Eye Research Center (MAF, SO, SM), Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Ophthalmology (SM), University of California, San Francisco, San Francisco, California; and Department of Ophthalmology (PSS), University of Colorado School of Medicine, Aurora, Colorado.
J Neuroophthalmol. 2019 Mar;39(1):28-34. doi: 10.1097/WNO.0000000000000641.
To compare macular and optic nerve head optical coherence tomography (OCT) measurements in mild to moderate papilledema and pseudopapilledema.
One hundred nineteen eyes of 61 patients with mild to moderate papilledema, 84 eyes of 48 patients with pseudopapilledema, and 60 eyes of 60 healthy normal individuals were enrolled in this cross-sectional study. Using Spectralis SD-OCT, macular scans with macular ganglion cell-inner plexiform layer (GCIPL) and macular retinal nerve fiber layer (RNFL) segmentation were performed and divided into 2 regions (inner and outer, with a diameter of 3 and 6 mm, respectively); in addition, Bruch membrane opening (BMO) area and peripapillary RNFL thickness were obtained.
BMO area was similar in papilledema (1.83 ± 0.34 mm), pseudopapilledema (1.85 ± 0.37 mm), and controls (1.85 ± 0.32 mm). Average inner region macular GCIPL thickness in the papilledema, pseudopapilledema, and control groups was 87.2 ± 14.4 μm, 90.8 ± 6.1 μm, and 91.2 ± 9.8 μm, respectively (P > 0.05). Outer temporal region macular GCIPL was significantly thinner in the papilledema group compared with control group (P = 0.01). By contrast, outer inferior and outer nasal macular RNFL sectors were significantly thicker in the papilledema group compared with control groups (P = 0.01 and P < 0.01, respectively). Those measures were not different between pseudopapilledema and control eyes.
In papilledema eyes, outer temporal region macular GCIPL thickness decreased and outer inferior and outer nasal macular RNFL sectors thickness increased compared with the control group. These changes were not observed in the pseudopapilledema group.
比较轻度至中度视盘水肿和假性视盘水肿的黄斑和视神经头光学相干断层扫描(OCT)测量值。
本横断面研究纳入了 61 例轻度至中度视盘水肿患者的 119 只眼、48 例假性视盘水肿患者的 84 只眼和 60 例健康正常个体的 60 只眼。使用 Spectralis SD-OCT 进行黄斑扫描,并进行黄斑神经节细胞-内丛状层(GCIPL)和黄斑视网膜神经纤维层(RNFL)分段,分为 2 个区域(内区和外区,直径分别为 3mm 和 6mm);此外,还获得了 Bruch 膜开口(BMO)面积和视盘周围 RNFL 厚度。
视盘水肿、假性视盘水肿和对照组的 BMO 面积相似(分别为 1.83±0.34mm、1.85±0.37mm 和 1.85±0.32mm)。视盘水肿、假性视盘水肿和对照组患者的平均内区黄斑 GCIPL 厚度分别为 87.2±14.4μm、90.8±6.1μm 和 91.2±9.8μm(P>0.05)。与对照组相比,视盘水肿组的外颞区黄斑 GCIPL 明显变薄(P=0.01)。相比之下,视盘水肿组的外下方和外鼻侧黄斑 RNFL 区明显增厚(P=0.01 和 P<0.01),而假性视盘水肿组与对照组之间无差异。
在视盘水肿眼中,与对照组相比,外颞区黄斑 GCIPL 厚度减少,外下方和外鼻侧黄斑 RNFL 区厚度增加。这些变化在假性视盘水肿组中未观察到。