Chen Monica F, Chui Toco Y P, Alhadeff Paula, Rosen Richard B, Ritch Robert, Dubra Alfredo, Hood Donald C
Department of Psychology, Columbia University, New York, New York, United States.
New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, United States.
Invest Ophthalmol Vis Sci. 2015 Jan 8;56(1):674-81. doi: 10.1167/iovs.14-15936.
To better understand the nature of glaucomatous damage of the macula, especially the structural changes seen between relatively healthy and clearly abnormal (AB) retinal regions, using an adaptive optics scanning light ophthalmoscope (AO-SLO).
Adaptive optics SLO images and optical coherence tomography (OCT) vertical line scans were obtained on one eye of seven glaucoma patients, with relatively deep local arcuate defects on the 10-2 visual field test in one (six eyes) or both hemifields (one eye). Based on the OCT images, the retinal nerve fiber (RNF) layer was divided into two regions: (1) within normal limits (WNL), relative RNF layer thickness within mean control values ±2 SD; and (2) AB, relative thickness less than -2 SD value.
As seen on AO-SLO, the pattern of AB RNF bundles near the border of the WNL and AB regions differed across eyes. There were normal-appearing bundles in the WNL region of all eyes and AB-appearing bundles near the border with the AB region. This region with AB bundles ranged in extent from a few bundles to the entire AB region in the case of one eye. All other eyes had a large AB region without bundles. However, in two of these eyes, a few bundles were seen within this region of otherwise missing bundles.
The AO-SLO images revealed details of glaucomatous damage that are difficult, if not impossible, to see with current OCT technology. Adaptive optics SLO may prove useful in following progression in clinical trials, or in disease management, if AO-SLO becomes widely available and easy to use.
使用自适应光学扫描激光检眼镜（AO-SLO），更好地了解黄斑部青光眼性损害的本质，尤其是在相对健康和明显异常（AB）的视网膜区域之间观察到的结构变化。
对7例青光眼患者的一只眼睛进行了自适应光学SLO图像和光学相干断层扫描（OCT）垂直线扫描，其中1例患者在10-2视野检查中的一个半视野（6只眼）或两个半视野（1只眼）存在相对较深的局部弓形缺损。根据OCT图像，将视网膜神经纤维（RNF）层分为两个区域：（1）正常范围（WNL），相对RNF层厚度在平均对照值±2标准差之内；（2）AB区域，相对厚度小于-2标准差。
如AO-SLO所见，WNL和AB区域边界附近的AB RNF束模式因眼而异。所有眼睛的WNL区域都有外观正常的束，在与AB区域边界附近有AB样外观的束。在一只眼中，这个有AB束的区域范围从几束到整个AB区域。所有其他眼睛都有一个大的没有束的AB区域。然而，在其中两只眼中，在这个原本没有束的区域内看到了几束。
AO-SLO图像揭示了青光眼性损害的细节，这些细节即使不是不可能，用当前的OCT技术也很难看到。如果AO-SLO变得广泛可用且易于使用，自适应光学SLO可能在临床试验的病情进展跟踪或疾病管理中证明是有用的。
