Hammel Naama, Belghith Akram, Weinreb Robert N, Medeiros Felipe A, Mendoza Nadia, Zangwill Linda M
Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, California.
Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, California.
Am J Ophthalmol. 2017 Jun;178:38-50. doi: 10.1016/j.ajo.2017.03.008. Epub 2017 Mar 16.
To compare the rates of circumpapillary retinal nerve fiber layer (RNFL) and macular retinal ganglion cell-inner plexiform layer (GCIPL) change over time in healthy and glaucoma eyes.
Cohort study.
The rates of circumpapillary RNFL and macular GCIPL loss in 28 healthy subjects and 97 glaucoma subjects from the Diagnostic Innovations in Glaucoma Study (DIGS) were compared using mixed-effects models.
The median follow-up time and number of visits were 1.7 years and 6 visits and 3.2 years and 7 visits for healthy and glaucoma eyes, respectively. Significant rates of loss of both global circumpapillary RNFL and average macular GCIPL thickness were detectable in early and moderate glaucoma eyes; in severe glaucoma eyes, rates of average macular GCIPL loss were significant, but rates of global circumpapillary RNFL loss were not. In glaucoma eyes, mean rates of global circumpapillary RNFL thickness change (-0.98 μm/year [95% confidence interval (CI), -1.20 to -0.76]) and normalized global circumpapillary RNFL change (-1.7%/year [95% CI, -2.1 to -1.3]) were significantly faster than average macular GCIPL change (-0.57 μm/year [(95% CI, -0.73 to -0.41]) and normalized macular GCIPL change (-1.3%/year [95% CI, -1.7 to -0.9]). The rates of global and inferior RNFL change were weakly correlated with global and inferior macular GCIPL change (r ranges from 0.16 to 0.23, all P < .05).
In this cohort, the rate of circumpapillary RNFL thickness change was faster than macular GCIPL change for glaucoma eyes. Global circumpapillary RNFL thickness loss was detectable in early and moderate glaucoma, and average macular GCIPL thickness loss was detectable in early, moderate, and severe glaucoma, suggesting that structural changes can be detected in severe glaucoma.
比较健康眼和青光眼眼中视乳头周围视网膜神经纤维层（RNFL）和黄斑区视网膜神经节细胞 - 内丛状层（GCIPL）随时间的变化率。
队列研究。
使用混合效应模型比较了青光眼诊断创新研究（DIGS）中28名健康受试者和97名青光眼受试者的视乳头周围RNFL和黄斑区GCIPL的丢失率。
健康眼和青光眼眼的中位随访时间和就诊次数分别为1.7年和6次就诊以及3.2年和7次就诊。在早期和中度青光眼眼中可检测到视乳头周围RNFL整体和黄斑区GCIPL平均厚度的显著丢失率；在重度青光眼眼中，黄斑区GCIPL平均丢失率显著，但视乳头周围RNFL整体丢失率不显著。在青光眼眼中，视乳头周围RNFL整体厚度变化的平均速率（-0.98μm/年[95%置信区间（CI），-1.20至-0.76]）和标准化视乳头周围RNFL变化（-1.7%/年[95%CI，-2.1至-1.3]）显著快于黄斑区GCIPL平均变化（-0.57μm/年[(95%CI，-0.73至-0.41)]）和标准化黄斑区GCIPL变化（-1.3%/年[95%CI，-1.7至-0.9]）。视乳头周围RNFL整体和下方变化率与黄斑区GCIPL整体和下方变化率弱相关（r范围为0.16至0.23，均P <.05）。
在该队列中，青光眼眼中视乳头周围RNFL厚度变化率快于黄斑区GCIPL变化率。在早期和中度青光眼中可检测到视乳头周围RNFL整体厚度丢失，在早期、中度和重度青光眼中可检测到黄斑区GCIPL平均厚度丢失，这表明在重度青光眼中可检测到结构变化。
