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青光眼患者单侧视野缺损眼的周边脉络膜厚度。

Peripapillary choroidal thickness in both eyes of glaucoma patients with unilateral visual field loss.

机构信息

Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.

出版信息

Am J Ophthalmol. 2013 Dec;156(6):1277-1284.e1. doi: 10.1016/j.ajo.2013.07.011. Epub 2013 Sep 4.

Abstract

PURPOSE

To investigate whether peripapillary choroidal thickness in perimetrically affected eyes of primary open-angle glaucoma (POAG) patients differs from that in perimetrically unaffected fellow eyes and eyes of healthy controls.

DESIGN

Retrospective, comparative, cross-sectional study.

METHODS

Thirty-one POAG patients with unilateral visual field loss and 31 healthy controls were included. Eyes were divided into 3 groups: 31 eyes in group A (eyes with visual field loss), 31 eyes in group B (perimetrically unaffected fellow eyes), and 31 eyes in group C (age- and sex-matched controls). A 360-degree 3.4-mm diameter peripapillary circle scan was performed for retinal nerve fiber layer (RNFL) assessment using enhanced depth imaging optical coherence tomography. The observer used the manual segmentation function to delineate the posterior edge of the retinal pigment epithelium and the sclerochoroidal interface. The RNFL thickness algorithm function was used to generate the choroidal thickness automatically in corresponding sectors. Statistical analysis was conducted to compare mean choroidal thickness and RNFL thickness among 3 groups and to correlate choroidal thickness with age, RNFL thickness, and visual field mean deviation.

RESULTS

The global mean RNFL and choroidal thickness measurements were 62.3 ± 16.7 μm and 154.3 ± 69.7 μm in group A, 90.4 ± 12.2 μm and 154.7 ± 68.9 μm in group B, and 106.6 ± 9.2 μm and 154.2 ± 60.9 μm in group C. The RNFL thickness was significantly thinner in group A than in groups B and C globally and at all peripapillary locations (all P = .000). The RNFL thickness also was significantly thinner in group B than in group C (P = .000 to .021). However, choroidal thickness measurements did not differ among 3 groups globally or at any peripapillary location (P = .273 to .934, P = .757 to .994, and P = .808 to .975, respectively). Age was the only significant factor associated with peripapillary choroidal thickness in each group (r = -0.418 to -0.641, r = -0.569 to -0.690, and r = -0.689 to -0.827, respectively; all P < .05).

CONCLUSIONS

There was no significant difference in peripapillary choroidal thickness of POAG eyes with visual field loss compared with that of perimetrically unaffected fellow eyes and eyes of healthy controls, which does not support using peripapillary choroidal thickness as a clinical parameter in POAG diagnosis or management.

摘要

目的

研究原发性开角型青光眼(POAG)患者周边视野受影响眼的视盘周围脉络膜厚度是否与周边视野不受影响的对侧眼和健康对照组不同。

设计

回顾性、对比性、横断面研究。

方法

纳入 31 例单侧视野丧失的 POAG 患者和 31 例健康对照者。将眼分为 3 组:A 组(视野丧失眼)31 只眼,B 组(周边视野不受影响的对侧眼)31 只眼,C 组(年龄和性别匹配的对照组)31 只眼。使用增强深度成像光学相干断层扫描对视网膜神经纤维层(RNFL)进行 360 度 3.4 毫米直径视盘周围圆扫描。观察者使用手动分割功能描绘视网膜色素上皮的后缘和巩膜脉络膜界面。使用 RNFL 厚度算法功能自动生成相应区域的脉络膜厚度。比较 3 组的平均脉络膜厚度和 RNFL 厚度,并分析脉络膜厚度与年龄、RNFL 厚度和视野平均偏差的相关性。

结果

A 组的全球平均 RNFL 和脉络膜厚度测量值分别为 62.3±16.7 μm 和 154.3±69.7 μm,B 组分别为 90.4±12.2 μm 和 154.7±68.9 μm,C 组分别为 106.6±9.2 μm 和 154.2±60.9 μm。A 组的 RNFL 厚度在全球范围内和所有视盘周围位置均显著薄于 B 组和 C 组(均 P<0.000)。B 组的 RNFL 厚度也显著薄于 C 组(P=0.000 至 0.021)。然而,3 组之间的脉络膜厚度测量值在全球或任何视盘周围位置均无差异(P=0.273 至 0.934、P=0.757 至 0.994 和 P=0.808 至 0.975,分别)。年龄是每组中唯一与视盘周围脉络膜厚度显著相关的因素(r=-0.418 至-0.641、r=-0.569 至-0.690 和 r=-0.689 至-0.827,均 P<0.05)。

结论

POAG 患者视野丧失眼的视盘周围脉络膜厚度与周边视野不受影响的对侧眼和健康对照组无显著差异,这并不支持将视盘周围脉络膜厚度用作 POAG 诊断或治疗的临床参数。

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