黄斑神经节细胞复合体的基线厚度可预测视野损失的进展。
Baseline thickness of macular ganglion cell complex predicts progression of visual field loss.
机构信息
Department of Ophthalmology, Toho University Ohashi Medical Center, 2-17-6, Ohashi Meguro-ku, Tokyo, 153-8515, Japan,
出版信息
Graefes Arch Clin Exp Ophthalmol. 2014 Jan;252(1):109-15. doi: 10.1007/s00417-013-2527-9. Epub 2013 Nov 20.
BACKGROUND
Previous studies reported that the thickness of the macular ganglion cell complex (mGCC) showed good diagnostic ability for detecting glaucoma. However, its impact on the progression of visual field loss in primary open angle glaucoma (POAG) is unknown. The purpose of this study was to assess whether baseline mGCC thickness is associated with the progression of visual field loss in POAG.
METHODS
Fifty-six patients with POAG were included in the study. All patients were followed for more than 2 years after baseline optical coherence tomography (OCT) measurements. They had at least five reliable Humphrey visual field tests with 30-2 Swedish Interactive Threshold Algorithm standard tests during the follow-up period. The subjects were divided into two groups according to the slope of the mean deviation (MD): the fast progression group (MD slope < -0.4 dB/y) and the slow progression group (MD slope ≥ -0.4 dB/y). Factors compared between the groups were as follows: age, baseline intraocular pressure (IOP), mean IOP during the follow-up, refraction, baseline MD, pattern standard deviation (PSD), and baseline OCT measurements.
RESULTS
There were no significant differences between the two groups in age, baseline IOP, mean IOP during the follow-up, refraction, baseline MD or PSD, average thickness of retinal nerve fiber layer (RNFL), or disc parameters. However, the baseline mGCC thickness (average and inferior hemifield) was significantly thinner in the fast progression group than in the slow progression group (74.0 ± 7.2 μm vs. 80.3 ± 8.6 μm; 68.0 ± 6.6 μm vs. 78.2 ± 11.6 μm, respectively). Moreover, global loss volume and focal loss volume, which are parameters of mGCC, showed significantly higher rates in the fast progression group than in the slow progression group. In multivariate analysis, only mGCC thickness of the inferior hemifield was associated with disease progression (P = 0.007).
CONCLUSIONS
Baseline mGCC thickness can be predictive of progressive visual field loss in patients with POAG.
背景
先前的研究表明，黄斑神经节细胞复合体（mGCC）的厚度对于青光眼的诊断具有良好的诊断能力。然而，其对原发性开角型青光眼（POAG）视野损失进展的影响尚不清楚。本研究旨在评估基线 mGCC 厚度是否与 POAG 视野损失的进展有关。
方法
本研究纳入了 56 名 POAG 患者。所有患者在基线光学相干断层扫描（OCT）测量后均进行了超过 2 年的随访。在随访期间，他们至少进行了 5 次可靠的 Humphrey 视野测试，其中 30-2 个采用瑞典互动阈值算法标准测试。根据平均偏差（MD）斜率将受试者分为两组：快速进展组（MD 斜率＜-0.4dB/y）和缓慢进展组（MD 斜率≥-0.4dB/y）。对两组间的因素进行比较：年龄、基线眼压（IOP）、随访期间的平均 IOP、屈光度、基线 MD、模式标准差（PSD）和基线 OCT 测量值。
结果
两组在年龄、基线 IOP、随访期间的平均 IOP、屈光度、基线 MD 或 PSD、视网膜神经纤维层（RNFL）平均厚度或视盘参数方面均无显著差异。然而，快速进展组的基线 mGCC 厚度（平均值和下半球）明显低于缓慢进展组（分别为 74.0±7.2μm 和 80.3±8.6μm；68.0±6.6μm 和 78.2±11.6μm）。此外，快速进展组的全局损失量和局灶性损失量（mGCC 的参数）明显高于缓慢进展组。多元分析显示，只有 mGCC 下半球厚度与疾病进展相关（P=0.007）。
结论
基线 mGCC 厚度可预测 POAG 患者的视野进行性损失。
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