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1.
探讨不同时期剥脱性青光眼(PXG)患者视盘视网膜神经纤维层(RNFL)厚度与视野缺损的相关性。方法:病例对照研究。连续性选取2013年1月至2018年1月在石家庄市第一医院青光眼科住院治疗的PXG患者97例(97眼),并将其分为早期PXG组28例,中期PXG组27例,晚期PXG组42例。另选择与PXG组匹配的正常志愿者32例(32眼)作为正常对照组。所有纳入对象均采用SD-OCT对视盘各区RNFL厚度进行扫描,采用单因素方差分析比较4组受检者视盘各区RNFL厚度差异,采用 Pearson相关分析对视盘RNFL厚度与视野平均缺损相关性进行分析。结果:正常对照组及早、中、晚期PXG组平均视盘RNFL厚度分别为(104±11)μm,(92±14)μm,(82±12)μm,(54±18)μm。4组受检者鼻侧、鼻上方、颞上方、颞侧、颞下方、鼻下方及平均RNFL厚度总体差异均具有统计学意义(F=24.38、36.40、47.84、8.70、95.46、54.75、82.28,均P<0.001)。进一步两两比较发现,正常对照组与早期PXG组颞上方、颞下方、鼻下方及平均视盘RNFL厚度差异有统计学意义(均P<0.05);正常对照组与中期PXG组鼻侧、鼻上方、颞上方、颞下方、鼻下方及平均RNFL厚度差异有统计学意义(均P<0.05);正常对照组与晚期PXG组各区RNFL厚度差异均有统计学意义(均P<0.001)。中、晚期 PXG组视盘平均RNFL厚度与视野平均缺损呈正相关(r=0.404,P=0.037;r=0.582,P<0.001)。结论:中、晚期PXG眼视盘平均RNFL厚度与视野缺损呈正相关,SD-OCT监测视盘RNFL厚度变化可以作为PXG诊断分期和随访的重要参考指标。  相似文献   

2.
苏宇星  牛童童 《国际眼科杂志》2023,23(10):1750-1753

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

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

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

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


3.
剥脱综合征性青光眼临床分析   总被引:1,自引:1,他引:0  
苏静  李弘  郭隽 《国际眼科杂志》2010,10(6):1143-1145
目的:探讨剥脱综合征性青光眼(peseudo exfoliation glaucoma,PEG)的临床表现及其特点,寻求有效的治疗途径。方法:对13例17眼剥脱综合征性青光眼患者的临床资料进行分析。结果:药物控制眼压理想3眼,行小梁切除术后眼压正常但视力降至光感1眼,小梁切除术后眼压视功能良好者4眼,白内障超声乳化术后眼压下降明显7眼,白内障超声乳化摘除联合小梁切除术2眼,其中1眼术后并发睫状环阻滞性青光眼,1眼眼压虽明显下降,但视力降至光感。结论:剥脱综合征青光眼是一种房水流出阻力增加的高眼压性开角型青光眼,其临床表现较为复杂。提高对本病的认识,能够选择正确治疗方法,减少手术并发症,最大程度减少视功能的进一步损害。  相似文献   

4.
目的:分析正视,高、中、低度近视眼球与黄斑厚度的相关性。
  方法:选取2013-01/2014-05来本院眼科就诊患者,挑选志愿参与研究并且处于18~28岁年龄段,矫正视力≥1.0,眼内压≤21 mmHg的青少年,共计276例276眼纳入本次研究。视力情况分布为:正视49眼,低度近视72眼,中度近视104眼,高度近视51眼。使用三维光学相干断层扫描(optical coherence tomography,OCT)仪器对黄斑中心区厚度,内环、外环的颞、上、鼻、下各个区域的厚度,黄斑区视网膜平均厚度,黄斑中心凹厚度以及视网膜体积进行检测,将正视,高、中、低度近视人群的眼球黄斑各部位厚度与视力情况的相关性进行统计学分析。
  结果:正视组与低、中、高度近视组的黄斑中心区厚度分别为(225.38±20.97)μm,(230.97±19.15)μm,(227.01±16.92)μm,(231.91±18.97)μm,黄斑区视网膜平均厚度分别为(280.92±12.71)μm,(278.15±11.90)μm,(270.05±12.07)μm,(267.93±11.08)μm。低、中、高度近视组与正视组的黄斑中心区厚度差异( F=1.253,P=0.291)及中心凹厚度差异(F=1.034,P=0.378)均无统计学意义。中度近视组的黄斑内环、外环与正视组相比,差异具有统计学意义(P<0.05)。低、中、高度近视组组间比较,中度近视组黄斑的内环、外环各象限视网膜厚度与低度近视组相比明显增厚,差异具有统计学差异(P<0.05)。而与高度近视组相比,黄斑内环、外环各象限视网膜厚度差异不具有统计学意义(P>0.05)。
  结论:对于矫正视力正常的近视青少年患者,其黄斑中心的视网膜仍保持正常厚度,但随着近视程度的加深,其它视区的视网膜厚度逐渐变薄,并且变薄的量从黄斑外环向内环逐渐增加。  相似文献   

5.
赵颖  戴惟葭  刘大川 《国际眼科杂志》2017,17(12):2335-2338
目的:研究不同分期糖尿病视网膜病变患者黄斑厚度及黄斑体积的变化特点.方法:选取2016-01-01/2017-01-01于我院眼科门诊就诊的40例78眼糖尿病视网膜病变患者作为研究对象,根据糖尿病视网膜病变(diabetic retinopathy,DR)的国际临床分类法分为非增殖期糖尿病视网膜病变(non prolifertive dibetic retinopthy,NPDR)组20例40眼,增殖期糖尿病视网膜病变(prolifertive dibetic retinopthy,PDR)组20例38眼.全部研究对象进行光学相干断层扫描(optical coherence tomography OCT)检查,以直径1、3、6mm ETDRS对黄斑区进行分区,分析随着糖尿病视网膜病变严重程度的增加,黄斑中心凹及其周围分区各象限视网膜厚度及体积的变化特点.结果:NPDR组及PDR组黄斑中心小凹的厚度(foveola thickness,FT)分别为252.57±31.36、362.47±20.81μm,分区中内环上方、鼻侧最厚,下方次之,颞侧最薄;外环鼻侧最厚,上方次之,颞侧、下方最薄;NPDR组黄斑中心凹厚度及分区各象限视网膜厚度数值均小于PDR组,差异具有统计学意义(P<0.05).NPDR组及PDR组黄斑中心小凹处体积(V)分别为0.20±0.02、0.28±0.16mm3,分区中内环上方、鼻侧最大,下方次之,颞侧最小;外环鼻侧最大,上方次之,颞侧、下方最小;NPDR组黄斑中心凹体积及分区各象限视网膜体积数值均小于PDR组,差异具有统计学意义(P<0.05).结论:糖尿病视网膜病变患者黄斑中心凹及分区各象限视网膜厚度及体积变化与糖尿病视网膜病变的病程进展有关.利用OCT对不同分期糖尿病视网膜病变患者黄斑厚度及黄斑体积进行定量分析,了解随着糖尿病视网膜病变严重程度的增加,黄斑区及其周围分区视网膜形态学变化的特点,为更好地分析不同严重程度糖尿病视网膜病变黄斑部位结构改变提供临床研究依据.  相似文献   

6.
剥脱综合征是一种以纤维样细胞外物质在眼球组织及全身多种器官组织中产生与沉积为特征的年龄相关性疾病。本文就该病的流行病学、临床表现、发病机制及其与青光眼的关系予以综述。  相似文献   

7.
剥脱综合征是一种常见的年龄相关性眼病,是导致青光眼的常见原因.剥脱综合征性青光眼较慢性单纯性青光眼更严重、预后更差.在此文中对近年来,剥脱综合征性青光眼发病机制的有关论著作一综述.  相似文献   

8.
王宁利  王兰  梁远波  乔春艳 《眼科》2004,13(2):125-126
患者男性,76岁,左眼视力差6年,于2002年6月11日来我院就诊,在外院诊断为“左眼视神经萎缩”,无其它眼部及垒身病史。眼科检查:视力:右眼0.6,左眼光感,眼压日曲线(Schioetz);右眼18~23mmHg(23.38,22.38,18.86,20.55mmHg,平均21.20mmHg),左眼37~54mmHg(54.66,45.12,40.18,37.19mmHg,平均44.29mmHg)。双角膜透明,周边前房深度为1/4CT。右眼虹膜色素正常,瞳孔直径约3mm,对光反应存在,散瞳后晶状体前囊表面中央见盘状灰白色物质;左眼虹膜基质硫松,瞳孔直径约6mm,对光反应迟钝,瞳孔缘可见头屑状灰白色物质,晶状体表面见灰白色混浊物。  相似文献   

9.
特发性黄斑裂孔患者黄斑部脉络膜厚度分析   总被引:2,自引:0,他引:2  
目的 评价特发性黄斑裂孔(IMH)患眼和对侧健眼的黄斑部脉络膜厚度,并与年龄性别相匹配的正常人群比较,分析其临床意义.方法 横断面分析研究.对2011年3~8月在中山眼科中心就诊的40例单眼IMH患者,分为患眼组(A组)40只眼,对侧健眼组(B组)38只眼;另设正常对照组(C组)40例40只眼为年龄、性别、屈光度匹配的正常成年人.采用海德馒Spcctralis频域OCT加强深度扫描(Enhanced Depth Imaging,EDI)测定中心凹下脉络膜厚度(Subfoveal choroidal thickness,SFCT)、距中心凹l mm和3 mm处上下鼻颞四方位脉络膜厚度(SCT1mm、SCT3mm、 ICT1mm、ICT3mm、NCT1mm、NCT3mm、TCT1mm、TCT3mm、).结果 单眼IMH患者,配对t检验显示患眼SFCT值较对侧健眼变薄,t =-3.906,P<0.001.三组间比较,A组、B组和C组SFCT均值分别为(214.82±66.67)μm,(243.53±76.67) μm和(259.87±64.39) μm,A组较C组明显降低.B组较C组降低,但差异无统计学意义.结论 IMH患眼中脉络膜厚度变薄明显,可能与其发病机制有关.对侧健眼的脉络膜厚度较正常对照组亦有降低,提示脉络膜血管代谢功能下降,可能是IMH发病的因素之一.  相似文献   

10.
目的:通过光学相干断层扫描(optical coherence tomography, OCT; RTVue 100-2; V 5.1, Optovue, Fremont, CA, USA)测量比较非新生血管性与新生血管性年龄相关性黄斑变性(age-related macular degeneration, AMD)黄斑中心凹下脉络膜厚度(subfoveal choroidal thickness, SFCT), 并分析脉络膜厚度(choroidal thickness, CT)对AMD新血管形成的影响。

方法:本研究为回顾性、横断面研究。以单侧眼患有新生血管性AMD且对侧眼患有非新生血管性AMD的24例患者(48眼)作为研究组,选取年龄与眼轴长度相匹配的40例健康眼作为对照组。非新生血管性AMD亚组研究对象是黄斑区有玻璃疣和/或色素变化眼,而新生血管性AMD亚组研究对象是由于脉络膜新生血管而致视网膜下或视网膜内有渗出液和/或脂性渗出眼。运用OCT垂直测量外侧高反射线(视网膜色素上皮层)到脉络膜巩膜交界面间的距离。选取7个不同点进行脉络膜厚度测量,测量区域为距黄斑中心凹颞侧和鼻侧1 500μm范围,测量间距为500μm。测量结果在亚组间进行统计学对比研究。

结果:研究组患者平均年龄为72.4±8.97(60~82)岁,对照组受试者平均年龄为71.2±8.8(58~81)岁。新生血管性AMD组中平均SFCT明显大于非新生血管性AMD组的厚度(P<0.05)。非新生血管性AMD组中,平均SFCT与平均鼻、颞侧脉络膜厚度比较,差异无统计学意义(P>0.05); 而新生血管性AMD组中,平均SFCT与平均鼻、颞侧脉络膜厚度比较,差异有统计学意义(P<0.05)。

结论:运用OCT对脉络膜厚度进行测量,有助于理解AMD的病理生理机制。然而,仍需要大型前瞻性研究来探求新生血管性AMD中SFCT增厚的原因。  相似文献   


11.

Purpose

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

Methods

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

Results

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

Conclusions

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

12.
Purpose: To investigate thickness of the retinal nerve fiber layer (RNFL) and choroid thickness in patients with pseudoexfoliation syndrome (PEX) and pseudoexfoliation glaucoma (PXG) compared to healthy volunteers. Methods: This cross-sectional, prospective study included 43 patients with PXG, 45 patients with PEX syndrome, and 48 healthy volunteers. The RNFL and macular thickness were analyzed with standard OCT protocol while choroidal thickness was analyzed with EDI protocol in all subjects. Results: The RNFL thickness was higher in the PEX and control groups compared to the PXG group (p<0.001). The choroid thickness was significantly higher in the control group compared to the PXG and PEX groups (p<0.05). No significant difference was detected between the both groups. Conclusions: PEX might weaken choroid circulation by accumulating in choroid vessels. The thinner choroid in the PXG group suggests that ischemia affects the duration of PEX and has a role in the development of glaucoma.  相似文献   

13.

Purpose

To evaluate the thickness and volume of the choroid in healthy Korean children using swept-source optical coherence tomography.

Methods

We examined 80 eyes of 40 healthy children and teenagers (<18 years) using swept-source optical coherence tomography with a tunable long-wavelength laser source. A volumetric macular scan protocol using the Early Treatment Diabetic Retinopathy Study grid was used to construct a choroidal thickness map. We also examined 44 eyes of 35 healthy adult volunteers (≥18 years) and compared adult measurements with the findings in children.

Results

The mean age of the children and teenagers was 9.47 ± 3.80 (4 to 17) vs. 55.04 ± 12.63 years (36 to 70 years) in the adult group (p < 0.001, Student''s t-test). Regarding the Early Treatment Diabetic Retinopathy Study subfields, the inner temporal subfield was the thickest (247.96 µm). The inner and outer nasal choroid were thinner (p = 0.004, p = 0.002, respectively) than the surrounding areas. The mean choroidal volumes of the inner and outer nasal areas were smaller (p = 0.004, p = 0.003, respectively) than those of all the other areas in each circle. Among the nine subfields, all areas in the children, except the outer nasal subfield, were thicker than those in adults (p < 0.05). Regression analysis showed that age, axial length, and refractive error correlated with subfoveal choroidal thickness (p < 0.05).

Conclusions

Overall macular choroidal thickness and volume in children and teenagers were significantly greater than in adults. The nasal choroid was significantly thinner than the surrounding areas. The pediatric subfoveal choroid is prone to thinning with increasing age, axial length, and refractive error. These differences should be considered when choroidal thickness is evaluated in children with chorioretinal diseases.  相似文献   

14.
Purpose: To examine factors associated with foveal thickness (FT) and macular thickness (MT) in Japanese persons from Hisayama.

Methods: A total of 2216 healthy eyes of 1384 participants were analyzed. Each participant underwent comprehensive physical and ophthalmic examinations, the latter including optical coherence tomography (OCT). Multiple regression analysis was used to determine the relationship of various factors (race, age, sex, refractive error, axial length, diabetes mellitus, fasting plasma glucose levels, alcohol intake and smoking status) to FT (central 1-mm foveal area) and MT (central 3-mm foveal region).

Results: Results of multiple linear regression analysis indicated that age was positively associated with FT (β coefficient 0.214 μm). FT was significantly smaller in women than men (β coefficient ?9.146 μm). For both sexes, body height was positively correlated (β coefficient 0.257 μm), while refractive error and current smoking were negatively associated (β coefficients ?1910 μm and ?4.410 μm, respectively) with FT. With respect to MT, there were negative associations between age, sex (female), and refractive error (β coefficients ?0.268 μm, ?4.815 μm and ?0.699 μm, respectively). For both sexes, body height was positively correlated (β coefficient 0.227 μm), while hypertension and current smoking were negatively associated (β coefficients ?1.999 μm and ?2.758 μm, respectively) with MT.

Conclusions: Our results indicated that age, body height, refractive error, and current smoking were significantly associated with FT, whereas age, body height, refractive error, current smoking, and hypertension were significantly related to MT. Women had significantly smaller FT and MT than men.  相似文献   

15.
Purpose: Cellular stress conditions are important mechanisms implicated in the pathogenesis of pseudoexfoliation syndrome. One of the potential cellular responses to these stress conditions is induction of autophagy. The purpose of this study was to evaluate whether genetic variants in three critical genes of autophagy (ATG16L, ATG2B, ATG5) may be involved in the development of pseudoexfoliation syndrome (XFS) and pseudoexfoliation glaucoma (XFG) in a Spanish population. Methods: 108 patients (64 XFS, 44XFG) and 118 healthy controls were evaluated. The analysis of genetic polymorphisms was performed by standard TaqMan allelic discrimination technique. Results: No significant differences in either genotype distributions or allelic frequencies of the tested polymorphisms were found between patients with XFS/XFG and control subjects. Conclusions: Our results suggest that these three genes that are critical components of the autophagy pathway (ATG16L, ATG2B, ATG5) are not significant risk factors among Spanish patients with either XFS or XFG.  相似文献   

16.
Purpose: To evaluate the association of the lysyl oxidase-like 1 (LOXL1) single nucleotide polymorphisms (SNPs) in a Spanish population with pseudoexfoliation syndrome (XFS) and pseudoexfoliation glaucoma (XFG).

Materials and methods: The present case-control study included 100 Spanish patients (60 patients with XFS and 40 patients with XFG) and 90 control subjects. Genotypes of the three single nucleotide polymorphisms of LOXL1 (rs1048661, rs3825942, and rs2165241) were analyzed with direct sequencing.

Results: The G allele and the GG genotype of SNP rs3825942 were detected at a statistically higher frequency in pseudoexfoliation patients than in control subjects (p?=?3.36?×?10?5, OR?=?5.71, 95% CI: 2.30–14.18; p?=?3.38?×?10?5, OR?=?6.91, 95% CI: 2.51–19.03 respectively). The T allele and the TT genotype of SNP rs2165241 presented at significantly higher frequencies in pseudoexfoliation patients than in controls (p?=?2.50?×?10?4, OR?=?2.18, 95% CI: 1.43–3.33; p?=?1.21?×?10?2, OR?=?2.13, 95% CI: 1.75–3.85 respectively). No significant association between XFS/XFG and the rs1048661 was observed. The GGT haplotype composed of all three risk alleles was determined to be significantly associated with pseudoexfoliation. The genotypic and allelic distributions of the three SNPs were similar between XFS and XFG.

Conclusions: This is the first study associating two SNPs of LOXL1 (rs3825942 and rs2165241) and XFS/XFG in a Spanish population, confirming findings in patients from Europe. However rs1048661 SNP did not show an association with XFS.  相似文献   

17.
Purpose: To evaluate the changes in the macular ganglion cell complex (GCC) thickness and central macular thickness (CMT) as measured by spectral domain optical coherence tomography (OCT) post-argon laser panretinal photocoagulation (PRP). Methods: The medical records of 25 patients with proliferative diabetic retinopathy (PDR) who underwent PRP, 29 patients with non-proliferative diabetic retinopathy (NPDR), and 29 patients with diabetes but without diabetic retinopathy (DR) were analyzed. The patients who received PRP were followed up for one year. The follow-up measurements were evaluated at baseline, and months 1, 6, and 12 post-argon laser PRP. The baseline values of CMT and GCC thickness were compared among the groups to assess changes with PRP therapy. Results: The CMT gradually increased in months 1 and 6 and then decreased; however, it was significantly higher than the baseline value at month 12 in the PDR group post-PRP. The GCC thickness also increased at months 1 and 6 in almost all segments of the macula, but at month 12 decreased to the baseline value. There was no correlation between the increasing thickness of the macula and change in the GCC thickness post-PRP period in the PDR group. In addition, no significant correlation was detected between the GCC thickness and best-corrected visual acuity during all follow-up visits. Conclusions: GCC thickness increased significantly until month 6 compared with baseline values in most of the macular segments post-PRP in the PDR group. The GCC thickness at month 12 was not different from the baseline thickness in any of the macular segments.  相似文献   

18.
Purpose: To investigate the serum lipid levels in pseudoexfoliation (PEX) syndrome and its association with systemic vascular disorders. Materials and Methods: Patients were divided into three groups: 52 patients with PEX syndrome (group 1), 20 patients with PEX glaucoma (group 2), and 47 control subjects without PEX syndrome or glaucoma (group 3). The fasting serum total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglyceride levels were evaluated by Beckman Coulter DXC 800/USA biochemical analyzer. Results: The mean LDL values were 138?±?33?mg/dl in group 1, 150?±?37?mg/dl in group 2, and 127?±?36?mg/dl in group 3. The mean LDL values in groups 1 and 2 were found to be significantly higher than that of group 3 (p?=?0.04). The patients in groups 1 and 2 were more often diabetic and hypertensive than group 3 (p?p?Conclusion: Increased LDL values are significantly associated with PEX.  相似文献   

19.
目的::对比分析维吾尔族假性剥脱综合征(PEX)、剥脱综合征性青光眼(PEXG)、原发性开角型青光眼(POAG)及年龄相关性白内障(ARC)角膜内皮形态学差异。方法::回顾性病例对照研究。选取2019年7月至2020年8月在中国人民解放军新疆军区总医院全军眼科中心就诊治疗的维吾尔族PEX患者76例(76眼),PEXG患...  相似文献   

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