增强深度成像光学相干断层扫描下选择性激光小梁成形术前后施累姆管的微观结构

Microarchitecture of Schlemm Canal Before and After Selective Laser Trabeculoplasty in Enhanced Depth Imaging Optical Coherence Tomography.

作者信息

Skaat Alon, Rosman Michael S, Chien Jason L, Ghassibi Mark P, Liebmann Jeffrey M, Ritch Robert, Park Sung Chul

机构信息

*Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai ‡Bernard and Shirlee Brown Glaucoma Research Laboratory, Harkness Eye Institute, Columbia University Medical Center §Department of Ophthalmology, Manhattan Eye, Ear and Throat Hospital, New York ∥Department of Ophthalmology, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY †Goldschleger Eye Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

J Glaucoma. 2017 Apr;26(4):361-366. doi: 10.1097/IJG.0000000000000624.

DOI:10.1097/IJG.0000000000000624

PMID:28079655

Abstract

PURPOSE

To characterize the in vivo effect of selective laser trabeculoplasty (SLT) on the Schlemm canal (SC) in eyes with primary open-angle glaucoma (POAG).

MATERIALS AND METHODS

Eighty-one serial horizontal enhanced depth imaging optical coherence tomograph B-scans (interval between B-scans, ∼35 μm) of the nasal corneoscleral limbus were obtained before and 4 weeks after SLT. Fifty B-scans in the overlapping regions before and after SLT were selected for analysis based on the structures of aqueous and blood vessels as landmarks. The SC cross-sectional area (CSA) was measured in each selected B-scan and averaged to generate the mean SC CSA of the eye. SC volume in the overlapping region was calculated using commercially available 3-dimensional reconstruction software. The mean SC CSA and SC volume were compared between pre-SLT and post-SLT B-scans. Correlation analysis was performed between SC CSA changes and intraocular pressure (IOP) changes.

RESULTS

Thirteen POAG eyes (13 patients) were included for analysis (mean age, 68.2±9.2 y). After SLT, the mean IOP was reduced from 19.8±7.6 to 14.4±3.8 mm Hg (P=0.003); the mean SC CSA increased by 8%, from 2478±550 to 2682±598 μm (P=0.029); and the mean SC volume increased from 4,304,592±954,777 to 4,658,250±1,039,956 μm (P=0.029). Increase in SC CSA had a significant positive correlation with IOP reduction after SLT (P=0.023, R=0.622).

CONCLUSIONS

SLT expands SC in POAG patients and even more so with greater IOP reduction after SLT. Post-SLT expansion of SC may be due to increased trabecular aqueous outflow, IOP decrease, or structural changes in trabecular meshwork resulting from SLT.

摘要

目的

探讨选择性激光小梁成形术（SLT）对原发性开角型青光眼（POAG）患者施莱姆管（SC）的体内影响。

材料与方法

在SLT术前及术后4周，获取鼻侧角膜缘81幅连续的水平增强深度成像光学相干断层扫描B扫描图像（B扫描图像间隔约35μm）。基于房水和血管结构作为标志，选择SLT术前和术后重叠区域的50幅B扫描图像进行分析。在每幅选定的B扫描图像中测量SC横截面积（CSA），并求平均值以得出患眼的平均SC CSA。使用商用三维重建软件计算重叠区域的SC体积。比较SLT术前和术后B扫描图像的平均SC CSA和SC体积。对SC CSA变化与眼压（IOP）变化进行相关性分析。

结果

纳入13例POAG患者的13只眼进行分析（平均年龄68.2±9.2岁）。SLT术后，平均IOP从19.8±7.6 mmHg降至14.4±3.8 mmHg（P = 0.003）；平均SC CSA增加8%，从2478±550μm²增至2682±598μm²（P = 0.029）；平均SC体积从4304592±954777μm³增至4658250±1039956μm³（P = 0.029）。SLT术后SC CSA的增加与IOP降低呈显著正相关（P = 0.023，R = 0.622）。