Zhang Li, Sun Chuan, Sun Xinquan
Department of Ophthalmology, China-Japan Friendship Hosiptal, Beijing 100029, China.
Zhonghua Yan Ke Za Zhi. 2016 May;52(5):335-42. doi: 10.3760/cma.j.issn.0412-4081.2016.05.005.
To evaluate patterns of macular retinal ganglion cell complex thickness (mRGCCT) in patients with two types of neurologic lesions in optic chiasm region.
Retrospective case review study. Visual field test was conducted with automated perimetry (HAAG-STREIT OCTOPUS101 V6.07g Seven-in-One and 2010(HFA Ⅱ750-40220-5.1.1/5.1.1) Carl Zeiss Meditec), and visual field in the central 30 degree region was measured. Three types of thickness mapping including macular retinal thickness (MRT), macular ganglion cell complex thickness (mGCCT) and peripapillary retinal nerve fiber layer (pRNFL) were recorded with TOPCON 3D-OCT 2000 spectral domain OCT. The results of OCT were compared with visual field.
Sixteen cases were included in this study, male 10 cases, female 6 cases. Age 5 to 77 years (average 48.2). Neurologic lesions including pituitary tumor (9 cases), craniopharyngioma (3 cases), optic canal dysplasia in optic chiasm region (1 case), meningioma (1 case), hemangioma (1 case) and aneurysm (1 case). 14 cases have chronic, progressive, long course of disease, OCT showed characteristic perpendicular bisector delimitation, bilateral nasal mGCCT atrophy and corresponding temporal hemianopsia. 2 cases (both were pituitary tumor ) have a chronic, short duration, accelerated attack, visual acuity and visual field rapidly declined, mGCCT is swelling or approach high limit of normal range. In pRNFL thickness map, atrophy of mRNFL in temporal peripapillary and nasal macular region could be observed.
Chronic, progressive, long course of disease, combined with characteristic perpendicular bisector delimitation, bilateral nasal mGCCT atrophy and corresponding temporal hemianopsia is helpful to predict lesion of disease. mGCCT map is of equal importance with visual field test for diagnosis of lesion within optic chiasm. In cases with a chronic, short disease course, and accelerated attack, mGCCT could be swelling, but pRNFL could be thinner in temporal peripapillary and nasal macular region of single or both eyes, and visual field test is thus necessary in these cases.
评估视交叉区域两种神经病变患者的黄斑视网膜神经节细胞复合体厚度（mRGCCT）模式。
回顾性病例研究。采用自动视野计（HAAG-STREIT OCTOPUS101 V6.07g七合一和2010（HFAⅡ750-40220-5.1.1/5.1.1）卡尔蔡司医疗技术公司）进行视野检查，并测量中央30度区域的视野。使用TOPCON 3D-OCT 2000光谱域光学相干断层扫描记录三种厚度图，包括黄斑视网膜厚度（MRT）、黄斑神经节细胞复合体厚度（mGCCT）和视乳头周围视网膜神经纤维层（pRNFL）。将光学相干断层扫描结果与视野进行比较。
本研究共纳入16例患者，男性10例，女性6例。年龄5至77岁（平均48.2岁）。神经病变包括垂体瘤（9例）、颅咽管瘤（3例）、视交叉区域视神经管发育异常（1例）、脑膜瘤（1例）、血管瘤（1例）和动脉瘤（1例）。14例患者病程慢性、进展性、病程长，光学相干断层扫描显示特征性垂直平分线界定、双侧鼻侧mGCCT萎缩及相应的颞侧偏盲。2例（均为垂体瘤）病程慢性、持续时间短、发作加速，视力和视野迅速下降，mGCCT肿胀或接近正常范围上限。在pRNFL厚度图中，可观察到视乳头周围颞侧和鼻侧黄斑区的mRNFL萎缩。
病程慢性、进展性、病程长，结合特征性垂直平分线界定、双侧鼻侧mGCCT萎缩及相应的颞侧偏盲有助于预测疾病病变。mGCCT图对视交叉内病变的诊断与视野检查同等重要。对于病程慢性、病程短且发作加速的病例，mGCCT可能肿胀，但单眼或双眼视乳头周围颞侧和鼻侧黄斑区的pRNFL可能变薄，因此这些病例需要进行视野检查。
