Fuse Nobuo, Aizawa Naoko, Yokoyama Yu, Nakamura Masahiko, Omodaka Kazuko, Sado Kazunari, Nakazawa Toru
Department of Ophthalmology, Tohoku University Graduate School of Medicine, Japan.
Nippon Ganka Gakkai Zasshi. 2012 Jun;116(6):575-80.
To evaluate the clinical characteristics of patients with superior segmental optic hypoplasia (SSOH) and quantitatively assess the structural characteristics using optical coherence tomography (OCT).
Forty-three eyes of 43 subjects with SSOH and 30 eyes of 30 normal subjects as controls (mean age; 40.2 +/- 14.1, 42.9 +/- 9.9 years, mean refraction; - 4.6 +/- 3.7 D, -3.6 +/- 2.7 D, mean intraocular pressure; 14.6 +/- 2.5 mmHg, 14.3 +/- 3.2 mmHg, Humphrey visual field mean deviation; -4.31 +/- 4.3 dB, 0.01 +/- 1.2 dB) were enrolled. Forty-three eyes of the 43 patients with SSOH were examined by OCT for the quantitative assessment of the RNFL thickness (RNFLT). For the comparison of RNFLT, total average thickness, four quadrants and clock hour-based (12 equal 30 degree sectors) RNFLT were analyzed using OCT.
OCT showed that the eyes with SSOH had significantly thinner RNFL than the normal subjects in total average thickness (SSOH 81.2 mm vs. 105.0 mm, p < 0.0001). Except for the temporal guadrant (p = 0.31), RNFL was thinner in superior, nasal(both p < 0.0001) and inferior (p = 0.002) guadrant. A comparison between the SSOH group and the normal control group for the 12 clock-hour segments in the OCT demonstrated that the patients with SSOH had decreased peripapillary RNFL thickness; the difference was statistically significant, except for the 7, 8, 9 and 10 o'clock segments. The area under the receiver operator characteristic curve (AUC) was greatest for the RNFL thickness of the 12 o'clock segment (AUC = 0.93), followed by the 1 o'clock segment (AUC = 0.90), and the 2 o'clock segment (AUC- = 0.87), as measured by the OCT.
More generalized thinning of the RNFL and decreasing total average thickness except for the RNFL from 7 o'clock to 10 o'clock were identified in the eyes with SSOH with a relatively superior entrance of the central retinal artery and thinning of the superior retinal nerve fiber layer. It was also demonstrated that segments 12, 1 and 2 o'clock of the SSOH were highly useful for differential diagnosis.
评估上半段视神经发育不全（SSOH）患者的临床特征，并使用光学相干断层扫描（OCT）定量评估其结构特征。
纳入43例患有SSOH的受试者的43只眼以及30例正常受试者的30只眼作为对照（平均年龄；40.2±14.1岁，42.9±9.9岁，平均屈光度；-4.6±3.7D，-3.6±2.7D，平均眼压；14.6±2.5mmHg，14.3±3.2mmHg，Humphrey视野平均偏差；-4.31±4.3dB，0.01±1.2dB）。对43例SSOH患者的43只眼进行OCT检查，以定量评估视网膜神经纤维层厚度（RNFLT）。为比较RNFLT，使用OCT分析总平均厚度、四个象限以及基于钟点（12个等份，每份30度扇形区域）的RNFLT。
OCT显示，SSOH患者的眼睛在总平均厚度方面的RNFL明显比正常受试者薄（SSOH为81.2μm，正常受试者为105.0μm，p<0.0001）。除颞侧象限外（p=0.31），上、鼻侧（均p<0.0001）和下侧象限（p=0.002）的RNFL较薄。OCT对SSOH组和正常对照组的12个钟点段进行比较，结果显示SSOH患者的视乳头周围RNFL厚度降低；除7、8、9和10点钟段外，差异具有统计学意义。根据OCT测量，接受者操作特征曲线（AUC）在12点钟段的RNFL厚度方面最大（AUC=0.93），其次是1点钟段（AUC=0.90）和2点钟段（AUC=0.87）。
在具有相对较高的视网膜中央动脉入口和上视网膜神经纤维层变薄的SSOH患者眼中，发现RNFL更普遍变薄且总平均厚度降低，除了7点至10点的RNFL。还证明了SSOH的12点、1点和2点钟段对鉴别诊断非常有用。
