Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada.
Invest Ophthalmol Vis Sci. 2012 Aug 24;53(9):5819-26. doi: 10.1167/iovs.12-9924.
To study changes in lamina cribrosa position and prelaminar tissue thickness (PTT) after surgical IOP reduction in glaucoma patients.
Twenty-two patients (mean age, 71.4 years) were imaged with spectral domain optical coherence tomography (SD-OCT; 24 radial B-scans centered on the optic nerve head [ONH]) before trabeculectomy or tube shunt implantation. Follow up images were acquired 1 week, 1 month, 3 months, and 6 months postsurgery. Bruch's membrane opening (BMO), the internal limiting membrane (ILM) and the anterior laminar surface (ALS) were segmented in each radial scan with custom software. Surfaces were fitted to the ILM and ALS with the extracted three-dimesional coordinates. PTT was the distance between the ILM and ALS, perpendicular to a BMO reference plane. Serial postsurgical laminar displacement (LD), relative to the BMO reference plane, and changes in PTT were measured. Positive values indicated anterior LD.
Mean (SD) presurgery IOP was 18.1 (6.5) mm Hg, and reduced by 4.7 (5.5), 2.4 (7.7), 7.0 (6.2), and 6.8 (7.5) mm Hg at 1 week, 1 month, 3 months, and 6 months postsurgery, respectively. At the four postsurgery time points, there was significant anterior LD (1.8 [9.5], -1.1 [8.9], 8.8 [20.2], and 17.9 [25.8] μm) and PTT increase (1.7 [13.3], 2.4 [11.9], 17.4 [13.7], and 13.9 [18.6] μm). LD was greater in ONHs with larger BMO area (P = 0.01) and deeper ALS (P = 0.04); however, PTT was not associated with any of the tested independent variables.
Both anterior LD and thickening of prelaminar tissue occur after surgical IOP reduction in patients with glaucoma.
研究青光眼患者手术降低眼内压后，视盘筛板位置和视盘筛板前组织厚度（PTT）的变化。
22 例患者（平均年龄 71.4 岁）在小梁切除术或引流管植入术前使用频域光学相干断层扫描（SD-OCT；24 条以视盘为中心的径向 B 扫描）进行成像。术后 1 周、1 个月、3 个月和 6 个月进行随访图像采集。在每条径向扫描中使用定制软件分割布鲁赫膜开口（BMO）、内界膜（ILM）和前层表面（ALS）。通过提取的三维坐标拟合 ILM 和 ALS 表面。PTT 是 ILM 和 ALS 之间垂直于 BMO 参考平面的距离。测量术后连续视盘层位移（LD），相对于 BMO 参考平面，并测量 PTT 的变化。正值表示前向 LD。
术前平均（标准差）眼压为 18.1（6.5）mmHg，术后分别降低 4.7（5.5）、2.4（7.7）、7.0（6.2）和 6.8（7.5）mmHg，术后 1 周、1 个月、3 个月和 6 个月。在四个术后时间点，均有明显的前向 LD（1.8[9.5]、-1.1[8.9]、8.8[20.2]和 17.9[25.8]μm）和 PTT 增加（1.7[13.3]、2.4[11.9]、17.4[13.7]和 13.9[18.6]μm）。在 BMO 面积较大（P = 0.01）和 ALS 较深（P = 0.04）的视盘，LD 更大；然而，PTT 与测试的任何独立变量均无关。
青光眼患者手术降低眼内压后，不仅发生前向 LD，而且视盘筛板前组织也增厚。
