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应用扫频源光学相干断层扫描对青光眼视盘筛板缺陷进行三维成像。

Three-dimensional imaging of lamina cribrosa defects in glaucoma using swept-source optical coherence tomography.

机构信息

Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.

出版信息

Invest Ophthalmol Vis Sci. 2013 Jul 18;54(7):4798-807. doi: 10.1167/iovs.13-11677.

Abstract

PURPOSE

To visualize lamina cribrosa defects using three-dimensional (3D) swept-source optical coherence tomography (SS-OCT), and to determine the factors associated with this feature.

METHODS

All subjects were examined using an SS-OCT prototype system, which uses a tunable laser as a light source, operated at 100,000 Hz A-scan repetition rate in the 1050-nm wavelength. A 3D raster scan protocol consisting of 256×256 A-scans was acquired over a square area of 3 mm×3 mm centered on the optic disc. En face sectioned volume and serial en face images and orthogonal (horizontal and vertical) serial B-scans were evaluated.

RESULTS

A total of 182 eyes of 111 patients with glaucoma and 29 healthy eyes of 26 subjects were included. Twenty full-thickness focal lamina cribrosa defects were found in 12 (6.6%) of 182 eyes with glaucoma, whereas no lamina defects were found in healthy eyes. Nine eyes (75.0%) showed 15 full-thickness lamina cribrosa defects near the margin of the lamina cribrosa, and 3 eyes showed 4 lamina defects at the margin, as if detached from the sclera. Focal lamina cribrosa defects corresponded with neuroretinal rim thinning, concurrent or previous disc hemorrhages, abnormal circumpapillary retinal nerve fiber layer thickness, and visual field defects. The presence of lamina cribrosa defects was significantly associated with longer axial length and disc hemorrhages (P=0.033 and 0.024, respectively).

CONCLUSIONS

3D SS-OCT imaging allows visualization of the lamina cribrosa defects, which may be more prevalent in eyes with longer axial length and related to disc hemorrhages.

摘要

目的

使用三维(3D)扫频源光相干断层扫描(SS-OCT)可视化视盘筛板缺陷,并确定与该特征相关的因素。

方法

所有受试者均使用 SS-OCT 原型系统进行检查,该系统使用调谐激光器作为光源,在 1050nm 波长下以 100,000Hz 的 A 扫描重复率运行。采集了一个 3mm×3mm 正方形视盘中心区域的 256×256 个 A 扫描的 3D 光栅扫描方案。评估了共面截面体积和连续共面图像以及正交(水平和垂直)连续 B 扫描。

结果

共纳入 111 例青光眼患者的 182 只眼和 26 例健康受试者的 29 只眼。在 182 只青光眼眼中,发现了 20 个全层焦点筛板缺陷,而在健康眼中则没有筛板缺陷。9 只眼(75.0%)显示 15 个全层筛板缺陷接近筛板边缘,3 只眼显示 4 个筛板缺陷,似乎与巩膜分离。焦点筛板缺陷与神经视网膜边缘变薄、同时或先前的盘状出血、异常的环视盘视网膜神经纤维层厚度和视野缺损相关。筛板缺陷的存在与眼轴较长和盘状出血显著相关(分别为 P=0.033 和 0.024)。

结论

3D SS-OCT 成像允许可视化视盘筛板缺陷,这些缺陷在眼轴较长的眼中可能更为普遍,并且与盘状出血有关。

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