dilation are comparable and may be used interchangeably without significant discrepancies both in normal and glaucomatous eyes.     

Macular and retinal nerve fiber layer analysis of normal and glaucomatous eyes in children using optical coherence tomography

PURPOSE: To evaluate macular and nerve fiber layer (NFL) thickness in normal and glaucomatous eyes of children 3 to 17 years old using optical coherence tomography (OCT-3). DESIGN: Observational cross-sectional study. METHODS: One hundred fifty-six eyes of 79 patients were enrolled in this institutional study. Fifty-two eyes (33.3%) met criteria for glaucoma and 104 (66.7%) were normal. There were 44 female (55.6%) and 35 male (44.3%) subjects whose ages ranged from 3 to 17 years old (mean 9.5 years, standard deviation 3.5 years, median 9 years). The OCT-3 (Carl Zeiss Meditec, Dublin, California) was used to obtain a fast macular thickness map as well as a fast retinal NFL map of each eye. Data from specific locations around the macula, as well as total macular volume, was analyzed. Similarly, the retinal NFL scan reports average NFL thickness from specific locations around the optic nerve. Data from the superior temporal and inferior temporal sections was analyzed. RESULTS: There was a statistically significant difference in macular thickness and NFL thickness when normal eyes were compared against those with glaucoma, in all quadrants studied (all P values 相似文献   

Detection of macular and circumpapillary structural loss in normal hemifield areas of glaucomatous eyes with localized visual field defects using spectral-domain optical coherence tomography

Background  

To investigate thickness of the macular ganglion cell complex (mGCC) and circumpapillary retinal nerve fiber layer (cRNFL) in retinal segments without visual field (VF) loss in glaucomatous eyes in which localized VF defects were confined to a single hemifield, using spectral-domain optical coherence tomography (SD-OCT).     

Optical coherence tomography measurement of macular and nerve fiber layer thickness in normal and glaucomatous human eyes

PURPOSE: To evaluate the hypothesis that macular thickness correlates with the diagnosis of glaucoma. DESIGN: Cross-sectional study. PARTICIPANTS: We studied 367 subjects (534 eyes), including 166 eyes of 109 normal subjects, 83 eyes of 58 glaucoma suspects, 196 eyes of 132 early glaucoma patients, and 89 eyes of 68 advanced glaucoma patients. METHODS: We used optical coherence tomography (OCT) to measure macular and nerve fiber layer (NFL) thickness and to analyze their correlation with each other and with glaucoma status. We used both the commercial and prototype OCT units and evaluated correspondence between measurements performed on the same eyes on the same days. MAIN OUTCOME MEASURE: Macular and NFL thickness as measured by OCT. RESULTS: All NFL parameters both in prototype and commercial OCT units were statistically significantly different comparing normal subjects and either early or advanced glaucoma (P < 0.001). Inner ring, outer ring, and mean macular thickness both in prototype and commercial OCT devices were found to be significantly different between normal subjects and advanced glaucomatous eyes (P < 0.001). The outer ring was the only macular parameter that could significantly differentiate between normal and early glaucoma with either the prototype or commercial OCT unit (P = 0.003, P = 0.008, respectively). The area under the receiver operator characteristic (AROC) curves comparing mean NFL thickness between normal and advanced glaucomatous eyes was 1.00 for both the prototype and commercial OCT devices for eyes scanned on both machines on the same day. The AROC comparing mean macular thickness in normal and advanced glaucomatous eyes scanned on both machines on the same day was 0.88 for the prototype OCT device and 0.80 for the commercial OCT. CONCLUSIONS: Both macular and NFL thickness as measured by OCT showed statistically significant correlations with glaucoma, although NFL thickness showed a stronger association than macular thickness. There was good correspondence between findings using both the prototype and commercial OCT units. Macular and NFL thickness measurements made with OCT may have usefulness in the clinical assessment of glaucoma.     

Spectral- and time-domain optical coherence tomography measurements of macular thickness in normal eyes and in eyes with diabetic macular edema

Purpose

To report macular thickness values in normal eyes and eyes with diabetic macular edema (DME) using time-domain (TD) and spectral-domain (SD) optical coherence tomography (OCT), and to derive a conversion equation.

Methods

The index study was a prospective investigation conducted on 80 eyes from 40 normal subjects and 130 eyes from 118 patients with DME seen in our clinic. Retinal thickness values from the central 1 mm of the macula and surrounding four ETDRS subfields were acquired using TD-OCT (Stratus OCT) and SD-OCT (SPECTRALIS HRA+OCT). Measurements of the central (C) subfield from both devices were used to derive a conversion equation. The equation was used to predict SD-OCT values using measurements from TD-OCT. Agreement between predicted and actual SD-OCT measurements was assessed.

Results

In normal eyes, the mean difference between TD-OCT and SD-OCT measurements of the C subfield was 76 μm (CI₉₅=74 and 77, respectively). The conversion equation, y=1.029x+72.49, was derived. In eyes with DME, using the equation, SPECTRALIS-predicted values were 5% higher than actual measurements, with 95% of predicted values falling within 9% of the actual measurements. Relocating SD-OCT grids to match the location on TD-OCT resulted in predicted values falling within 7% of actual measurements.

Conclusions

The percent difference between actual thickness measurements from SPECTRALIS and predicted thickness measurements, using the conversion equation, was within reported limits of repeatability of Stratus in eyes with DME. Our equation may help correlate OCT values from both devices in standard care and clinical trials for DME.     

Scanning laser polarimetry with variable corneal compensation and optical coherence tomography in normal and glaucomatous eyes

PURPOSE: To evaluate the relationship between visual function and retinal nerve fiber layer (RNFL) measurements obtained with scanning laser polarimetry with variable corneal compensation (SLP-VCC) and optical coherence tomography (OCT). DESIGN: Cross-sectional analysis of normal and glaucomatous eyes in a tertiary care academic referral practice. METHODS: A commercial GDx nerve fiber analyzer was modified to enable the measurement of corneal polarization axis and magnitude so that compensation for corneal birefringence was eye specific. Complete examination, SLP with fixed corneal compensation (FCC) and variable corneal compensation (VCC), optical coherence tomography (OCT) imaging of the peripapillary RNFL, and automated achromatic perimetry were performed in all subjects. Exclusion criteria were visual acuity less than 20/40, diseases other than glaucoma, and unreliable perimetry. RESULTS: Fifty-nine patients (59 eyes; 29 normal, 30 glaucomatous) were enrolled (mean age, 56.7 +/- 20.3 years, range, 20-91). All eyes with glaucoma had associated visual field loss (average mean defect, -8.4 +/- 5.8 dB). Using SLP-FCC, nine of 12 retardation parameters (75%) were significantly less in glaucomatous eyes. Using SLP-VCC, 11of 12 retardation parameters (92%) were significantly less in glaucomatous eyes. Multiple regression models constructed for each retardation parameter with visual field demonstrated that the following VCC parameters were statistically significant whereas FCC parameters were not: ellipse average (FCC, P =.28, VCC, P =.001), superior average (FCC, P =.38, VCC, P <.001), inferior average (FCC, P =.10, VCC, P =.008), average thickness (FCC, P =.30, VCC, P =.031), and superior integral (FCC, P =.43, VCC, P =.001). Similar results were obtained for multiple regression models constructed with OCT-derived RNFL thickness: ellipse average (FCC, P =.99, VCC, P =.002), superior average (FCC, P =.90, VCC, P <.001), inferior average (FCC, P =.61, VCC, P =.007), and superior integral (FCC, P =.92, VCC, P <.001). CONCLUSIONS: Compared with fixed compensation, mean-based SLP parameters generated with SLP-VCC have greater correlation with visual function and RNFL thickness assessments obtained with OCT.     

Scanning laser polarimetry with enhanced corneal compensation and optical coherence tomography in normal and glaucomatous eyes

PURPOSE: To examine the association between scanning laser polarimetry (SLP), using enhanced (ECC) and variable corneal compensation (VCC) with optical coherence tomography (OCT), and to compare their discriminating ability in the diagnosis of glaucoma. METHODS: Normal and glaucomatous eyes enrolled from four clinical sites underwent complete examination, automated perimetry, SLP-ECC, SLP-VCC, and OCT. Eyes were characterized in two groups based on the typical scan score (TSS): Normal birefringence pattern (NBP) was defined as a TSS of 80 to 100 and abnormal birefringence pattern (ABP) as TSS 相似文献   

Evaluation of scanning resolution on retinal nerve fiber layer measurement using optical coherence tomography in normal and glaucomatous eyes

PURPOSE: To evaluate the effect of varying the scanning resolution of optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) measurement on diagnostic sensitivity and functional correlation in glaucoma. PATIENTS AND METHODS: 314 eyes from 182 subjects including 107 normal eyes, 83 glaucoma suspect eyes, and 124 glaucoma eyes were included in this cross-sectional study. Standard automated perimetry and OCT measurement of RNFL thickness were performed. Each individual underwent two scanning protocols: (1) fast RNFL thickness (3.4) scan (with resolution of 256 scan points) and (2) RNFL thickness (3.4) scan (with resolution of 512 scan points). RNFL thickness was compared among the groups. Diagnostic sensitivity was evaluated with Receiver Operating Characteristic (ROC) Curve. Relationship between RNFL thickness and visual field mean deviation was examined using linear regression analysis. RESULTS: Measured RNFL thickness using fast RNFL thickness (3.4) scan was significantly higher compared with RNFL thickness (3.4) scan in average, superior, nasal and inferior RNFL in all diagnostic groups. Comparing normal and glaucoma groups, RNFL thickness (3.4) scan produced the largest area under the ROC curve (0.912) based on average RNFL thickness. A stronger correlation between average RNFL and visual field mean deviation was found in RNFL thickness (3.4) scan (R = 0.75, R = 0.56). CONCLUSIONS: Higher resolution RNFL scan provides better diagnostic sensitivity in glaucoma detection and a stronger correlation with visual function.     

Comparative glaucomatous diagnosis using macular optical coherence tomography and perimetry with centrally condensed stimuli

The presentation and measurement of the internal retinal layers by current optical coherence tomography (OCT) instruments allow a precise topographic localization of macular glaucomatous damage. Ganglion cell analysis in particular can reveal slight central defects and can effectively be correlated with perimetric strategies with centrally condensed stimuli, so that small glaucomatous defects can be confirmed earlier and more confidently. Progression can also be verified in the early stages of the disease as enlargement and deepening of small localized defects. Macular OCT (mOCT) cannot sufficiently detect peripheral glaucomatous defects and may be impaired by macular pathologies; therefore, mOCT should be combined with other morphometric examinations. In order to take advantage of the technical capabilities of current OCT devices appropriate perimetric strategies should also be applied. As the algorithms for documentation and evaluation of the results of current OCT instruments are far less advanced than the technical capabilities, OCT results still have to be visually scrutinized together with the visual field results to benefit from the technical possibilities provided by modern OCT devices.     

频域干涉光断层扫描观察正常人眼脉络膜厚度的研究

目的 应用频域干涉光断层扫描仪(spectral-domain optical coherence tomography,SDOCT)观测正常人眼脉络膜厚度,并观察其与年龄、性别的关系.方法 临床观察研究.对2010年6～12月在沈阳军区总医院眼科,无视网膜或脉络膜疾病的109人(109只眼)应用Cirrus HD-OCT行黄斑部扫描,测量黄斑中心凹下及由中心凹向鼻侧及颞侧每隔500μm直至2500μm的脉络膜厚度.并评估脉络膜厚度与年龄、眼别及性别的关系.结果 黄斑中心凹下脉络膜平均厚度为(298.13 ±44.56)μm,明显厚于其鼻、颞两侧部位(P＜0.01).由中心凹向鼻、颞两侧脉络膜厚度逐渐变薄,且距中心凹同等距离颞侧脉络膜厚度明显大于鼻侧脉络膜厚度(P＜0.01).中心凹下平均脉络膜厚度与性别、眼别无关,与年龄呈负相关(r =-0.48,P＜0.01).结论 脉络膜厚度与所处位置有关,与年龄呈负相关.