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。     

开角型青光眼患者视盘及脉络膜变化分析

目的　通过频域OCT检查探讨开角型青光眼（open-angle glaucoma,OAG）患者视网膜及脉络膜各参数的变化。方法　回顾性病例对照研究。临床检查确诊为OAG的19例（30眼）患者为OAG组,健康人15名（30眼）为对照组。采用频域OCT的EDI模式测量2组视盘周围神经纤维层厚度、视盘周围脉络膜厚度及黄斑中心凹处神经纤维层厚度、黄斑中心凹处脉络膜厚度,并作对比。结果　OAG组受检眼6方位视盘周围神经纤维层厚度均明显低于对照组,差异均有统计学意义（均为P＜0.05）;5方位（颞上方、颞侧、鼻上方、鼻侧及鼻下方）视盘周围脉络膜厚度均明显低于对照组（均为P＜0.05）,尤其以鼻侧及鼻下方变薄更明显。OAG组黄斑处神经纤维层厚度［（11.27±1.93）μm］及黄斑中心凹处脉络膜厚度［（217.37±11.46）μm］与正常对照组［（11.57±1.65）μm、(215.65±12.42)μm］相比,差异均无统计学意义（均为P>0.05）;两组间黄斑部直径3 mm的内环鼻侧、颞侧区域和直径6 mm的外环鼻侧、颞侧区域脉络膜厚度差异均无统计学意义（均为P>0.05）。结论　OAG患者与正常人相比,视盘周围脉络膜厚度减少,且视盘鼻侧及鼻下方脉络膜厚度变薄更为显著,可能与脉络膜血供减少造成的青光眼缺血性损伤相关。OAG患者黄斑部脉络膜厚度并未发生明显变化。     

原发性房角关闭性疾病患者脉络膜厚度的临床研究

目的:应用频域光学相干断层扫描深度增强成像技术(EDI-OCT)测量并探讨原发性房角关闭性疾病(PACD)患者黄斑区及视盘周围脉络膜厚度的特点及规律,分析脉络膜厚度在PACD发病机制中的作用。方法:前瞻性研究。收集2015-01/2019-12于我院就诊的PACD患者82例155眼,其中可疑原发性房角关闭(PACS)组24例24眼;急性原发性房角关闭(APAC)组28例35眼;慢性原发性房角关闭(CPAC)组30例38眼;原发性闭角型青光眼(PACG)组38例58眼。另收集健康志愿者87例87眼纳入正常对照组。所有研究对象均应用EDI-OCT测量黄斑区及视盘周围脉络膜厚度。结果:PACD各组黄斑区脉络膜厚度均高于正常对照组(P<0.05)。在PACD患者中,除距黄斑中心凹3mm处鼻侧,PACG组黄斑区其余各点位脉络膜厚度均低于PACS组、APAC组、CPAC组(P<0.05)。APAC组黄斑中心凹下脉络膜(357.17±61.49μm)最厚,PACS组(318.04±56.52μm)次之,PACG组最薄(263.55±67.87μm)。除CPAC组,其余各组黄斑中心凹旁1mm处脉络膜厚度均较黄斑中心凹下脉络膜厚度降低(P<0.05)。各组受检者黄斑中心凹旁3mm处脉络膜厚度均低于黄斑中心凹下和黄斑中心凹旁1mm处(P<0.05)。各组受检者视盘周围脉络膜厚度无差异(P>0.05)。结论:PACD患者及正常人黄斑中心凹下脉络膜最厚,离黄斑中心凹越远,脉络膜越薄。黄斑区脉络膜增厚是PACD患者又一特征性解剖结构,可能是诱发青光眼急性发作的重要因素。PACD患者视盘周围脉络膜厚度与正常人相比并无特征性改变。     

增强深度成像OCT对急性期视神经炎患者早期视网膜和脉络膜变化的定量评估

背景 视神经炎是常见的神经眼科疾病之一.频域OCT(SD-OCT)是客观评价视网膜厚度变化的有用工具,而增强深度成像(EDI)OCT则可进一步对视网膜和脉络膜的形态进行定量评估.目前关于视神经炎的早期视网膜和脉络膜形态变化尚未阐明. 目的 采用SD-OCT和EDI OCT对视神经炎早期的视网膜和脉络膜形态进行定量检测,了解视神经炎早期的视网膜和脉络膜变化特征. 方法 采用前瞻性队列研究方法,于2015年7月至2016年5月纳入天津市眼科医院确诊的急性发作期视神经炎患者20例20眼,同期纳入性别和年龄匹配的健康体检者22人22眼.采用SD-OCT及EDI OCT测量受检者视盘周围3.4mm区域上、下、鼻、颞侧4个象限的视网膜神经纤维层(RNFL)平均厚度及上、下、鼻、颞侧4个象限的脉络膜厚度以及黄斑区RNFL、神经节细胞层(GCL)、内丛状层(IPL)、内核层(INL)、外丛状层(OPL)、外核层(ONL)、光感受器层的平均厚度.所有受检者均行图形视觉诱发电位(P-VEP)及视野检查,评价视野平均缺损(MD)与视盘周围RNFL平均厚度、脉络膜厚度、黄斑区RNFL、GCL、IPL、INL、OPL、ONL、光感受器层厚度的相关性. 结果 视神经炎患者视盘周围3.4 mim区域上方、下方及鼻侧3个象限的RNFL厚度分别为(424.00±160.30)、(428.40±169.83)和(108.15±50.66) μm,较正常对照组的(265.68±26.25)、(283.27±52.81)和(72.68±12.01) μm均明显增加,差异均有统计学意义(t=4.571、3.814、3.190,均P＜0.01),2个组间颞侧象限的RNFL厚度差异无统计学意义(t=0.849,P=0.401);2个组间上方、下方、鼻侧、颞侧4个象限的脉络膜厚度的差异均无统计学意义(均P＞0.05).视神经炎组患者黄斑1 mm区域RNFL、GCL、IPL平均厚度较正常对照组受检者明显变薄,视神经炎组患者黄斑3 mm区域GCL、IPL、INL平均厚度较正常对照组受检者明显变薄,差异均有统计学意义(均P＜0.05).视神经炎组患者P-VEP P100波潜伏期为(133.15±11.11)s,较正常对照组的(94.59±4.38)s明显延长,差异有统计学意义(t=15.058,P＜0.05).MD与视盘周围上方、下方、鼻侧3个象限的RNFL平均厚度呈中等线性正相关(r=O.649、0.649、0.635,均P＜0.05),而各象限脉络膜厚度与MD均无明显线性相关(r=-0.120、-0.102、-0.415、0.120,均P＞0.05);黄斑区RNFL、GCL、IPL、INL、OPL、ONL、光感受器层厚度与MD均无明显线性相关. 结论 EDI OCT检测发现视神经炎早期患者视盘周围RNFL发生水肿,厚度增加,黄斑区各层视网膜厚度均不同程度地变薄,但患者的脉络膜厚度无明显改变.EDI OCT是客观和定量评价视神经炎早期视网膜和脉络膜形态学的有用工具.     

基于EDI-OCT技术观察远视性弱视儿童脉络膜结构的变化

目的:通过增强深度成像光学相干断层扫描(EDI-OCT)技术比较远视性弱视与同龄正常儿童脉络膜结构的差异。方法:选取2021-01/12就诊于我院的远视性弱视儿童35例50眼纳入弱视组,选取同期就诊一般资料相匹配的健康儿童30例51眼纳入对照组,均进行EDI-OCT检查,测量脉络膜厚度(CT),并对图像进行处理后获取总脉络膜面积(TCA)、血管腔面积(LA)、基质面积(SA)、脉络膜血管指数(CVI)。结果:弱视组各区域TCA(下方除外)、SA(外环下方除外)、LA与CT(下方、颞侧除外)均明显大于对照组(P<0.05);除外环颞侧外,两组各区域CVI无明显差异(P>0.05);除鼻侧外,不同远视程度弱视儿童CT无明显差异(P>0.05)。结论:远视性弱视存在脉络膜结构异常,随着远视度数增加,TCA、LA、SA有增大趋势,脉络膜结构改变与远视性弱视有关。     

同一屈光范围高度近视性弱视眼与高度近视眼眼底结构的特点

目的：探讨在同一屈光度数范围内高度近视性弱视眼与高度近视眼在EDI-OCT下视网膜、脉络膜、视盘神经纤维层的形态特征。

方法：本试验招募6～16岁的中国儿童19例26眼进行研究。将研究对象分为高度近视性弱视组(11眼)和高度近视组(15眼)。采用频域OCT深层影像扫描模式，检查黄斑中心凹及黄斑中心凹旁不同区域的视网膜、脉络膜和视盘神经纤维层厚度。

结果：中心凹外1.0、1.5、2.0、2.5、3.0mm区域的视网膜厚度在绝大多数方位上，两组比较有差异(P<0.05)。下方3.0mm处，高度近视性弱视组脉络膜厚度显著薄于高度近视组(P=0.012)。两组各方位视盘神经纤维层厚度比较均无差异(P>0.05)。

结论：在同一屈光度数范围内，中心凹周围的视网膜厚度，高度近视性弱视眼明显薄于高度近视眼，弱视的发生发展可能参与其变化过程。     

定量分析单眼视网膜静脉阻塞患者视盘区变化

目的:通过光学相干断层扫描血管成像技术(OCTA)定量分析单眼视网膜静脉阻塞(RVO)患者视盘旁放射状毛细管血流密度(ppVD)与视盘旁视网膜神经纤维层(pRNFL)厚度的变化及相关性。方法:前瞻性观察性研究。纳入2021-01/12于安徽理工大学第一附属医院眼科就诊的单眼RVO患者43例,其中RVO患眼43眼作为患侧组,未受累眼43眼作为对侧组,同时期选取年龄、性别与RVO患者相匹配的健康志愿者21例42眼作为对照组。采用OCTA测量视盘内血流密度(VD)、视盘周围VD及其上侧(pS)、下侧(pI)、颞侧上方(TS)、上方颞侧(ST)、上方鼻侧(SN)、鼻侧上方(NS)、鼻侧下方(NI)、下方鼻侧(IN)、下方颞侧(IT)、颞侧下方(TI)的ppVD与pRNFL厚度,分析纳入受检者ppVD和pRNFL厚度的特征性改变及相关性。结果:与对照组相比,患侧组视盘内VD、视盘周围整体VD及pS、pI、TI、ST、SN侧ppVD均下降,对侧组仅视盘内VD降低(均P<0.05)。与对照组相比,患侧组TS侧pRNFL厚度升高,对侧组ST和IT侧pRNFL厚度降低(均P<0.01)。典型...     

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.     

近视及近视性弱视儿童视网膜神经纤维层OCT检测及分析

目的分析近视及近视性弱视儿童视网膜光学相干断层扫描（OCT）各项指标的变化,研究近视及近视性弱视儿童的视网膜结构的变化特征。方法对52只眼近视性弱视组和32只眼单纯近视组行视网膜OCT检查,记录黄斑中心凹中心视网膜厚度和视盘上方、下方、鼻侧、颞侧及平均视网膜神经纤维层（RNFL）厚度,并与32只眼正常对照组进行比较。结果近视性弱视组和正常对照组比较,视盘下方和视盘周围平均RNFL厚度变薄,且有统计学意义（P〈0.05）,而视盘上方、颞侧和鼻侧RNFL厚度和黄斑中心凹中心视网膜厚度均无显著差异（P〉0.05）。单纯近视组和正常对照组比较,视盘周围RNFL厚度和黄斑中心凹视网膜厚度均无显著差异（P〉0.05）。近视性弱视组高度近视儿童的视盘上方、下方、鼻侧和视网膜平均RNFL厚度较健眼变薄（P〈0.05）,而颞侧和黄斑中心凹中心视网膜厚度无明显变化（P〉0.05）,单纯近视组中高度近视儿童的视盘颞侧RNFL层厚度和黄斑中心凹中心视网膜厚度增加明显（P〈0.05）。结论近视及近视性弱视儿童的视网膜结构存在异常。     

高度近视性弱视儿童脉络膜厚度及其影响因素

目的：：研究高度近视性弱视儿童脉络膜厚度变化,并探讨其脉络膜厚度与眼轴、年龄的关系。方法：2014-01/07在我院眼科门诊就诊的儿童50例65眼,年龄4~15(平均9.91±3.41)岁,所有受检眼排除眼底疾病和眼前节病变。根据扩瞳验光的结果,分成高度近视性弱视组(24眼)、高度近视组(19眼)、正视眼组(22眼),运用海德堡EDI-OCT技术对中心凹下脉络膜厚度及距中心凹0.5,1.0,1.5,2.0,2.5,3.0mm处上方( S,12：00方位)、颞侧( T,9：00方位)、下方( I,6：00方位)、鼻侧( N,3：00方位)的脉络膜厚度进行测量,并通过A超测量出所有受检者眼轴长度。结果：高度近视性弱视组中心凹下及各方位脉络膜厚度与高度近视组、正视眼组相比最薄,有统计学意义(P<0.05)。高度近视弱视组中心凹下脉络膜厚度与眼轴长度有显著负相关性(r=-0.531, R2=0.282, F=7.476, P=0.013);与年龄无明显相关性( r=-0.292, R2=0.085, F=2.044, P=0.167)。结论：高度近视性弱视儿童的脉络膜厚度变薄,眼轴长度是重要的影响因素。     

Is quantitative spectral‐domain superior to time‐domain optical coherence tomography (OCT) in eyes with age‐related macular degeneration?

Purpose: The aim of this study was to determine the variability of macular map measurements, for two generations of optical coherence tomography (OCT) instruments, in eyes with wet age related macular degeneration (AMD) and low visual acuity. Methods: Patients were examined with Stratus OCT and Cirrus HD‐OCT. The macular thickness was assessed with the ‘macular thickness map scan’ and ‘fast protocol’ in Stratus and with the 512 × 128 and 200 × 200 cube protocols in Cirrus OCT. Two measurements were taken one directly after the other, at the first visit to analyse repeatability. Approximately 1 week later, a third measurement was taken to analyse reproducibility. In Cirrus OCT, a manual correction of foveal location was also performed. Repeatability and reproducibility were calculated as a coefficient of variance (CoV) and a coefficient of repeatability/reproducibility. Results: Repeatability for central macular thickness (expressed as CoV) was about three per cent for all protocols, and the coefficient of repeatability between 34 and 54 μm. Reproducibility (also expressed as CoV) was between four to seven per cent and coefficient of repeatability between 64 and 89 μm. After manual adjustment of foveal location in Cirrus OCT, the coefficient of repeatability improved to 12–18 μm, and the coefficient of reproducibility to 44–47 μm. Conclusions: In eyes affected by wet AMD, there were small differences in repeatability and reproducibility when comparing quantitative maps in Stratus and Cirrus OCT. However, when the software for manual correction of foveal position in Cirrus OCT was used, the variability decreased markedly, and the repeatability was close to what had been reported in normal eyes, demonstrating a significant, potential advantage of spectral‐domain over time‐domain OCT.     

长扫描深度谱域OCT测量圆锥角膜患者全角膜厚度的重复性和再现性

目的探讨长扫描深度谱域OCT（UL-OCT）N4量圆锥角膜患者的全角膜三维厚度分布的重复性与再现性。方法前瞻性研究。选取圆锥角膜患者10例（10眼）,使用自行搭建的UL-OCT获得角膜的横断面图像．采用以角膜顶点为中心进行均等放射状B型扫描获取i维图像。通过全自动分割算法获取10mm直径范围角膜厚度分布图,并将测量结果与Pentacam三维眼前节分析诊断系统进行对比。2个仪器的重复性与再现性通过重复性系数与再现性系数（CoR）、组内相关系数（ICC）和变异系数（CV）进行比较。2个仪器的一致性通过配对t检验和Bland-Ahman方法进行分析。结果对于圆锥角膜患者,UL-OCT测量值的重复性系数为3．43～4．31μm,再现性系数为3．58～8．10μm。重复性和再现性的组内相关系数分别为0．998和0．995以上。Pentacam测量值的重复性系数为8．63～14．30μm,再现性系数为14．59～19．17μm。重复性和再现性的组内相关系数分别为0．997和0．994以上。UL-OCT系统测量的角膜厚度在中央区、旁中央区、过渡区、周围区分别为（468．9±38．6）μm、（482．5±48．6）μm、（515．5±57．0）μm、（588．0±52．5）μm。Pentacam系统测量的各区角膜厚度分别为（500．9＋50．0）μm、（533．9＋49．7）μm、（587．9±60．6）μm、（635．3±62．0）μm。Bland-Altman分析角膜厚度测量结果显示,2种仪器测量结果差值的95％一致性界限在中央区、旁中央区、过渡区分别为-44．49～108．59μm、-7．47～110．23μm、-13．21～131．68μm。结论在测量圆锥角膜患者全角膜厚度时,与Pentacam系统相比,UL-OCT系统具有更好的重复性和再现性。UL-OCT系统与Pentacam系统得到的角膜厚度测量结果存在差异,因此2种仪器在临床应用时不可互换。     

Simplified Method to Measure the Peripapillary Choroidal Thickness Using Three-dimensional Optical Coherence Tomography

Purpose

To evaluate a simplified method to measure peripapillary choroidal thickness using commercially available, three-dimensional optical coherence tomography (3D-OCT).

Methods

3D-OCT images of normal eyes were consecutively obtained from the 3D-OCT database of Korea University Medical Center On the peripapillary images for retinal nerve fiber layer (RNFL) analysis, choroidal thickness was measured by adjusting the segmentation line for the retinal pigment epithelium to the chorioscleral junction using the modification tool built into the 3D-OCT image viewer program. Variations of choroidal thickness at 12 sectors of the peripapillary area were evaluated.

Results

We were able to measure the peripapillary choroidal thickness in 40 eyes of our 40 participants, who had a mean age of 41.2 years (range, 15 to 84 years). Choroidal thickness measurements had strong inter-observer correlation at each sector (r = 0.901 to 0.991, p < 0.001). The mean choroidal thickness was 191 ± 62 µm. Choroidal thickness was greatest at the temporal quadrant (mean ± SD, 210 ± 78 µm), followed by the superior (202 ± 66 µm), nasal (187 ± 64 µm), and inferior quadrants (152 ± 59 µm).

Conclusions

The measurement of choroidal thickness on peripapillary circle scan images for RNFL analysis using the 3D-OCT viewing program was highly reliable and efficient.     

Variability of subfoveal choroidal thickness measurements in patients with age-related macular degeneration and central serous chorioretinopathy

Purpose

To evaluate the variability in subfoveal choroidal thickness measurements in patients with age-related macular degeneration (AMD) and central serous chorioretinopathy using enhanced depth imaging optical coherence tomography (EDI-OCT).

Methods

One hundred and sixty eyes of 160 patients who were diagnosed with early AMD (N=40), exudative AMD (N=40), polypoidal choroidal vasculopathy (PCV, N=40), or central serous chorioretinopathy (CSC, N=40) were included in this retrospective observational study. In addition, we included 40 normal eyes of 40 subjects. Subfoveal choroidal thickness was measured manually by two masked observers based on EDI-OCT images. The correlation of choroidal thickness with the absolute value of the difference in the choroidal thickness measurement was estimated for all 200 eyes. Intraobserver and interobserver coefficients of repeatability (CRs) were calculated.

Results

There was a significant positive correlation between subfoveal choroidal thickness and both intraobserver (P<0.001) and interobserver (P<0.001) difference in choroidal thickness measurements. The mean intraobserver CRs in nonexudative AMD, exudative AMD, PCV, CSC, and normal eyes were ∼15–21, 23–29, 24–35, 32–38, and 19–25 μm, respectively. The mean interobserver CRs were ∼24–28, 30–36, 39–45, 46–57, and 26–35 μm, respectively.

Conclusions

Relatively great measurement variability should be considered when investigating eyes with pathologic conditions related to a thick choroid, including PCV or CSC.     

中心性浆液性脉络膜视网膜病变患者脉络膜毛细血管扩张和中心凹下脉络膜厚度关系的研究

目的 探讨中心性浆液性脉络膜视网膜病变患者脉络膜毛细血管扩张和黄斑中心凹下脉络膜厚度的关系.方法 选取2015年2月至2016年4月我院收治的中心性浆液性脉络膜视网膜病变患者84例(84眼),依据荧光素眼底血管造影检查结果分为3组:轻度组(注射后9 ～ 10 min渗漏)26例,中度组(注射后5～8 min渗漏)37例,重度组(注射后5 min内渗漏)21例,利用OCTA技术确定脉络膜毛细血管扩张程度,利用EDI-OCT测量3组患者以及脉络膜毛细血管不同扩张程度下患者的黄斑中心凹下脉络膜厚度,并进行相关性分析.结果 轻度、中度、重度患者的脉络膜毛细血管重度扩张比例依次升高(7.69％、13.52％、23.81％),黄斑中心凹下脉络膜厚度依次增加,差异具有统计学意义(P＜0.05).脉络膜毛细血管轻度、中度、重度扩张患者的黄斑中心凹下脉络膜厚度分别为(306.59±74.18)μm、(367.21±85.04) μm、(416.27±104.56) μm,差异具有统计学意义(P＜0.05).中心性浆液性脉络膜视网膜病变患者患侧脉络膜毛细血管扩张程度与黄斑中心凹下脉络膜厚度明显正相关(r =0.812,P=0.037).结论 随着病情的加重,中心性浆液性脉络膜视网膜病变患者脉络膜毛细血管扩张程度和黄斑中心凹下脉络膜厚度明显增加,且二者存在明显的正相关关系.     

Quantitative analysis of subfoveal choroidal thickness using enhanced depth imaging optical coherence tomography in normal eyes

To evaluate subfoveal choroidal thickness of normal eyes with the use of the enhanced depth imaging technique of optical coherence tomography (EDI-OCT) and correlation of choroidal thickness with patient age. A retrospective analysis of 123 healthy eyes was performed. Age, gender, refractive state and spheric equivalencies were noted. Subfoveal choroidal thickness was measured and noted manually by two independent observers. A total of 72 patients (123 eyes) were included in this study. The mean age of the patients was 47.47 (15–84). The mean spheric equivalent of the refractive error was ?0.24 D. According to LogMAR, the mean visual acuity was ?0.006. The mean subfoveal choroidal thickness was 280.23 μm (SD ± 81.15, range 124–527 μm). The choroidal thickness showed a negative correlation with age for the subfoveal location (p = 0.000^a). Regression analysis showed that subfoveal choroidal thickness decreased 3.14 μm for each year of age. The regression formulation was choroidal thickness = 429 ? 3.14 × age. When we compared eyes according to their spheric equivalencies, there was no statistically significant correlation between spheric equivalency and subfoveal choroidal thickness. (p = 0.14). In this study, we report choroidal thickness measurement among healthy eyes within the Turkish population to demonstrate that EDI-OCT imaging can give cross-sectional information regarding the choroid, thereby facilitating quantitative imaging.     

Reproduzierbarkeit der Messung der peripapillären Nervenfaserschichtdicke

Purpose

The aim of this study was to compare the intra- and inter-examiner reproducibility of measurements obtained by optical coherence tomography (OCT) and retinal thickness analyzer (RTA).

Patients and methods

During a period of 2 months, 22 eyes of 16 patients and 6 healthy subjects were included. Two examiners (EMH, RK) successively performed three measurements of the peripapillary retinal nerve fibre layer (RNFL) thickness with RTA and OCT. The reproducibility of three individual measurements of one examiner (intra-examiner) as well as the reproducibility of the measurements between both examiners (inter-examiner) was evaluated using the Friedman test and sign test.

Results

The average thickness of the peripapillary RNFL was 154.4 µm for the first investigator (EMH) and 155.1 µm for the other investigator (RK) measured with RTA. The results obtained by OCT were 137.3 µm (EMH) and 138.9 µm (RK), respectively, generally indicating a threefold smaller range. Comparing the three measurements of one single examiner, no appreciable intra-observer dependency neither for RTA (EMH: p=0.19, RK: p=0.95) nor for OCT (EMH: p=0.51, RK: p=0.62) was observed. Inter-examiner analysis for RTA and OCT also revealed an acceptable reproducibility.

Conclusions

Measurements of peripapillary RNFL thickness using RTA and OCT exhibited intra- and inter-observer agreement.     

应用深度增强型成像技术研究早期年龄相关性黄斑变性患者黄斑区脉络膜厚度的变化

目的应用深度增强型相干光断层扫描(EDI-OCT)技术研究早期年龄相关性黄斑变性(AMD)患者黄斑区脉络膜厚度的变化及其与AMD发病的关系。 方法收集2015年3月至2017年3月于中国康复研究中心北京博爱医院眼科就诊的早期AMD患者90例(90只眼)和眼底正常者60例(60只眼)的临床资料。早期AMD患者为患者组,眼底正常者为正常组。患者组中男性51例(51只眼),女性39例(39只眼);年龄63~85岁,平均年龄(74.3±10.9)岁。正常组中男性24例(24只眼),女性36例(36只眼);年龄58~78岁,平均年龄(68.6±10.8)岁。采用EDI-OCT测量两组受试者黄斑中心凹处及由中心凹向鼻侧、颞侧各500 μm、1000 μm处的脉络膜厚度,共测量5个点位。数据以均数±标准差( ±s)表示。两组间脉络膜厚度的比较采用t检验,多组间比较采用单因素方差分析,组间两两比较采用Tukey检验。 结果患者组黄斑区脉络膜的平均厚度为(254.84±51.46)μm;正常组黄斑区脉络膜的平均厚度为(271.46±43.36)μm。患者组黄斑区脉络膜的厚度较正常组低,且两组间差异有统计学意义(t＝-2.061,P<0.05)。所有受试者的年龄与脉络膜的厚度呈负相关,且差异有统计学意义(r＝-0.23,P<0.05)。 结论早期AMD患者的脉络膜厚度较眼底正常者偏薄,且早期AMD患者脉络膜厚度的改变可作为黄斑变性发展的预警因素,能为早期的临床干预提供参考。     

Subfoveal choroidal thickness and volume in severe internal carotid artery stenosis patients

AIM: To demonstrate the differences of retinal and choroidal structure changes in internal carotid artery (ICA) patients of China by enhanced-depth imaging optical coherence tomography (EDI-OCT). METHODS: A retrospective review was conducted of 46 patients with a diagnosis of ICA stenosis greater than 65% on only one side (the opposite ICA Stenosis had less than 40% stenosis) from June 2015 through June 2016. All of the patients were combined with amaurosis fugax, but without any abnormality with other ocular examination. Thickness and volume of choroid and retina were manually measured by EDI-OCT. Differences were compared between ICA stenosis eyes and fellow eyes. RESULTS: There were no significant differences in the retinal thickness, macular retinal nerve fiber layer (mRNFL) thickness, inner thickness, or outer retinal thickness between the ICA Stenosis group and the control group (P=0.834, 0.187, 0.552, and 0.903, respectively). The mean central choroidal thickness of the ICA Stenosis group was significantly lower than that of the control group (239.70±23.76 µm vs 257.46±22.13 µm, P<0.001). The percentage of ICA stenosis was significantly associated with the central choroidal thickness, central retinal thickness, foveal center choroidal volume, and foveal center retinal volume (r=0.854, 0.678, 0.729, and 0.785, respectively; P<0.001). There were no significant differences in the retinal and choroidal volume values in the 4 inner and 4 outer sectors between the two groups. CONCLUSION: The choroidal thickness in severe ICA stenosis eyes is lower than in fellow eyes. The choroidal thinning may occur before the retinal changes in patients with ocular ischemic syndrome. Evaluations of choroidal thickness may be useful to choose the optimal therapeutic schedule for ICA patients.