Differences by quadrant of retinal nerve fiber layer thickness in healthy eyes

PURPOSE: The purpose of this study was to determine the distribution of retinal nerve fiber layer thickness by quadrant in healthy eyes. PATIENTS AND METHODS: Forty subjects with healthy eyes were included in the study. A complete ophthalmic examination was performed, including determination of visual fields by automated perimetry. The subjects had no family history of retinal disease or glaucoma. Forty right eyes and 40 left eyes were measured. Retinal nerve fiber layer thickness was measured using simultaneous stereophotographs with stereophotogrammetry at the disc margin. For the total disc and four quadrants, absolute retinal nerve fiber layer thickness and optic disc area was determined using a magnification correction formula. RESULTS: Comparison of the quadrants showed that the retinal nerve fiber layer thicknesses of the superior, inferior, and nasal quadrants were significantly thicker than the temporal quadrant (P = 0.00006 for right and left eyes). No significant differences were observed between the superior, inferior, and nasal quadrants in the right eye. In the left eye, the superior retinal nerve fiber layer thickness was significantly greater than the inferior (P = 0.028) and nasal retinal nerve fiber layer thicknesses (P = 0.00006), while the inferior was not significantly different from the nasal. No significant difference in quadrant retinal nerve fiber layer thickness was noted between eyes. CONCLUSIONS: Measurements of retinal nerve fiber layer thickness in healthy eyes show the thinnest quadrant to be the temporal, with the other three quadrants having similar thicknesses. This pattern corresponds to the histologic measurements of retinal nerve fiber layer thickness.     

Correlation between optic nerve head parameters and retinal nerve fibre layer thickness measured by spectral-domain optical coherence tomography in myopic eyes

Background: To evaluate the correlation between optic nerve head parameters and retinal nerve fiber layer thickness measured by Cirrus HD spectral‐domain optical coherence tomography (Cirrus HD‐OCT; Carl Zeiss Meditec) in healthy myopic eyes. Design: Cross‐sectional study. Participants: One hundred and sixty‐one right eyes from 161 healthy young myopic subjects. Methods: Optic nerve head parameters and retinal nerve fiber layer thickness were measured with the Cirrus HD‐OCT. The distance between optic disc margin and scan circle (disc margin‐to‐scan distance) was measured on the Cirrus HD‐OCT en‐face optic nerve head image with aid of National Institutes of Health ImageJ image‐analysis software (developed by Wayne Rasbands, National Institutes of Health, Bethesda, MD). Main Outcome Measures: The correlations among optic nerve head parameters, retinal nerve fibre layer thickness and the disc margin‐to‐scan distance were evaluated with and without adjustment of the magnification effect. Results: Without correction of the magnification effect, the thicker average retinal nerve fiber layer was correlated with greater rim area and lower degree of myopia (P < 0.001). When the magnification effect was corrected, thicker average retinal nerve fibre layer was associated with greater disc area and greater rim area in univariate and multivariate analyses (P ≤ 0.028); however, degrees of myopia and the disc margin‐to‐scan distance were not significantly associated with average RNFL thickness (P ≥ 0.104). Conclusions: Thicker average retinal nerve fibre layer thickness was associated with greater rim and disc areas. Disc margin‐to‐scan distance was not significantly correlated with average retinal nerve fibre layer thickness in healthy myopic eyes.     

新型频域相关断层扫描对健康年轻人视网膜各参数的测量分析

目的：采用新型频域相关断层扫描测量分析健康年轻人中视网膜各参数生理的不对称性。方法：对146名健康年轻人进行横断面观察研究,采用新型频域相关断层扫描对其双眼视网膜参数（视网膜神经纤维层厚度、视盘、黄斑）进行扫描。通过右眼减去左眼所得参数值的平均差进行配对t检验。两眼间的差异采用2．5％～97．5％之间进行评估。视网膜参数相关。通过回归分析,评价性别和血压对视网膜参数的影响。结果：两眼的视网膜神经纤维层平均厚度无统计学差异（＋0．7μm,P＝0．09）。两眼视网膜颞侧象限（＋2．51μm,P＝0．02）,鼻侧象限（＋2．50μm,P＝0．04）,钟表位右眼2点与左眼10点（＋5．85μm,P＝0．002）,右眼3点与左眼9点（＋3．20μm,P＝0．005）,右眼11点与左眼1点（＋3．80μm,P＝0．024）,平均厚度（－0．034μm,P＝0．013）和垂直方向杯盘比（－0．028μm,P＝0．008）,黄斑部鼻侧象限（＋7．76μm,P＝0．003）。左眼上方视网膜明显较薄（－2．40μm, P＝0．03）。平均视网膜神经纤维层厚度和黄斑厚度分别为11μm和18μm。视网膜参数在双眼有中度的相关性（0．41～0．6）,而两眼视网膜参数与性别、血压不相关（P＜0．05）。研究表明通过新型频域相关断层扫描发现健康年轻人的视网膜神经纤维层厚度和黄斑厚度两眼间的差异分别不应超过11μm和18μm。结论：视网膜参数的不对称性存在于健康视网膜,并对早期视网膜病变的诊断提供有价值的评估。     

Optical coherence tomographic findings in optic nerve hypoplasia

We investigated a case of unilateral optic nerve hypoplasia using spectral domain optical coherence tomography (SDOCT). Optical coherence tomography was done on both eyes using 5-line Raster scan for the fovea to analyze the retinal nerve fiber layer thickness, inner retinal layer thickness, outer retinal layer thickness, and optic disc cube scan for the disc. Retinal nerve fiber layer thickness, inner retinal layer thickness, and outer retinal layer thickness were manually measured at 21-points of each five lines, and results were compared between both eyes. Retinal nerve fiber layer thickness and inner retinal layer thickness of optic nerve hypoplasia were significantly thinner than the opposite eye, but there was no significant difference in the thickness of the outer retinal layer between both eyes.     

Distribution characteristics of retinal nerve fiber layer thickness in macular area and its relationship with vessel density in highly myopic eyes

AIM: To investigate the distribution characteristics of retinal nerve fiber layer thickness and vessel density in macular area of eyes with high myopia, using optical coherence tomography angiography (OCTA). METHODS: Forty eyes in 20 patients diagnosed with high myopia, age 29.90±7.92 years old, with a spherical equivalent of -8.95±2.01 D, were recruited. The retinal nerve fiber layer (RNFL) thickness and the vessel density of the superficial retinal capillary plexus, deep retinal capillary plexus, and choroidal capillary were measured by OCTA. Macular regions within a 6-mm diameter circle were divided into 9 subfields: the central subfield, and the pericentral and peripheral regions of superior, inferior, nasal, and temporal quadrants. The retinal nerve fiber layer thicknesses of different subfields were compared, and their relationships with spherical equivalent, axial length, and vessel density were analyzed. RESULTS: In the pericentral region, the retinal nerve fiber layer thickness of the superior quadrant was the lowest, whereas thickness was highest in the inferior quadrant (all P<0.05). In the peripheral region, the retinal nerve fiber layer thickness of the temporal quadrant was the lowest (all P<0.05). A negative correlation was found between the retinal nerve fiber layer thickness and spherical equivalent (r=-0.356, P=0.024) in the peripheral superior subfield. The vessel density of superficial retinal capillary plexus was positively correlated with retinal nerve fiber layer thickness in the nasal and inferior quadrants of the pericentral region and in the superior, nasal, and inferior quadrants of the peripheral region (r=0.314, 0.408, 0.467, 0.655, and 0.737 respectively; and all P<0.05), whereas the vessel density of choroidal capillary was negatively correlated with retinal nerve fiber layer thickness in the peripheral superior subfield (r= -0.356, P=0.024). CONCLUSION: The RNFL of macular areas is not uniformly distributed in high myopia (HM). As the spherical equivalent (SE) increases, the RNFL thickness decreases in certain areas, which correlates with the vessel density(VD) of superficial retinal capillary plexus (SCP) and choroidal capillary (CC) layers.     

Evaluation of the retinal nerve fiber layer thickness in eyes with idiopathic macular holes

PURPOSE: To compare the retinal nerve fiber layer thickness in eyes with idiopathic macular holes and age-matched normal controls using scanning laser polarimeter. METHODS: The retinal nerve fiber layer thickness was measured in 40 eyes of 40 consecutive patients with idiopathic macular hole (stage 1, 10 eyes; stage 2, eight eyes; stage 3, 15 eyes; stage 4, seven eyes) and 40 eyes of 40 age-matched normal controls with a scanning laser polarimeter. The retinal nerve fiber layer thickness within a 10-pixel-wide ellipse located concentrically with the disk and located 1.5-disk diameters from the center of the disk was measured. The mean overall retinal nerve fiber layer thickness of the peripapillary retina, four 90-degree quadrants, and 16 equal sectors of every 22.5 degrees was calculated for both groups. The retinal nerve fiber layer thickness in the two groups was statistically compared. RESULTS: The mean retinal nerve fiber layer thickness measurement for the overall peripapillary retina and for three of the four 90-degree quadrants was not significantly different between the two groups. However, the temporal 90-degree quadrant was significantly thinner in the macular hole group (47.2 versus 54.6 microm, P =.026). For the 16 sectors of 22.5 degrees, the lower three sectors of the four sectors in the temporal quadrant were thinner in the macular hole group (P <.05). CONCLUSIONS: The retinal nerve fiber layer thickness of the papillomacular area is thinner in eyes with idiopathic macular hole than that in normal eyes. The progressive thinning of the retinal nerve fiber layer thickness as the stage of the macular hole advances may suggest that surgery should be done at the earliest stage.     

视网膜神经纤维层厚度及黄斑中心凹在儿童远视屈光参差性弱视中的临床意义

目的:分析眼轴长度与屈光度数及视网膜神经纤维层厚度在儿童远视屈光参差弱视患儿中的临床意义.方法:选取2015-01/2017-01在本院接受治疗被诊断为远视性屈光参差性弱视患儿103例,均为单眼发病,发病眼设为试验组(103眼),另一正常眼为对照组(103眼);检测患儿眼轴长度、屈光度数、黄斑中心凹厚度、矫正视力、屈光度和视盘周围神经纤维层的平均厚度.结果:两组对象在眼轴、屈光度和矫正视力方面的差异均有统计学意义(P<0.05);两组对象在视盘周围神经纤维层厚度对比差异无统计学意义(P>0.05),黄斑中心凹厚度对比差异有统计学意义(P<0.05);患儿矫正视力、眼轴与黄斑中心凹、视盘周围神经纤维层厚度无明显相关性(P>0.05),屈光度与黄斑中心凹、视盘周围的神经纤维层的厚度无明显相关性(P>0.05).结论:远视屈光参差弱视患儿的视网膜黄斑中心凹的厚度比正常眼要厚,弱视眼视盘周围的神经纤维层厚度和对侧眼无显著差异,屈光度和眼轴与视盘的周围神经纤维层和黄斑的中心凹厚度没有显著的关联.     

Relationships of retinal vessel diameters with optic disc, macular and retinal nerve fiber layer parameters in 6-year-old children

PURPOSE: To describe the normal anatomic relationships of retinal vessel diameters with optic disc, macula, and retinal nerve fiber layer parameters in young children. METHODS: This was a population-based, cross-sectional study of 1204 healthy children 6 years of age who were participating in the Sydney Childhood Eye Study. Retinal arteriolar and venular diameters were measured from fundus photographs using standardized computer-based methods. Optical coherence tomography was performed to obtain measurements of the optic disc, macula, and retinal nerve fiber layer parameters. RESULTS: In multivariate analyses, each standard deviation (SD) decrease in optic disc area was associated with a 0.14-pixel decrease (P = 0.05) in arteriolar diameter and a 0.31-pixel decrease (P < 0.01) in venular diameter. Each SD decrease in optic cup area was associated with a 0.15-pixel decrease (P = 0.05) in arteriolar diameter and a 0.43-pixel decrease (P < 0.01) in venular diameter. Each SD decrease in macular (inner/outer) thickness or volume was associated with a 0.25- to 0.39-pixel decrease (P < 0.01) in arteriolar diameter and a 0.36- to 0.71-pixel decrease (P < 0.01) in venular diameter, and each SD decrease in retinal nerve fiber layer thickness was associated with a 0.62-pixel decrease (P < 0.01) in arteriolar diameter and a 0.99-pixel decrease (P < 0.01) in venular diameter. CONCLUSIONS: Children's eyes with a smaller optic disc, thinner macula, and thinner retinal nerve fiber layer have narrower retinal vessels. These anatomic relationships may provide new insights into the vascular etiology of various ocular diseases.     

单眼屈光参差性弱视眼视网膜神经纤维层厚度分析

目的:比较单眼屈光参差性弱视患者弱视眼和非弱视眼视盘周围视网膜神经纤维层(retinal nerve fiber layer,RNFL)的厚度。方法:选择38例不伴有斜视的单眼屈光差性弱视患者,应用光学相干断层成像技术(OCT)测量其弱视眼和非弱视眼的视盘周围RNFL平均厚度。结果:弱视患者38例的平均年龄为10.73岁,弱视眼RNFL平均厚度为106.38±12.05μm,下方象限RNFL(I):133.67±19.44μm最厚,其次为上方象限(S):123.31±13.95μm,鼻侧象限(N):89.96±17.71μm,颞侧象限(T):70.06±10.18μm最薄;单眼屈光参差性弱视中,弱视眼的RNFL平均厚度和鼻侧象限RNFL厚度较对侧非弱视眼厚,差异具有统计学意义(P=0.016;P=0.01)。结论:单眼屈光参差性弱视患者弱视眼的RNFL厚度较非弱视眼厚,以鼻侧象限RNFL厚度和RNFL平均厚度的差异最为显著。     

单纯远视性弱视与远视散光性弱视视网膜神经纤维层和黄斑中心凹厚度比较

目的：比较青少年儿童单纯远视性弱视与远视散光性弱视状态下视网膜神经纤维层和黄斑中心凹厚度的差异。方法：病例对照研究。选取2015 年1 月至2016 年12 月山东省枣庄市立医院眼科视光中心收治的单眼屈光参差性弱视青少年儿童147例，根据屈光状态不同，分为B组（单纯远视性弱视）75例（75 眼）和C组（远视散光性弱视）72 例（72 眼），并以所有患儿对侧健康眼为A组进行对照。使用光学相干断层扫描（OCT）测量各组视网膜神经纤维层厚度和黄斑中心凹厚度。采用单因素方差分析进行组间比较分析。结果：A组、B组、C组视网膜神经纤维层厚度分别为（105±10）μm、（113±10）μm、（119±14）μm，黄斑中心凹厚度分别为（190±25）μm、（201±23）μm、（209±24）μm，3组间视网膜神经纤维层厚度与黄斑中心凹厚度比较差异均有统计学意义（F=14.241、16.179，均P < 0.001）。与A组比较，B、C组视网膜神经纤维层厚度和黄斑中心凹厚度均明显较大（均P < 0.001），且C组视网膜神经纤维层厚度和黄斑中心凹厚度均显著大于B组（均P < 0.001）。结论：屈光参差性青少年儿童远视散光性弱视眼的黄斑中心凹和视网膜神经纤维层厚度略厚于单纯远视性弱视眼。     

Optic disc area in different types of glaucoma

AIM: To evaluate the possible relationship of optic disc area with retina nerve fiber layer in different glaucoma subtypes. METHODS: One eye each was chosen from 45 patients with ocular hypertension, 45 patients with primary open angle glaucoma, 45 patients with pseudoexfoliation glaucoma and 45 healthy controls followed in our hospital. The records of the patients were reviewed retrospectively. Optic disc area and circumpapillary retina nerve fiber layer measurements were obtained using optical coherence tomography. Central corneal thickness was measured by ultrasound pachymetry. RESULTS: The median disc area in the patients with primary open angle glaucoma was significantly higher than the patients with ocular hypertension (2.19 vs 1.90 mm2, P=0.030). The median retina nerve fiber layer was thinner in the patients with primary open angle glaucoma and pseudoexfoliation glaucoma than the patients with ocular hypertension for superior, inferior and temporal quadrants. After adjustment for age, no difference in central corneal thickness was found between the groups. Greater disc area was associated with thicker retinal nerve fiber layer for superior, inferior and nasal quadrants in the patients with primary open angle glaucoma. There was no correlation between disc area and central corneal thickness measurements of the groups. CONCLUSION: Disc size affects the retinal nerve fiber layer thickness in eyes with primary open angle glaucoma and is a possible risk factor for glaucomatous optic nerve damage.     

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.     

三维OCT在开角型青光眼鉴别诊断价值

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.     

Analysis of optic disc damage by optical coherence tomography in terms of therapy in non-arteritic anterior ischemic optic neuropathy

This study aimed to assess the relationship between the rate of nerve fiber loss in non-arteritic anterior ischemic optic neuropathy (NAION) and time delay before therapy. Total 24 patients received the same treatment within or after 2wk (early and late groups). There were significantly lower level of destruction of nerve fibers (P=0.0014) and significantly better visual field sensitivity (P=0.039) in early group. The results indicate that therapy should be started within 2wk. The degree of ischemic damage due to NAION correlates well with retinal nerve fiber layer thickness and the ischemia-induced decrease in visual field sensitivity.     

Evaluation of retinal nerve fiber layer thickness in the area of apparently normal hemifield in glaucomatous eyes with optical coherence tomography

PURPOSE: The authors investigated the correlation between visual field defects detected by automated perimetry and the thickness of the retinal nerve fiber layer measured with optical coherence tomography, and examined whether there is a decrease in retinal nerve fiber layer thickness in the apparently normal hemifield of glaucomatous eyes. PATIENTS AND METHODS: Forty-one patients with glaucoma and 41 normal control subjects were included in this study. Statistical correlations between the sum of the total deviation of 37 stimuli of each hemifield and the ratio of decrease in retinal nerve fiber layer thickness were evaluated. The statistical difference between the retinal nerve fiber layer thickness of the apparently normal hemifield in glaucomatous eyes and that of the corresponding hemifield in normal subjects was also evaluated. RESULTS: There was a statistically significant correlation in the sum of the total deviation and retinal nerve fiber layer thickness decrease ratio (superior hemifield, P = 0.001; inferior hemifield, P = 0.003). There was no significant decrease in retinal nerve fiber layer thickness in the area that corresponded to the normal visual field in the hemifield defect with respect to the horizontal meridian in glaucomatous eyes (superior side, P = 0.148; inferior side, P = 0.341). CONCLUSIONS: Optical coherence tomography was capable of demonstrating and measuring retinal nerve fiber layer abnormalities. No changes in the retinal nerve fiber layer thickness of the apparently normal hemifield were observed in glaucomatous eyes.     

EDI-OCT评估妊娠高血压疾病眼底病变中视网膜和脉络膜厚度的改变

目的：采用光学相干断层扫描增强深部成像(enhanced depth imaging optical coherence tomography,EDI-OCT)技术观察和比较不同程度妊娠高血压疾病(pregnancy-induced hypertension syndrome,PIH)眼底病变患者黄斑区视网膜和脉络膜厚度的变化。

方法：对确诊为PIH的孕产妇150例289眼进行散瞳眼底检查和黄斑EDI-OCT检查,并根据Duke-Elder分期标准对患者进行分组P1(血管痉挛期组)、P2(血管硬化期组)、P3(视网膜病变期组),以眼底正常患者作为对照组P0(眼底正常组),分别对每组患者的黄斑区各象限视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度、中心凹处视网膜厚度和脉络膜厚度分别进行测量。

结果：本研究150例289眼妊娠高血压疾病患者中,眼底正常者36例72眼(24.9%),有眼底病变者114例217眼(75.1%)。不同程度眼底病变的PIH患者视网膜和脉络膜厚度有不同改变。血管硬化期组黄斑中央区(central subfield,CSF)、中心凹视网膜厚度和脉络膜厚度均低于眼底正常组,差异有统计学意义(P<0.05)。视网膜病变期组黄斑区各象限神经纤维层(retinal nerve fiber layer,RNFL)厚度、中心凹视网膜厚度和脉络膜厚度均显著高于其他三组,差异有统计学意义(P<0.05)。

结论：EDI-OCT是研究PIH相关眼底病变的重要工具之一,借助EDI-OCT观察和分析PIH眼底病变患者黄斑区视网膜和脉络膜厚度的改变,对深入研究 PIH所引起的视网膜和脉络膜局部微循环的病理性改变具有重要意义。     

视野缺损计分与OCT测量RNFL厚度的关系

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

Structural measurements and vessel density of spectral-domain optic coherence tomography in early, moderate, and severe primary angle-closure glaucoma

AIM: To compare the macular ganglion cell-inner plexiform layer (GCIPL) thickness, retinal nerve fiber layer (RNFL) thickness, optic nerve head (ONH) parameters, and retinal vessel density (VD) measured by spectral-domain optical coherence tomography (SD-OCT) and analyze the correlations between them in the early, moderate, severe primary angle-closure glaucoma (PACG) and normal eyes. METHODS: Totally 70 PACG eyes and 20 normal eyes were recruited for this retrospective analysis. PACG eyes were further separated into early, moderate, or severe PACG eyes using the Enhanced Glaucoma Staging System (GSS2). The GCIPL thickness, RNFL thickness, ONH parameters, and retinal VD were measured by SD-OCT, differences among the groups and correlations within the same group were calculated. RESULTS: The inferior and superotemporal sectors of the GCIPL thickness, rim area of ONH, average and inferior sector of the retinal VD were significantly reduced (all P<0.05) in the early PACG eyes compared to the normal and the optic disc area, cup to disc ratio (C/D), and cup volume were significantly higher (all P<0.05); but the RNFL was not significant changes in early and moderate PACG. In severe group, the GCIPL and RNFL thickness were obvious thinning with retinal VD were decreasing as well as C/D and cup volume increasing than other three groups (all P<0.01). In the early PACG subgroup, there were significant positive correlations between retinal VD and GCIPL thickness (except superonasal and inferonasal sectors, r=0.573 to 0.641, all P<0.05), superior sectors of RNFL thickness (r=0.055, P=0.049). More obvious significant positive correlations were existed in moderate PACG eyes between retinal VD and superior sectors of RNFL thickness (r=0.650, P=0.022), and temporal sectors of RNFL thickness (r=0.740, P=0.006). In the severe PACG eyes, neither GCIPL nor RNFL thickness was associated with retinal VD. CONCLUSION: The ONH damage and retinal VD loss appears earlier than RNFL thickness loss in PACG eyes. As the PACG disease progressed from the early to the moderate stage, the correlations between the retinal VD and RNFL thickness increases.     

LASIK负压吸引对高度近视眼黄斑区视网膜厚度和RNFL的影响

目的探讨准分子激光角膜原位磨镶术(excimer laser in situ keratomileusis,LASIK)负压吸引对高度近视眼黄斑区视网膜厚度和视网膜神经纤维层(retinal nerve fiber layer,RNFL)的影响。方法随机选择接受LASIK手术、矫正视力≥1.0的高度近视眼患者15例(30只眼)(>6.00D),采用Zeiss-Humphrey光学相干断层成像仪(optical coherence tomography,OCT)观察近视眼LASIK术前、术后1周眼底黄斑区和RNFL的变化,并测量以黄斑中心凹为中心3mm半径内的视网膜平均厚度,以地形图分9个区域显示,以及测量以视乳头为中心、直径为3.4mm的RNFL厚度,以地形图分4个区域显示。结果15例(30只眼)高度近视患者LASIK术后1周黄斑中心凹(A1)视网膜平均厚度改变与术中负压吸引时间呈正相关(r=0.310,P=0.05),RNFL厚度改变与术中负压吸引时间呈正相关(r=0.232,P=0.05)。结论高度近视眼LASIK术后出现的黄斑中心凹视网膜水肿和RNFL轻度变薄与负压吸引时间的长短有关。