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用光学相干断层扫描诊断青光眼进展。

Diagnosing glaucoma progression with optical coherence tomography.

机构信息

Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, People's Republic of China.

出版信息

Curr Opin Ophthalmol. 2014 Mar;25(2):104-11. doi: 10.1097/ICU.0000000000000024.

Abstract

PURPOSE OF REVIEW

Optical coherence tomography (OCT) imaging of the retinal nerve fiber layer (RNFL), optic nerve head (ONH) and macula has gained popularity in recent years to detect and monitor glaucoma. With significant improvement in scan speed and scan resolution, spectral-domain OCT has become an efficient platform to evaluate progressive RNFL thinning and ONH remodeling. This review summarizes the recent progress of OCT RNFL, ONH and macular measurements for the detection of glaucoma progression.

RECENT FINDINGS

The RNFL thickness map facilitates visualization of RNFL defects and their progression patterns, and attains a higher sensitivity to detect glaucoma progression compared with the conventional circumpapillary RNFL thickness profile. The measurement of lamina cribrosa displacement is informative to discern the relationship between intraocular pressure and ONH modeling. Ganglion cell and inner plexiform layer analysis has offered a useful alternative to track glaucoma progression. In the interpretation of progression analysis, the impact of age-related change, disease severity and image signal-to-noise ratio should always be considered.

SUMMARY

The analyses of the RNFL thickness map, lamina cribrosa displacement and inner macular thickness have provided a new paradigm to evaluate glaucomatous damage and its progression.

摘要

目的综述

近年来,光学相干断层扫描(OCT)对视网膜神经纤维层(RNFL)、视神经盘(ONH)和黄斑的成像已得到普及,用于青光眼的检测和监测。随着扫描速度和分辨率的显著提高,频域 OCT 已成为评估进行性 RNFL 变薄和 ONH 重塑的有效平台。本文综述了 OCT RNFL、ONH 和黄斑测量在青光眼进展检测中的最新进展。

最新发现

RNFL 厚度图有助于可视化 RNFL 缺陷及其进展模式,与传统的环周 RNFL 厚度曲线相比,其检测青光眼进展的敏感性更高。测量筛板位移有助于分辨眼内压与 ONH 重塑之间的关系。神经节细胞和内丛状层分析为跟踪青光眼进展提供了一种有用的替代方法。在解释进展分析时,应始终考虑年龄相关性变化、疾病严重程度和图像信噪比的影响。

总结

RNFL 厚度图、筛板位移和内黄斑厚度分析为评估青光眼损伤及其进展提供了新的范式。

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