Takagi Seiji, Tomita Goji
Department of Ophthalmology, Toho University Ohashi Medical Center, Japan.
Am J Ophthalmol Case Rep. 2016 May 3;2:41-43. doi: 10.1016/j.ajoc.2016.04.008. eCollection 2016 Jul.
To report longitudinal changes over time after surgery in the topography of the optic disc, thickness of the circum papillary retinal nerve fiber layer (c-RNFL), and thickness of the macular ganglion cell complex (m-GCC) in a case of juvenile open angle glaucoma.
Case report based on one patient. After significant edema of the optic disc for 2 months, the cup depth and cup volume measured by Heidelberg retina tomograph images showed reversal, which lasted for 3 years. The c-RNFL thickness and m-GCC thickness measured by spectral domain optical coherence tomography first increased for a week and then continued to decrease until 6 months after operation. These two parameters reached a plateau after 3 years. The mean deviation of global visual field indices of the Humphrey visual field revealed a very mild reduction for this 3 year period.
In juvenile onset glaucoma, changes in c-RNFL thickness and m-GCC thickness after operation were not consistent with changes in optic disc cupping. Changes in the thicknesses of the c-RNFL or m-GCC, rather than changes in the optic disc changes, may be good surrogate measures to confirm the effectiveness of glaucoma surgery.
报告一例青少年开角型青光眼患者术后视盘形态、视乳头周围视网膜神经纤维层(c-RNFL)厚度及黄斑神经节细胞复合体(m-GCC)厚度随时间的纵向变化。
基于一名患者的病例报告。视盘明显水肿2个月后,通过海德堡视网膜断层扫描图像测量的杯深和杯容积出现逆转,持续3年。通过光谱域光学相干断层扫描测量的c-RNFL厚度和m-GCC厚度最初在一周内增加,然后持续下降直至术后6个月。这两个参数在3年后达到平台期。 Humphrey视野的总体视野指数平均偏差在这3年期间显示出非常轻微的降低。
在青少年型青光眼患者中,术后c-RNFL厚度和m-GCC厚度的变化与视盘杯状凹陷的变化不一致。c-RNFL或m-GCC厚度的变化,而非视盘变化,可能是确认青光眼手术有效性的良好替代指标。