Department of Ophthalmology, Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Invest Ophthalmol Vis Sci. 2012 Jul 3;53(8):4539-45. doi: 10.1167/iovs.11-9300.
To characterize by Fourier-domain optical coherence tomography (FD-OCT) the loss of nerve fiber layer (NFL) and ganglion cell complex (GCC) in nonarteritic ischemic optic neuropathy (NAION).
Patients diagnosed with NAION were enrolled and categorized into "superior field loss (SFL)," "inferior field loss (IFL)," and "bihemispheric field loss (BFL)" groups based on the Swedish interactive threshold algorithm 30-2 achromatic visual field (VF) tests. Six months after presentation, they were scanned by FD-OCT to map peripapillary NFL and macular GCC thicknesses. Age-matched normals were selected from participants in the Advanced Imaging for Glaucoma Study (www.AIGStudy.net). Deviation maps were defined as the difference between the thickness maps and the average normal maps. Pearson's correlation coefficient was used to assess the correlation between VF and OCT measurements.
Twenty-five NAION eyes in 20 subjects were analyzed. Most (2/3) SFL cases showed inferior NFL loss with variable sparing of inferonasal losses. All (4/4) IFL cases showed superior NFL loss with variable inferonasal extension. The GCC maps demonstrated clear hemispheric loss pattern in agreement with VFs. NFL and GCC losses could be detected even in the less affected hemispheres (P < 0.001). NFL and GCC were highly correlated (P < 0.001) with VF in terms of both overall averages and superior-inferior hemispheric differences.
NFL and GCC losses correlated well with VF losses in both magnitude and location. Hemispheric GCC loss correlated with altitudinal VF loss and this pattern may be of diagnostic value. FD-OCT is useful in the evaluation of NAION.
通过傅里叶域光学相干断层扫描（FD-OCT）来描述非动脉炎性前部缺血性视神经病变（NAION）中神经纤维层（NFL）和节细胞复合体（GCC）的丢失。
招募了被诊断为 NAION 的患者，并根据瑞典交互式阈值算法 30-2 非彩色视觉场（VF）测试，将他们分为“上方视野损失（SFL）”、“下方视野损失（IFL）”和“双侧视野损失（BFL）”组。在出现后 6 个月，对他们进行 FD-OCT 扫描，以绘制视盘周围 NFL 和黄斑 GCC 厚度图。从 Advanced Imaging for Glaucoma Study（www.AIGStudy.net）的参与者中选择年龄匹配的正常人。偏差图定义为厚度图与平均正常图之间的差异。使用 Pearson 相关系数评估 VF 和 OCT 测量之间的相关性。
分析了 20 名受试者的 25 只 NAION 眼。大多数（2/3）SFL 病例表现为下方 NFL 丢失，伴有可变的鼻侧下损失保留。所有（4/4）IFL 病例均表现为上方 NFL 丢失，伴有可变的鼻侧下延伸。GCC 图显示出与 VF 一致的清晰半球性丢失模式。即使在受影响较小的半球中也可以检测到 NFL 和 GCC 丢失（P < 0.001）。NFL 和 GCC 与 VF 在总体平均值和上下半球差异方面均具有高度相关性（P < 0.001）。
NFL 和 GCC 丢失在幅度和位置上与 VF 丢失高度相关。半球性 GCC 丢失与高度 VF 丢失相关，这种模式可能具有诊断价值。FD-OCT 可用于评估 NAION。
