Menke Marcel N, Feke Gilbert T, Trempe Clement L
Schepens Retina Associates Foundation, Boston, MA 02215, USA.
Invest Ophthalmol Vis Sci. 2005 Oct;46(10):3807-11. doi: 10.1167/iovs.05-0352.
This study investigated the influence of disc edema (DE) caused by inflammatory optic neuropathies or retinal vein occlusions on optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) thickness measurements.
OCT RNFL circle scans centered on the optic disc were made for 13 patients with DE (7 with retinal vein occlusions and 6 with inflammatory optic neuropathies) and 13 controls. RNFL thickness was assessed using the OCT normative database. The same circle scans were also used for peripapillary total retinal thickness measurements. The RNFL percentage of total retinal thickness was calculated, normalized (nRNFL%), and averaged separately for affected and unaffected regions of each eye.
Average RNFL thickness was 122 +/- 23 microm in the DE group, and 91 +/- 8 microm in the control group (P = 0.0001). Mean peripapillary total retinal thickness was 329 +/- 56 microm in the DE group and 255 +/- 12 microm in the control group (P < 0.001). Comparison of the averaged nRNFL% values at measurement locations above the range of the normative database with averaged nRNFL% values at measurement locations within the range of the normative database in the optic neuropathy group showed a significant difference (P = 0.024); however, the same analysis in the retinal vein occlusion group revealed no significant difference.
OCT measurements are influenced by DE and show significantly greater thickness values in those patients than in controls. The presence of a significant difference within the averaged nRNFL% values in the optic neuropathy group and the absence of such a difference in the retinal vein occlusion group could be explained by edema primarily affecting the RNFL in optic neuropathy in contrast to what occurs in retinal vein occlusion, where edema affects all retinal layers.
本研究调查了炎症性视神经病变或视网膜静脉阻塞所致的视盘水肿（DE）对光学相干断层扫描（OCT）测量视网膜神经纤维层（RNFL）厚度的影响。
对13例患有DE的患者（7例视网膜静脉阻塞患者和6例炎症性视神经病变患者）及13例对照者进行以视盘为中心的OCT RNFL环形扫描。使用OCT标准数据库评估RNFL厚度。同样的环形扫描也用于测量视乳头周围的视网膜总厚度。计算每只眼睛患侧和未患侧视网膜总厚度中RNFL的百分比，进行标准化处理（nRNFL%），并分别求平均值。
DE组的平均RNFL厚度为122±23微米，对照组为91±8微米（P = 0.0001）。DE组视乳头周围视网膜总平均厚度为329±56微米，对照组为255±12微米（P < 0.001）。视神经病变组中，测量位置在标准数据库范围之上的平均nRNFL%值与测量位置在标准数据库范围之内的平均nRNFL%值相比较，差异有统计学意义（P = 0.024）；然而，视网膜静脉阻塞组的同样分析未显示出显著差异。
OCT测量受DE影响，与对照组相比，这些患者的测量厚度值显著更高。视神经病变组平均nRNFL%值存在显著差异，而视网膜静脉阻塞组不存在此差异，这可能是因为在视神经病变中水肿主要影响RNFL，而在视网膜静脉阻塞中水肿影响所有视网膜层。
