Baniasadi Neda, Paschalis Eleftherios I, Haghzadeh Mahdi, Ojha Pallavi, Elze Tobias, Mahd Mufeed, Chen Teresa C
*Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Glaucoma Service ‡Schepens Eye Research Institute, Harvard Medical School, Boston Departments of †Biomedical Engineering and Biotechnology §Electrical and Computer Engineering, University of Massachusetts, Lowell, MA.
J Glaucoma. 2016 Oct;25(10):865-872. doi: 10.1097/IJG.0000000000000534.
The purpose of the study was to determine whether there are different patterns of retinal nerve fiber layer (RNFL) thinning as measured by spectral domain optical coherence tomography (SD-OCT) for 4 subtypes of open angle glaucoma (OAG): primary OAG (POAG), normal tension glaucoma (NTG), pseudoexfoliation glaucoma (PXG), and pigmentary glaucoma (PDG) and to compare them with normal controls.
SD-OCT RNFL thickness values were measured for 4 quadrants and for 4 sectors (ie, superior-nasal, superior-temporal, inferior-nasal, and inferior-temporal). Differences in RNFL thickness values between groups were analyzed using analysis of variance. Paired t tests were used for quadrant comparisons.
Two hundred eighty-five participants (102 POAG patients, 33 with NTG, 48 with PXG, 13 with PDG, and 89 normal patients) were included in this study. All 4 subtypes of OAG showed significant RNFL thinning in the superior, inferior, and nasal quadrants as well as the superior-temporal and inferior-temporal sectors (all P-values <0.0001) compared with normals. POAG and NTG patients had greater RNFL thinning inferiorly and inferior-temporally than superiorly (P-values: 0.002 to 0.018 and 0.006, respectively) compared with PXG patients. In contrast, PDG patients had greater RNFL thinning superiorly and superior-nasally than inferiorly compared with other OAG subtypes (ie, POAG, NTG, PXG groups, with P-values: 0.009, 0.003, 0.009, respectively). Of the 4 OAG subtypes, PXG patients exhibited the greatest degree of inter-eye RNFL asymmetry.
This study suggests that SD-OCT may be able to detect significant differences in patterns of RNFL thinning for different subtypes of OAG.
本研究的目的是确定通过光谱域光学相干断层扫描(SD - OCT)测量,开角型青光眼(OAG)的4种亚型,即原发性开角型青光眼(POAG)、正常眼压性青光眼(NTG)、剥脱性青光眼(PXG)和色素性青光眼(PDG),是否存在视网膜神经纤维层(RNFL)变薄的不同模式,并将它们与正常对照组进行比较。
测量4个象限和4个扇区(即鼻上、颞上、鼻下和颞下)的SD - OCT RNFL厚度值。使用方差分析来分析组间RNFL厚度值的差异。配对t检验用于象限比较。
本研究纳入了285名参与者(102例POAG患者、33例NTG患者、48例PXG患者、13例PDG患者和89名正常患者)。与正常对照组相比,所有4种OAG亚型在上方、下方和鼻侧象限以及颞上和颞下扇区均显示出显著的RNFL变薄(所有P值<0.0001)。与PXG患者相比,POAG和NTG患者在下方和颞下方向的RNFL变薄程度大于上方(P值分别为0.002至0.018和0.006)。相比之下,与其他OAG亚型(即POAG、NTG、PXG组)相比,PDG患者在上方和鼻上方向的RNFL变薄程度大于下方(P值分别为0.009、0.003、0.009)。在4种OAG亚型中,PXG患者两眼间RNFL不对称程度最大。
本研究表明,SD - OCT可能能够检测出不同亚型OAG在RNFL变薄模式上的显著差异。