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色素性视网膜炎黄斑部神经节细胞-内丛状层和视网膜神经纤维层的改变:频域光学相干断层扫描研究。

Ganglion cell-inner plexiform layer and retinal nerve fibre layer changes within the macula in retinitis pigmentosa: a spectral domain optical coherence tomography study.

机构信息

Department of Ophthalmology, Inje University Busan Paik Hospital, Busan, Korea.

Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.

出版信息

Acta Ophthalmol. 2018 Mar;96(2):e180-e188. doi: 10.1111/aos.13577. Epub 2017 Nov 2.

Abstract

PURPOSE

To investigate how macular ganglion cell-inner plexiform layer (GCIPL) and retinal nerve fibre layer (RNFL) thicknesses within the macula change with retinitis pigmentosa (RP) severity.

METHODS

Spectral domain optical coherence tomography (SD-OCT) was used to examine 177 patients with RP and 177 normal controls. An optical coherence tomography (OCT) line scan was used to grade RP severity. Retinitis pigmentosa (RP) was categorized as more advanced if there was no identifiable inner segment ellipsoid (ISe) band (NISE) and as less advanced if an ISe band could be identified and peripheral loss of ISe was apparent (IISE). Ganglion cell-inner plexiform layer (GCIPL) and RNFL thicknesses were manually measured on OCT images and analysed. Pearson's correlation analyses were used to examine correlations between GCIPL thickness, RNFL thickness, visual acuity (VA) and visual field extent in patients and controls.

RESULTS

Ganglion cell-inner plexiform layer (GCIPL) was significantly thicker in IISE than in control eyes (p < 0.001), but significantly thinner in NISE than in IISE eyes (p < 0.001) in both horizontal and vertical OCT scans. Retinal nerve fibre layer (RNFL) was significantly thicker in eyes with IISE and NISE than in control eyes in both horizontal and vertical meridians (all p < 0.001). Ganglion cell-inner plexiform layer (GCIPL) thickness showed a weak positive correlation with vision, and RNFL thickness showed a weak negative correlation with vision and visual field extent.

CONCLUSION

Based on these results, the inner retina, including the GCIPL and RNFL, maintains its gross integrity longer than the photoreceptor layer in RP. Additionally, thickening of the inner retina may have some functional implications in patients with RP.

摘要

目的

探讨色素性视网膜炎(RP)严重程度与黄斑部神经节细胞-内丛状层(GCIPL)和视网膜神经纤维层(RNFL)厚度变化的关系。

方法

采用频域光学相干断层扫描(SD-OCT)检查 177 例 RP 患者和 177 例正常对照者。采用 OCT 线扫描对 RP 严重程度进行分级。如果没有可识别的内节椭圆体(ISe)带(NISE),则认为 RP 更严重,如果可以识别 ISe 带且周边 ISe 丢失明显,则认为 RP 较轻(IISE)。在 OCT 图像上手动测量 GCIPL 和 RNFL 厚度并进行分析。采用 Pearson 相关分析评估患者和对照组 GCIPL 厚度、RNFL 厚度、视力(VA)和视野范围之间的相关性。

结果

IISE 组的 GCIPL 明显比对照组厚(p<0.001),而 NISE 组则比 IISE 组薄(p<0.001),水平和垂直 OCT 扫描均如此。IISE 和 NISE 眼的 RNFL 均明显比对照组厚,水平和垂直子午线均如此(均 p<0.001)。GCIPL 厚度与视力呈弱正相关,RNFL 厚度与视力和视野范围呈弱负相关。

结论

基于这些结果,与光感受器层相比,包括 GCIPL 和 RNFL 在内的内层视网膜在 RP 中保持其总体完整性的时间更长。此外,内层视网膜的增厚可能在 RP 患者中具有一定的功能意义。

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