Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Acta Ophthalmol. 2016 Dec;94(8):e697-e708. doi: 10.1111/aos.13086. Epub 2016 Jun 11.
To measure the juxtapapillary choroidal thickness in eyes with normal-tension glaucoma (NTG) and to compare it with healthy eyes.
Twelve radial B-scan images of the optic nerve head (ONH) were obtained from 96 patients with NTG and 48 healthy subjects matched by age using swept-source (SS) optical coherence tomography (OCT). The juxtapapillary choroidal thickness was defined as the average choroidal thickness within 500 μm from the border tissue of Elschnig. Choroidal thinning in patients with NTG was assessed by calculating the relative choroidal thickness, defined as the ratio of the measured juxtapapillary choroidal thickness in each meridian to the corresponding value in age-matched healthy controls. Retinal nerve fibre layer (RNFL) damage as reflected by circumpapillary RNFL thickness (measured using spectral-domain OCT) was also assessed.
The juxtapapillary choroid was significantly thinner in NTG eyes than in healthy control eyes in the inferotemporal and superotemporal sectors. The relative choroidal thinning was topographically associated with the hemispheric location of dominant RNFL damage. The average juxtapapillary choroidal thickness was not associated with either the global RNFL thickness or the visual field mean deviation. Age and untreated intraocular pressure were significantly associated with the juxtapapillary choroidal thickness in NTG eyes in both univariate and multivariate analyses (all p < 0.05).
Decreased microvascular circulation in the ONH as a result of juxtapapillary choroidal thinning could be an important part of the pathogenesis of optic nerve damage in NTG.
测量正常眼压性青光眼(NTG)眼中的神经旁脉络膜厚度,并与健康眼进行比较。
使用扫频源(SS)光学相干断层扫描(OCT),从 96 例 NTG 患者和 48 例年龄匹配的健康对照者的视神经头(ONH)获得 12 条径向 B 扫描图像。神经旁脉络膜厚度定义为Elschnig 边界组织 500μm 范围内的平均脉络膜厚度。通过计算每条子午线测量的神经旁脉络膜厚度与年龄匹配的健康对照组相应值的比值,评估 NTG 患者的脉络膜变薄情况,定义为相对脉络膜厚度。还评估了反映在环视盘视网膜神经纤维层厚度(使用频域 OCT 测量)的视网膜神经纤维层(RNFL)损伤。
与健康对照组相比,NTG 眼的神经旁脉络膜在下方和上方区域明显变薄。相对脉络膜变薄与优势 RNFL 损伤的半球位置具有空间相关性。神经旁脉络膜厚度与全球 RNFL 厚度或视野平均偏差均无相关性。在单变量和多变量分析中(均 p<0.05),年龄和未治疗的眼内压与 NTG 眼中的神经旁脉络膜厚度显著相关。
由于神经旁脉络膜变薄导致的 ONH 微血管循环减少,可能是 NTG 视神经损伤发病机制的重要组成部分。