扫频光学相干断层扫描检测慢性闭角型青光眼中的视神经乳头特征
Optic Nerve Head Characteristics in Chronic Angle Closure Glaucoma Detected by Swept-Source OCT.
作者信息
Li Dejiao, Li Taibo, Paschalis Eleftherios I, Wang Haobing, Taniguchi Elise V, Choo Zi-Ning, Shoji Marissa K, Greenstein Scott H, Brauner Stacey C, Turalba Angela V, Pasquale Louis R, Shen Lucy Q
机构信息
a Department of Ophthalmology , China-Japan Friendship Hospital , Beijing , China.
b Department of Ophthalmology , Massachusetts Eye and Ear, Harvard Medical School , Boston , MA , USA.
出版信息
Curr Eye Res. 2017 Nov;42(11):1450-1457. doi: 10.1080/02713683.2017.1341535. Epub 2017 Sep 18.
PURPOSE
To compare structural features in prelaminar and laminar tissues of the optic nerve head (ONH) in chronic angle closure glaucoma (CACG), primary open angle glaucoma (POAG), and control subjects.
MATERIALS AND METHODS
ONH imaging was performed using swept-source optical coherence tomography (SS-OCT) for measurements of minimum rim width at Bruch's membrane opening (BMO-MRW), horizontal, and vertical lamina cribrosa depth (LCD). Prelaminar defects, categorized as hole and wedge, and lamina cribrosa (LC) defects were identified. Enhanced depth imaging spectral domain OCT (EDI-OCT) customized to perform high-resolution volume scans was used in conjunction to further characterize prelaminar holes. One eye per subject was analyzed.
RESULTS
Eighty subjects (20 CACG, 40 POAG, and 20 controls) were included in the study. CACG and POAG groups had similar mean deviation on Humphrey visual field testing (-6.9 ± 5.1 vs. -6.3 ± 6.0 dB, p > 0.05) and IOP on the day of imaging (14.0 ± 3.1 vs. 13.8 ± 2.7 mmHg, p > 0.05). Thinnest and global BMO-MRW in CACG (120.3 ± 44.8, 225.5 ± 53.9 μm) and POAG (109.7 ± 56.3, 213.8 ± 59.7 μm) groups were lower than controls (200.1 ± 40.8, 308.3 ± 70.8 μm; p < 0.001 for both). Prelaminar holes were most frequent in CACG (65.0%) than POAG (25.0%, p=0.008) or control groups (20.0%, p=0.01). After adjusting for demographic and ophthalmic covariates, CACG was associated with increased odds of having prelaminar holes compared to POAG (odds ratio, 9.79; 95% CI, 2.12-45.19; p=0.003). Hole volume was similar between CACG and POAG (p > 0.05), but the CACG group had more holes per scan than POAG (maximum 2.5 ± 1.9 vs. 1.2 ± 0.4, p=0.02). Prelaminar wedge defects were less common in the CACG than the POAG group (5.0% vs. 37.5%, p=0.02). The CACG group did not differ from controls in laminar characteristics, such as LCD and LC defects.
CONCLUSIONS
SS-OCT evaluation of the ONH revealed more frequent prelaminar holes in CACG compared to POAG and control patients.
目的
比较慢性闭角型青光眼（CACG）、原发性开角型青光眼（POAG）和对照受试者视神经乳头（ONH）的层前组织和板层组织的结构特征。
材料与方法
使用扫频光学相干断层扫描（SS-OCT）进行ONH成像，以测量布鲁赫膜开口处的最小视盘边缘宽度（BMO-MRW）、水平和垂直筛板深度（LCD）。识别分类为孔和楔形的层前缺陷以及筛板（LC）缺陷。结合使用定制的用于执行高分辨率容积扫描的增强深度成像光谱域OCT（EDI-OCT）来进一步表征层前孔。对每位受试者一只眼睛进行分析。
结果
该研究纳入了80名受试者（20名CACG患者、40名POAG患者和20名对照者）。CACG组和POAG组在汉弗莱视野测试中的平均偏差相似（-6.9±5.1对-6.3±6.0 dB，p>0.05），且成像当天的眼压也相似（14.0±3.1对13.8±2.7 mmHg，p>0.05）。CACG组（120.3±44.8，225.5±53.9μm）和POAG组（109.7±56.3，213.8±59.7μm）的最薄和整体BMO-MRW低于对照组（200.1±40.8，308.3±70.8μm；两者p<0.001）。层前孔在CACG组中最为常见（65.0%），高于POAG组（25.0%，p=0.008）和对照组（20.0%，p=0.01）。在调整人口统计学和眼科协变量后，与POAG相比，CACG发生层前孔的几率增加（优势比，9.79；95%CI，2.12 - 45.19；p=0.003）。CACG组和POAG组的孔体积相似（p>0.05），但CACG组每次扫描的孔比POAG组更多（最多2.5±1.9对1.2±0.4，p=0.02）。CACG组的层前楔形缺陷比POAG组少见（5.0%对37.5%，p=0.02）。CACG组在筛板特征（如LCD和LC缺陷）方面与对照组无差异。
结论
ONH的SS-OCT评估显示，与POAG患者和对照患者相比，CACG患者的层前孔更常见。
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