Walia Saloni, Fishman Gerald A, Edward Deepak P, Lindeman Martin
Department of Ophthalmology and Visual Sciences, University of Illinois, Chicago, Illinois 60612-7234, USA.
Invest Ophthalmol Vis Sci. 2007 Oct;48(10):4748-52. doi: 10.1167/iovs.07-0404.
To determine, with the use of optical coherence tomography (OCT), the peripapillary retinal nerve fiber layer (RNFL) thickness among patients with retinitis pigmentosa (RP) of different degrees of disease severity.
One eye in each of 25 RP patients was included. All patients underwent complete ocular examination, including the measurement of intraocular pressure, corneal thickness, and detailed fundus examination. Visual fields were evaluated by Goldmann perimetry. An RNFL thickness protocol was used to acquire circular scans of 3.46 mm in diameter around the optic nerve. For each eye, RNFL thickness was studied in the temporal (316 degrees -45 degrees ), superior (46 degrees -135 degrees ), nasal (136 degrees -225 degrees ), and inferior (226 degrees -315 degrees ) quadrants. Three smaller segments were also measured within each quadrant, all automatically calculated by the existing OCT software. The severity of damage to the peripapillary nerve fiber layer was compared with the clinical appearance of the optic disc, severity of field loss, and mode of inheritance for RP.
The mean age of patients included in the study was 48.6 years (range, 23-73 years). Of the 25 patients examined, 10 had abnormal thinning of the peripapillary RNFL in 2 or more segments, and 7 of those had abnormal thinning in at least 1 quadrant. The number of patients with abnormal thinning of the RNFL was considerably greater in those with clinically observed moderately severe or severe pallor of the optic disc than in those with normal appearance or mild pallor of the optic disc. No consistent association was noted between the remaining visual field and the presence of a RNFL defect (P > 0.05).
Patients with retinitis pigmentosa may have a measurable degree of RNFL thinning as determined by OCT. These observations could have an impact on future treatment strategies and imply that patients considered for various treatment options would benefit by an evaluation of nerve fiber layer thickness.
运用光学相干断层扫描（OCT）技术，测定不同疾病严重程度的视网膜色素变性（RP）患者的视乳头周围视网膜神经纤维层（RNFL）厚度。
纳入25例RP患者的单眼。所有患者均接受全面的眼部检查，包括眼压测量、角膜厚度测量及详细的眼底检查。采用Goldmann视野计评估视野。使用RNFL厚度测量方案获取视神经周围直径3.46 mm的环形扫描图像。对于每只眼睛，在颞侧（316度 - 45度）、上方（46度 - 135度）、鼻侧（136度 - 225度）和下方（226度 - 315度）象限研究RNFL厚度。每个象限内还测量了三个较小的节段，均由现有的OCT软件自动计算。将视乳头周围神经纤维层的损伤严重程度与视盘的临床表现、视野缺损严重程度及RP的遗传方式进行比较。
纳入研究的患者平均年龄为48.6岁（范围23 - 73岁）。在检查的25例患者中，10例患者的视乳头周围RNFL在2个或更多节段出现异常变薄，其中7例在至少1个象限出现异常变薄。视盘临床观察为中度严重或严重苍白的患者中，RNFL异常变薄的患者数量明显多于视盘外观正常或轻度苍白患者。其余视野与RNFL缺损的存在之间未发现一致的关联（P > 0.05）。
视网膜色素变性患者可能存在可通过OCT测量的RNFL变薄程度。这些观察结果可能会对未来的治疗策略产生影响，并意味着考虑各种治疗方案的患者通过评估神经纤维层厚度将受益。
