Grewal Dilraj S, Sehi Mitra, Greenfield David S
Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Palm Beach Gardens, FL 33418, USA.
Arch Ophthalmol. 2009 Nov;127(11):1442-8. doi: 10.1001/archophthalmol.2009.196.
To compare the retinal nerve fiber layer (RNFL) thickness and retinal sensitivity in the normal visual hemifield of glaucomatous eyes with localized visual field loss with those of normal eyes and eyes with suspected glaucoma, and to evaluate the relationship between RNFL atrophy and glaucoma severity.
One randomly selected eye of each subject underwent standard automated perimetry, stereoscopic photography, scanning laser polarimetry with enhanced corneal compensation, and time-domain and spectral-domain optical coherence tomography (OCT). Mean retinal sensitivity values were calculated in the normal standard automated perimetry hemifield of the glaucoma group and randomly selected hemifields in the normal and suspected glaucoma groups. The mean RNFL thickness values corresponding to the normal hemifield were calculated. Glaucoma severity was judged using standard automated perimetry pattern standard deviation and the Heidelberg retina tomograph-derived linear cup-disc ratio.
Fifty subjects were enrolled in each group. Mean RNFL thickness in the normal hemifield obtained using spectral-domain OCT, time-domain OCT, and scanning laser polarimetry with enhanced corneal compensation was significantly (P <or= .01) thinner in the glaucoma group compared with the normal and suspected glaucoma groups. Mean retinal sensitivity in the normal hemifield was significantly (P < .001) reduced in the glaucoma group compared with the normal and suspected glaucoma groups. The Heidelberg retina tomograph-derived cup-disc ratio was significantly correlated with mean RNFL thickness in the normal hemifield obtained using spectral-domain OCT, time-domain OCT, and scanning laser polarimetry with enhanced corneal compensation (P <or= .01).
Diffuse RNFL atrophy and retinal sensitivity loss exist in glaucomatous eyes with localized standard automated perimetry deficits. Glaucomatous damage affects both structure and function in a linear proportion.
比较青光眼患者局限性视野缺损侧正常视野半侧的视网膜神经纤维层（RNFL）厚度和视网膜敏感度与正常眼及疑似青光眼眼的差异，并评估RNFL萎缩与青光眼严重程度之间的关系。
每位受试者随机选取一只眼进行标准自动视野计检查、立体照相、带增强角膜补偿的扫描激光偏振仪检查以及时域和频域光学相干断层扫描（OCT）。计算青光眼组正常标准自动视野计半侧的平均视网膜敏感度值，以及正常组和疑似青光眼组随机选取半侧的平均视网膜敏感度值。计算对应正常视野半侧的平均RNFL厚度值。使用标准自动视野计模式标准差和海德堡视网膜断层扫描仪得出的线性杯盘比来判断青光眼严重程度。
每组纳入50名受试者。与正常组和疑似青光眼组相比，青光眼组使用频域OCT、时域OCT和带增强角膜补偿的扫描激光偏振仪检查得出的正常视野半侧的平均RNFL厚度显著变薄（P≤0.01）。与正常组和疑似青光眼组相比，青光眼组正常视野半侧的平均视网膜敏感度显著降低（P<0.001）。海德堡视网膜断层扫描仪得出的杯盘比与使用频域OCT、时域OCT和带增强角膜补偿的扫描激光偏振仪检查得出的正常视野半侧的平均RNFL厚度显著相关（P≤0.01）。
存在局限性标准自动视野计缺损的青光眼患者存在弥漫性RNFL萎缩和视网膜敏感度丧失。青光眼损害以线性比例影响结构和功能。
