Kobe University Graduate School of Medicine, Department of Surgery, Division of Ophthalmology, Kobe, Japan.
Invest Ophthalmol Vis Sci. 2019 Jul 1;60(8):2811-2821. doi: 10.1167/iovs.18-25910.
The present study aimed to assess the ability of en face slab images of maculae to detect residual nerve fiber bundles in eyes with advanced glaucoma.
This study included 36 eyes with diffuse thinning of the ganglion cell and inner plexiform layers (GCL+IPL). Inclusion criterion was GCL+IPL thickness of <1% of the normative database level as detected using optical coherence tomography (OCT). En face slab images (50-μm thickness) were reconstructed from the macular cube scan data using advanced visualization settings. Thereafter, we assessed the agreement of the locations between hyperreflective nerve fiber bundles and normal points in the Humphrey visual field test 10-2 pattern deviation (PD) plots. Additionally, total deviation (TD) corresponding to hyperreflective and hyporeflective areas was compared.
Hyperreflective areas were detected in 31 out of 36 eyes; all 31 eyes exhibited at least one normal PD point despite the substantial GCL+IPL thinning in the macular region. Two eyes with abnormalities in all PD points showed no hyperreflective area. The remaining three eyes had normal PD points despite the lack of high reflectivity areas in the slab images. Therefore, 91.7% of eyes showed agreement between en face slab images and PD plots. Moreover, hyperreflective areas demonstrated significantly better TD than hyporeflective areas.
En face slab images of maculae were able to reveal the residual nerve fiber bundles in the eyes with advanced glaucoma despite the GCL+IPL thickness in the maculae being diffusely and substantially reduced.
本研究旨在评估黄斑区切面图像在检测晚期青光眼患者剩余神经纤维束中的能力。
本研究纳入了 36 只弥漫性神经节细胞和内丛状层（GCL+IPL）变薄的眼。纳入标准为光学相干断层扫描（OCT）检测到 GCL+IPL 厚度<正常数据库水平的 1%。使用高级可视化设置从黄斑立方体扫描数据中重建 50-μm 厚的切面图像。然后，我们评估了神经纤维束的高反射区域与 Humphrey 视野测试 10-2 模式偏差（PD）图中正常点之间的位置一致性。此外，还比较了高反射和低反射区域对应的总偏差（TD）。
在 36 只眼中，有 31 只眼检测到高反射区域；尽管黄斑区 GCL+IPL 明显变薄，但所有 31 只眼均显示至少一个正常 PD 点。两只在所有 PD 点都存在异常的眼没有高反射区域。其余三只眼尽管在切片图像中没有高反射区域，但仍有正常 PD 点。因此，91.7%的眼在切面图像和 PD 图之间存在一致性。此外，高反射区域的 TD 明显优于低反射区域。
尽管黄斑区 GCL+IPL 弥漫性且明显变薄，黄斑区切面图像仍能显示晚期青光眼患者的剩余神经纤维束。
