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1.

Purpose

To compare the ability of scanning laser polarimetry with variable corneal compensation (GDx-VCC) and Stratus optical coherence tomography (OCT) to detect photographic retinal nerve fiber layer (RNFL) defects.

Methods

This retrospective cross-sectional study included 45 eyes of 45 consecutive glaucoma patients with RNFL defects in red-free fundus photographs. The superior and inferior temporal quadrants in each eye were included for data analysis separately. The location and presence of RNFL defects seen in red-free fundus photographs were compared with those seen in GDx-VCC deviation maps and OCT RNFL analysis maps for each quadrant.

Results

Of the 90 quadrants (45 eyes), 31 (34%) had no apparent RNFL defects, 29 (32%) had focal RNFL defects, and 30 (33%) had diffuse RNFL defects in red-free fundus photographs. The highest agreement between GDx-VCC and red-free photography was 73% when we defined GDx-VCC RNFL defects as a cluster of three or more color-coded squares (p<5%) along the traveling line of the retinal nerve fiber in the GDx-VCC deviation map (kappa value, 0.388; 95% confidence interval (CI), 0.195 to 0.582). The highest agreement between OCT and red-free photography was 85% (kappa value, 0.666; 95% CI, 0.506 to 0.825) when a value of 5% outside the normal limit for the OCT analysis map was used as a cut-off value for OCT RNFL defects.

Conclusions

According to the kappa values, the agreement between GDx-VCC deviation maps and red-free photography was poor, whereas the agreement between OCT analysis maps and red-free photography was good.  相似文献   

2.
目的 比较相干光断层扫描仪StratusOCT与激光偏振光视网膜扫描仪GDxVCC测量视网膜神经纤维层(RNFL)厚度的相关性及差异,探讨两者测量值与视野的相关性及其对青光眼的诊断效能.方法 84例原发性开角型青光眼(POAG)患者及50名正常人,随机选取一眼进行StratusOCT和GDxVCCRNFL厚度测量及Humphery自动视野计检查.相关分析比较两种仪器测量的全周、上方、下方RNFL厚度;回归分析研究视野的平均偏差与两种仪器测量的RNFL厚度值之间的关系;ROC曲线下面积分析两种仪器诊断青光眼的效能.结果 Stratus OCT测量正常人及POAG患者的全周RNFL厚度分别为(100.00±7.36)μm和(75.12±17.11)μm,GDxVCC对应测量值(57.16±5.05)μm和(48.00.4±8.46)μm.两种仪器测量的RNFL厚度呈线性相关(r>0.75).两种仪器测量的RNFL厚度值与视野的平均偏差呈正相关,三次曲线拟合度较直线相关的拟合度好.对于青光眼诊断,Stratus OCT的最大ROC曲线下面积为0.908,GDxVCC最大ROC曲线下面积为0.842.结论 Stratus OCT与GDxVCC测量RNFL厚度值存在差异,但两者呈线性相关,均与视野的平均偏差呈曲线相关.两种仪器诊断青光眼的效能均较好.  相似文献   

3.

Purpose

To examine the effects of panretinal photocoagulation (PRP) using a pattern scanning laser (PASCAL) system on the retinal nerve fiber layer (RNFL) thickness in patients with diabetic retinopathy.

Methods

This retrospective study included 105 eyes with diabetic retinopathy, which consisted of three groups: the PASCAL group that underwent PRP with the PASCAL method (33 eyes), the conventional group that underwent conventional PRP treatment (34 eyes), and the control group that did not receive PRP (38 eyes). The peripapillary RNFL thickness was measured by optical coherence tomography before, six months, and one year after PRP to evaluate the changes in peripapillary RNFL.

Results

The RNFL thickness in the PASCAL group did not show a significant difference after six months (average 3.7 times, p = 0.15) or one year after the PRP (average 3.7 times, p = 0.086), whereas that in the conventional group decreased significantly after six months (average 3.4 times, p < 0.001) and one year after PRP (average 3.4 times, p < 0.001).

Conclusions

The results of this study suggest that the PASCAL system may protect against RNFL loss by using less energy than conventional PRP.  相似文献   

4.

Purpose

To evaluate the effect of pattern scan laser (PASCAL) photocoagulation on peripapillary retinal nerve fiber layer (RNFL) thickness, central macular thickness (CMT), and optic nerve morphology in patients with diabetic retinopathy.

Methods

Subjects included 35 eyes for the PASCAL group and 49 eyes for a control group. Peripapillary RNFL thickness, cup-disc area ratio and CMT were measured before PASCAL photocoagulation and at 2 and 6 months after PASCAL photocoagulation in the PASCAL or control groups.

Results

The average RNFL thickness had increased by 0.84 µm two months after and decreased by 0.4 µm six months after PASCAL photocoagulation compared to baseline, but these changes were not significant (p = 0.83, 0.39). The cup-disc area ratio was unchanged after PASCAL photocoagulation. CMT increased by 18.11 µm (p = 0.048) at two months compared to baseline thickness, and partially recovered to 11.82 µm (p = 0.11) at six months in the PASCAL group.

Conclusions

PASCAL photocoagulation may not cause significant change in the peripapillary RNFL thickness, CMT, and optic nerve morphology in patients with diabetic retinopathy.  相似文献   

5.
眼RNFL损伤特点不同,因此RNFL测量可以作为在近视患者中检测和评价青光眼视神经损害的有用的指标.  相似文献   

6.
Purpose: To determine longitudinal retinal nerve fiber layer (RNFL) thickness measurement change with aging, after a period of 3 years using spectral optical coherence tomography/scanning laser ophthalmoscope (OCT/SLO).

Methods: A total of 50 eyes of 25 normal subjects underwent RNFL thickness measurement in 2008 and again in 2011 by a single operator, using spectral OCT/SLO. Measurements were compared at baseline and at follow-up. Linear mixed model analysis was used to measure the effect of age on RNFL thickness measurements over the 3 years.

Results: Mean RNFL thickness was 107.92 ± 11.1 µm in 2008 and 106.56 ± 10.8 µm in 2011. For every year increase in age, mean RNFL thickness showed a statistically significant decrease by ?0.54 µm (95% confidence interval, ?0.76 to ?0.31; p < 0.0001). There was a statistically significant loss of peripapillary RNFL thickness in most RNFL regions, except for the temporal quadrant (p = 0.37) and corresponding 7, 8, 9, and 10 o’clock hour sectors (p = 0.72, 0.75, 0.17, 0.14, respectively).

Conclusion: RNFL thickness as measured by spectral OCT/SLO decreased significantly with advancing age over a period of 3 years, and was not uniform across the four quadrants. This age-related variation should be taken into account in RNFL thickness measurements when evaluating patients for diagnosis and follow-up of glaucoma.  相似文献   

7.
PurposeTo investigate the retinal nerve fiber layer (RNFL) thickness concordance when measured by spectral domain (SD) and swept source (SS) optical coherence tomography (OCT), and to compare glaucoma-discriminating capability.MethodsRNFL thicknesses were measured with the scan circle, centered on the optic nerve head, in 55 healthy, 41 glaucoma suspected, and 87 glaucomatous eyes. The RNFL thickness measured by the SD-OCT (sdRNFL thickness) and SS-OCT (ssRNFL thickness) were compared using the t-test. Bland-Altman analysis was performed to examine their agreement. We compared areas under the receiver operating characteristics curve and examined sdRNFL and ssRNFL thickness for discriminating glaucomatous eyes from healthy eyes, and from glaucoma suspect eyes.ResultsThe average ssRNFL thickness was significantly greater than sdRNFL thickness in healthy (110.0 ± 7.9 vs. 100.1 ± 6.8 µm, p < 0.001), glaucoma suspect (96.8 ± 9.3 vs. 89.6 ± 7.9 µm, p < 0.001), and glaucomatous eyes (74.3 ± 14.2 vs. 69.1 ± 12.4 µm, p = 0.011). Bland-Altman analysis showed that there was a tendency for the difference between ssRNFL and sdRNFL to increase in eyes with thicker RNFL. The area under the curves of the average sdRNFL and ssRNFL thickness for discriminating glaucomatous eyes from healthy eyes (0.984 vs. 0.986, p = 0.491) and glaucoma suspect eyes (0.936 vs. 0.918, p = 0.132) were comparable.ConclusionsThere was a tendency for ssRNFL thickness to increase, compared with sdRNFL thickness, in eyes with thicker RNFL. The ssRNFL thickness had comparable diagnostic capability compared with sdRNFL thickness for discriminating glaucomatous eyes from healthy eyes and glaucoma suspect eyes.  相似文献   

8.
9.
PurposeTo determine the effects of intravitreal anti-vascular endothelial growth factor (VEGF) on thickness of the retinal nerve fiber layer (RNFL) in patients with age-related macular degeneration.MethodsTwenty eyes of 20 patients diagnosed with age-related macular degeneration who underwent intravitreal anti-VEGF injection were studied. Postinjection RNFL thickness was measured using optical coherence tomography. Average thickness, four-quadrant RNFL thicknesses, and intraocular pressure (IOP) in affected eyes were measured before and 6 and 12 months after anti-VEGF injection for comparison. RNFL thickness and IOP in affected and normal fellow eyes were also compared. Given that macular lesions can affect RNFL thickness, the changes in thickness were evaluated by dividing the 12 clock-hour RNFL into the pathologic areas adjacent to the lesion and the non-pathologic area.ResultsThe mean clock-hour segment in the pathologic area was 4.8 hours. A significantly thicker RNFL was exhibited in temporal quadrants and pathologic areas (p = 0.043 and 0.048, respectively) in affected eyes before injection compared to the baseline RNFL thickness in normal eyes. No significant differences were found in RNFL thickness or IOP between affected and normal eyes after injection. The changes over time in the temporal and pathologic areas were statistically significant at 6 and 12 months after injection compared to baseline data (p < 0.05). No significant differences were displayed in RNFL thickness in the other three quadrants or in non-pathologic areas in either affected or normal eyes. Sequential changes in RNFL thickness in affected eyes were not significant.ConclusionsRepeat intravitreal anti-VEGF treatment did not have a significant effect on RNFL thickness. RNFL thickness significantly decreased with time in the pathologic areas and in the temporal segment adjacent to exudative macular lesions. The reduction in RNFL thickness was most likely associated with changes in the macular lesion rather than with anti-VEGF injection.  相似文献   

10.
Purpose: Visual examination of the retinal nerve fiber layer is difficult because of its low contrast and granular appearance. Previous attempts toward enhancement mainly have concerned contrast. Reduction of granularity also could have merit. Methods: Digital anisotropic processing of color slides from normal and abnormal ocular fundi, with superpositioning of image pairs of slightly different sizes. Results and Conclusion: Qualitative comparison of native and processed images indicated that longitudinal enhancement of nerve fiber bundles is feasible. This novel type of processing may allow more reliable evaluation of conditions causing wasting or swelling of the retinal nerve fiber layer.  相似文献   

11.
Background Optic tract syndrome (OTS) is characterized by incongruous homonymous hemianopia and a perpendicular pattern of bilateral optic atrophy due to the optic tract lesion. However, loss of retinal nerve fiber layer thickness (RNFLT) associated with OTS has not been quantitatively assessed.Case A 20-year-old woman with blunt head trauma showed normal visual acuity, color vision, ocular motility, and intraocular pressure. Because of a relative afferent pupillary defect in her left eye and left-sided homonymous hemianopia, we suspected right-sided optic tract damage, although magnetic resonance imaging detected no intracranial lesion.Observations Using optical coherence tomography (OCT), the RNFLT of this case was measured at 31 months after the trauma and compared with age-matched normal controls (n = 41). Nasal, temporal, superior, and inferior quadrant RNFLT was reduced by 22%, 21%, 5%, and 46% in the right eye and 76%, 64%, 25%, and 27% in the left eye, respectively. The reduction was > 3 × the standard deviation of the normal mean values in the nasal and temporal quadrants of the left eye and in the inferior quadrant of the right eye.Conclusions OCT can determine the RNFLT reduction corresponding to the characteristic patterns of optic atrophy of OTS. Jpn J Ophthalmol 2005;49:294–296 © Japanese Ophthalmological Society 2005  相似文献   

12.

Purpose

To evaluate the relationship between the structural damage as assessed by time-domain optical coherence tomography (OCT) and functional changes in glaucoma.

Methods

In total, 190 patients with normal tension glaucoma or primary open angle glaucoma were included in this study. The thickness of retinal nerve fiber layer (RNFL) around the optic disc and the area of RNFL defect were determined using OCT scans. The relationships between the RNFL thickness or area of the defect and visual field (VF) indices were assessed using the Lowess function, regression analysis and partial Spearman correlation. The differences between these associations depending on the stage of VF damage were further analyzed. Age, optic disc size, refraction, central corneal thickness and the presence of systemic disease were corrected for in order to exclude confounding factors.

Results

A logarithmic scale of RNFL thickness showed a negative linear relationship with VF indices. The area of the RNFL defect showed a weak correlation with the pattern of standard deviation, whereas the remnant RNFL thickness was moderately correlated with the pattern of standard deviation (partial Spearman correlation coefficient, 0.39, -0.47, respectively; p < 0.0001). Many outliers were detected in the Lowess-plotted graphs. Multiplication of the area and the inverted RNFL thickness showed a moderately correlated logarithmic relationship with the VF indices (partial Spearman correlation coefficient, 0.46; 95% confidence interval, 0.34 to 0.57; p < 0.0001). In the severe stage of VF damage, correlation between the area of the RNFL defect and mean deviation was significantly greater than in other stages (partial Spearman correlation coefficient, -0.66; p = 0.02).

Conclusions

The thickness of the RNFL had a negative logarithmic correlation with the VF indices and was more relevant to the VF indices than the area of the RNFL defect, as measured by OCT.  相似文献   

13.
目的 采用频域光学相干断层成像术测量正常人视乳头旁视网膜神经纤维层(Retina nerve fiberlayer,RNFL)容积,分析视乳头旁神经纤维层立体结构,为评价视神经、视网膜等疾病的神经纤维层容积改变提供参考数据.方法 368名健康人经视力、眼压、裂隙灯、屈光和眼底等常规眼科检查,排除青光眼、视神经和视网膜等影响RNFL疾患后,行双眼以视乳头为中心的三维光学相干断层扫描.每名受检者随机抽取一眼的测量结果进行统计.结果 正常人视乳头旁RNFL平均容积以下方象限最大(0.558±0.059)mm~3,上象限次之(0.549±0.059)mm~3,鼻侧偏小(0.347 ±0.049)mm~3,颞侧最小(0.321±0.043)mm~3;不同性别、眼别之间各象限RNFL平均容积没有差异;鼻、颞象限的RNFL容积在各年龄组之间没有差异,而上、下象限在各年龄组之间的差异具有统计学意义.结论 频域光学相干断层成像术能够精确地测量RNFL容积,研究初步建立正常人视乳头旁RNFL容积数据库,为今后临床和科研提供参考.  相似文献   

14.
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.  相似文献   

15.
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。  相似文献   

16.
PurposeThere are limited data from Asian countries regarding retinal thickness in children with type 1 diabetes mellitus (T1DM). This study aimed to compare the macular and retinal nerve fiber layer (RNFL) parameters between diabetic children without retinopathy and non-diabetic healthy children. We also evaluated the factors associated with RNFL thickness in children with T1DM.MethodsA comparative cross-sectional study was conducted among children with T1DM and healthy children aged 7 to 17 years old in Hospital Universiti Sains Malaysia from 2017 to 2019. Children with retinal disease or glaucoma were excluded. Macular and RNFL thicknesses were measured using spectral-domain optical coherence tomography. Demographic information, duration of diabetes, blood pressure, body mass index, visual acuity, and retinal examination findings were documented. Glycosylated hemoglobin levels, renal function, and blood lipid levels were also collected.ResultsForty-one children with T1DM and 80 age- and sex-matched children were enrolled. Both sexes were affected. Mean duration of diabetes mellitus was 3.66 years. The mean glycated hemoglobin levels in the T1DM group was 9.99%. The mean macular and RNFL thicknesses in children with T1DM were 277.56 (15.82) μm and 98.85 (12.05) μm, respectively. Children with T1DM had a significantly thinner average macula, superior outer macula, nasal outer macula, mean RNFL, and inferior RNFL thickness compared to controls (p < 0.05). There was a significant association between nephropathy and the mean RNFL thickness.ConclusionsChildren with T1DM had significantly decreased mean macular and RNFL thicknesses. Nephropathy is associated with an increased RNFL thickness.  相似文献   

17.
目的:光学相干断层成像术(optical coherence tomograpy,OCT)测定国人视网膜神经纤维层(reti-nal nerve fiber layer,RNFL)厚度的正常值,为在青光眼早期诊断中的应用奠定基础。方法:使用OCT对77例111只正常眼进行环绕视乳头的RNFL扫描(3.46mm直径),分析不同年龄、性别、眼别RNFL厚度的差异。结果:不同性别、眼别间RNFL的相应厚度无显著差异(P>0.05);各年龄组RNFL厚度平均值(x±s,μm):上象限为128.00±10.31~149.00±13.17、下象限132.95±9.54~142.33±10.60、全周平均RNFL109.00±4.72~114.28±7.98;RNFL随年龄增长有变薄的趋势,以上象限为明显(P<0.05)。结论:OCT检测所得RNFL厚度的均值与性别及眼别无关;应以年龄分组,在本研究的基础上扩大检验的样本数,建立RNFL正常值。眼科学报1998;14:207~209。  相似文献   

18.
陈瑛 《眼科研究》1997,15(3):211-214
青光眼的主要病理过程是视网膜节细胞轴突(即视神经纤维)的丢失,故测量视网膜神经纤维层(retinalnervefiberlayer,RNFL)来确定轴突丢失的程度在青光眼的早期诊断和治疗上具有非常重要的意义。近年来,计算机图像分析技术应用于眼科,它能对RNFL作出客观的量化检测。该文综述有关文献,就RNFL定量测定方法的原理,以及它们在青光眼RNFL损害检测方面的应用情况作一介绍。  相似文献   

19.

Purpose

To determine whether a significant correlation exists between the amplitude of the s wave of the multifocal electroretinogram (mfERG) and the retinal nerve fiber layer thickness (RNFLT) in glaucomatous eyes.

Methods

Twenty-three eyes of 23 patients with glaucoma were studied. In all eyes, the severity of the defects in the upper visual field differed significantly from the severity of those in the lower half. Patients having visual field halves with mean deviation (MD) values lower than ?5?dB were placed in group A, and patients having visual field halves with MD values greater than ?5?dB were placed in group B. The mfERGs were elicited by 37 stimulus elements alternating from white to black in a pseudorandom binary m-sequence at a frequency of 9.4?Hz. The mfERGs in the upper and lower visual field halves were summed to yield upper and lower averaged waves. The GDx variable corneal compensator and optical coherence tomography were used to measure the RNFLT.

Results

The retinal nerve fiber layer was significantly thinner in group A than in group B. There was a significant correlation between the RNFLT and the MD values of visual field defects. The s-wave amplitude was significantly smaller in group A than in group B. The s-wave amplitude also correlated significantly with the MD and the RNFLT.

Conclusion

The significant correlations between the s-wave amplitude and the MD, and between the S-wave amplitude and the RNFLT, indicate that the s-wave receives significant contributions from the retinal ganglion cells and their axons. Jpn J Ophthalmol 2005;49:481–490 © Japanese Ophthalmological Society 2005  相似文献   

20.
Purpose: To evaluate retinal nerve fiber layer (RNFL) thickness in acromegalic patients. Methods: A study group of 29 patients with acromegaly and a control group of 38 age-matched healthy individuals were enrolled in a cross-sectional study. The study group was further divided by tumor size into two subgroups, a macroadenoma group and a microadenoma group. Serum growth hormone (GH) and insulin-like growth factor-1 (IGF-I) levels were detected at the time of ophthalmological examination in the study group. In both the study and control group, the RNFL thickness in the four quadrants was measured by optical coherence tomography. The relationship between GH and IGF-I levels and RNLF thickness was also evaluated. Results: The difference in mean RNLF thickness in all quadrants between the study and control groups was not statistically significant. In acromegalic patients with macroadenoma, the mean RNLF thickness of the inferior quadrant decreased significantly compared to both patients with microadenoma and healthy individuals (p?=?0,032 and p?=?0,046). GH and IGF-1 levels were not significantly correlated with the RNLF thickness in the study group. Conclusions: Excessive GH and IGF-1 levels do not affect the optic nerve or RNLF thickness, whereas the RNLF becomes thinner in the inferior quadrant in acromegalic patients with macroadenoma as a result of the chiasmal compression.  相似文献   

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