Gama Rita, Relha Catarina, Gomes Costa Joana, Eiro Nuno
Hospital da Luz, Lisbon 1500, Portugal.
Med Hypothesis Discov Innov Ophthalmol. 2017 Fall;6(3):82-88.
The main purpose of this study was to assess the differences in the peripapillary retinal nerve fiber layer (pRNFL) and ganglion cell-inner plexiform layer (GCIPL) thicknesses between subjects with megalopapilla (MP) and those with large (physiological) cup discs (LCD) measured by spectral-domain optical coherence tomography. The secondary purpose was to determine whether pRNFL and GCIPL thicknesses increase with the optic nerve head (ONH) area. This cross-sectional study included 184 eyes (92 eyes with MP and 92 eyes with LCD). The subjects with LCD were used as sex-and-age-matched controls. All subjects were imaged using the Cirrus HD-OCT system. Macula and pRNFL thickness maps were obtained for all subjects. The inferior quadrant pRNFL thickness was higher in the MP group than in the LCD group (P < 0.05). There were no differences in the GCIPL thickness between the two groups. A positive correlation was found between average, superior, and inferior quadrant pRNFL thicknesses and the ONH area (P < 0.05). The slope of the correlation curve was higher for the inferior quadrant. No correlation was found between the GCIPL thickness and the ONH area. In comparison to patients with LCD, the inferior quadrant pRNFL thickness of patients with MP was higher. As the ONH area increased, the average, superior, and inferior quadrant pRNFL thicknesses also increased. In patients with MP, the assessment of a glaucomatous lesion based on pRNFL thickness measurements may not be reliable. It is recommended that in these patients, the evaluation of glaucomatous damage be based on the GCIPL thickness map analysis rather than on the pRNFL thickness.
本研究的主要目的是通过光谱域光学相干断层扫描评估巨乳头（MP）患者与大（生理性）杯盘（LCD）患者的视乳头周围视网膜神经纤维层（pRNFL）和神经节细胞-内网状层（GCIPL）厚度的差异。次要目的是确定pRNFL和GCIPL厚度是否随视神经乳头（ONH）面积增加。这项横断面研究纳入了184只眼（92只MP眼和92只LCD眼）。将LCD患者作为性别和年龄匹配的对照。所有受试者均使用Cirrus HD-OCT系统进行成像。为所有受试者获取黄斑和pRNFL厚度图。MP组下象限pRNFL厚度高于LCD组（P<0.05）。两组间GCIPL厚度无差异。平均、上象限和下象限pRNFL厚度与ONH面积呈正相关（P<0.05）。下象限相关曲线的斜率更高。未发现GCIPL厚度与ONH面积之间存在相关性。与LCD患者相比，MP患者下象限pRNFL厚度更高。随着ONH面积增加，平均、上象限和下象限pRNFL厚度也增加。在MP患者中，基于pRNFL厚度测量评估青光眼性病变可能不可靠。建议在这些患者中，基于GCIPL厚度图分析而非pRNFL厚度来评估青光眼性损害。
