用谱域光学相干断层扫描测量脉络膜厚度：青光眼患者厚度的影响因素。
Choroidal thickness measured by spectral domain optical coherence tomography: factors affecting thickness in glaucoma patients.
机构信息
The Glaucoma Service and Dana Center for Preventive Ophthalmology, The Wilmer Eye Institute at Johns Hopkins University, USA.
出版信息
Ophthalmology. 2011 Aug;118(8):1571-9. doi: 10.1016/j.ophtha.2011.01.016. Epub 2011 Apr 13.
PURPOSE
To measure choroidal thickness and to determine parameters associated with it.
DESIGN
Cross-sectional study.
PARTICIPANTS
Seventy-four glaucoma patients and glaucoma suspects.
METHODS
Spectral domain optical coherence tomography (SD-OCT) scans were obtained to estimate average choroidal thickness in a group of glaucoma suspects and glaucoma patients. The average thickness was calculated from enhanced depth SD-OCT images and manually analyzed with Image J software. Open-angle glaucoma, open-angle glaucoma suspect, primary angle-closure glaucoma, primary angle closure, and primary angle-closure suspect were defined by published criteria. Glaucoma suspects had normal visual fields bilaterally. Glaucoma was defined by specific criteria for optic disc damage and visual field loss in ≥1 eye. The most affected eye was analyzed for comparisons across individuals, and right/left and upper half/lower half comparisons were made to compare thickness against degree of visual field damage.
MAIN OUTCOME MEASURES
Average macular and peripapillary choroidal thickness measured using SD-OCT.
RESULTS
The choroidal-scleral interface was visualized in 86% and 96% of the macular and peripapillary scans, respectively. In multivariable linear regression analysis, the macular choroid was significantly thinner in association with 4 features: Longer eyes (22 μm per mm longer [95% confidence interval (CI), -33, -11]), older individuals (31 μm thinner per decade older [95% CI, -44, -17]), lower diastolic ocular perfusion pressure (26 μm thinner per 10 mmHg lower [95% CI, 8, 44]), and thicker central corneas (6 μm per 10 μm thicker cornea [95% CI, -10, 0]). The choroid was not significantly thinner in glaucoma patients than in suspects (14 μm [95% CI, -54, 26]; P = 0.5). Peripapillary choroidal thickness was not significantly different between glaucoma and suspect patients. Thickness was not associated with damage severity as estimated by visual field mean deviation or nerve fiber layer thickness, including comparisons of right with left eye or upper with lower values.
CONCLUSIONS
Age, axial length, CCT, and diastolic ocular perfusion pressure are significantly associated with choroidal thickness in glaucoma suspects and glaucoma patients. Degree of glaucoma damage was not consistently associated with choroidal thickness.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.
目的
测量脉络膜厚度并确定与之相关的参数。
设计
横断面研究。
参与者
74 名青光眼患者和疑似青光眼患者。
方法
使用谱域光相干断层扫描（SD-OCT）扫描来估计一组疑似青光眼和青光眼患者的平均脉络膜厚度。使用增强深度 SD-OCT 图像计算平均厚度，并使用 Image J 软件进行手动分析。开角型青光眼、开角型青光眼疑似患者、原发性闭角型青光眼、原发性闭角型青光眼和原发性闭角型青光眼疑似患者均根据已发表的标准定义。青光眼疑似患者双眼视野正常。青光眼的定义是根据特定的标准，即 1 只或多只眼的视盘损伤和视野丧失。对最受影响的眼睛进行分析，以比较个体之间的差异，并比较右眼/左眼和上半/下半的厚度与视野损伤程度的关系。
主要观察指标
使用 SD-OCT 测量黄斑和视盘周围脉络膜的平均厚度。
结果
分别有 86%和 96%的黄斑和视盘周围扫描可观察到脉络膜-巩膜界面。在多变量线性回归分析中，以下 4 个特征与黄斑脉络膜变薄显著相关：眼轴较长（每毫米长 22μm[95%置信区间（CI），-33，-11]）、年龄较大（每 10 年衰老 31μm 变薄[95%CI，-44，-17]）、舒张期眼灌注压较低（每降低 10mmHg 降低 26μm[95%CI，8，44]）和中央角膜较厚（每增加 10μm 角膜增加 6μm[95%CI，-10，0]）。青光眼患者的脉络膜厚度并不明显比疑似青光眼患者薄（14μm[95%CI，-54，26]；P=0.5）。青光眼和疑似青光眼患者的视盘周围脉络膜厚度无显著差异。脉络膜厚度与视野平均偏差或神经纤维层厚度所估计的损伤严重程度无关，包括右眼与左眼或上半与下半的比较。
结论
年龄、眼轴长度、中央角膜厚度和舒张期眼灌注压与青光眼疑似患者和青光眼患者的脉络膜厚度显著相关。青光眼损害的严重程度与脉络膜厚度并不一致相关。
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