Uzunel Umut Duygu, Kusbeci Tuncay, Yuce Berna, Yüksel Bora
Izmir Bozyaka Training and Research Hospital, Department of Ophthalmology, Izmir, Turkey.
Giresun University Medical Faculty, Department of Ophthalmology, Giresun, Turkey.
Clin Exp Optom. 2015 Jul;98(4):319-22. doi: 10.1111/cxo.12287.
The aim was to evaluate the effect of irregular astigmatism on the retinal nerve fibre layer (RNFL), macular thickness and ganglion cell analysis obtained by spectral domain optical coherence tomography (OCT) in eyes with keratoconus.
Fifty-two eyes of 31 patients (20 females) with keratoconus that required correction of irregular astigmatism with rigid gas-permeable (RGP) contact lenses were included to this study. The average, superior, nasal, inferior, temporal and 12 clock hour sector's RNFL, ganglion cell and macular thickness analyses before and 30 minutes after RGP contact lens (Rose K2 -Menicon Z material, David Thomas Contact Lenses Ltd, Northampton, United Kingdom) wear were performed to all patients with Cirrus HD spectral domain optical coherence tomography.
The average thickness of the retinal nerve fibre layer, the thickness at the nasal quadrants and 1-2-3-4 o'clock hour sectors and mean signal strength were increased significantly by RGP contact lens wearing independent of the stage of keratoconus. Central sub-field thickness increased after correction with RGP contact lens (p = 0.037). After wearing RGP contact lenses, changes on ganglion cell analysis were not significant (all p values ≥ 0.111).
OCT is a widely used device for retinal nerve fibre layer and macular thickness evaluation in patients with glaucoma and macular diseases. The study demonstrates that OCT parameters such as retinal nerve fibre layer, central sub-field thickness and mean signal strength are affected by irregular astigmatism. Correction of irregular astigmatism with RGP contact lenses should be recommended before analysing keratoconic eyes to obtain optimum results on OCT measurements.
本研究旨在评估圆锥角膜患者中不规则散光对通过频域光学相干断层扫描(OCT)获得的视网膜神经纤维层(RNFL)、黄斑厚度和神经节细胞分析的影响。
本研究纳入了31例(20例女性)需要使用硬性透气性(RGP)隐形眼镜矫正不规则散光的圆锥角膜患者的52只眼睛。使用Cirrus HD频域光学相干断层扫描对所有患者在佩戴RGP隐形眼镜(Rose K2 - Menicon Z材料,英国北安普敦David Thomas隐形眼镜有限公司)前及佩戴后30分钟进行平均、上方、鼻侧、下方、颞侧及12个钟点扇形区域的RNFL、神经节细胞和黄斑厚度分析。
佩戴RGP隐形眼镜后,视网膜神经纤维层的平均厚度、鼻侧象限及1 - 2 - 3 - 4点扇形区域的厚度和平均信号强度均显著增加,与圆锥角膜的阶段无关。RGP隐形眼镜矫正后中央子区域厚度增加(p = 0.037)。佩戴RGP隐形眼镜后,神经节细胞分析的变化不显著(所有p值≥0.111)。
OCT是一种广泛用于青光眼和黄斑疾病患者视网膜神经纤维层和黄斑厚度评估的设备。该研究表明,诸如视网膜神经纤维层、中央子区域厚度和平均信号强度等OCT参数会受到不规则散光的影响。在分析圆锥角膜眼之前,建议使用RGP隐形眼镜矫正不规则散光,以便在OCT测量中获得最佳结果。