Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea.
Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea.
Sci Rep. 2019 Sep 25;9(1):13901. doi: 10.1038/s41598-019-50406-7.
Recent reports show varying results regarding peripapillary retinal nerve fibre layer (RNFL) thickness after intraocular pressure (IOP)-lowering glaucoma surgery. We hypothesised that different levels of the preoperative IOP influence RNFL thickness. A total of 60 patients (60 eyes) with glaucoma, who underwent glaucoma surgery and had a stable postoperative mean IOP < 22 mmHg, were enrolled. The RNFL thickness was measured using spectral domain optical coherence tomography, before and at 3-6 months after surgery. The preoperative peak IOP, 37.4 ± 10.8 mmHg, decreased to a postoperative mean IOP of 14.8 ± 3.5 mmHg (p < 0.001). The average RNFL thickness was significantly reduced from 75.6 ± 17.7 μm to 70.2 ± 15.8 μm (p < 0.001). In subgroup analyses, only patients with a preoperative peak IOP ≥ median value (37 mmHg) exhibited significant RNFL thinning (9.7 ± 6.6 μm, p < 0.001) associated with a higher preoperative peak IOP (r = 0.475, p = 0.008). The RNFL thinning was evident for a few months after glaucoma surgery in patients with a higher preoperative peak IOP, although the postoperative IOP was stable.
最近的报告显示，在降低眼内压（IOP）的青光眼手术后，视盘周围视网膜神经纤维层（RNFL）厚度的结果各不相同。我们假设术前 IOP 的不同水平会影响 RNFL 厚度。共纳入 60 例（60 只眼）接受青光眼手术且术后平均眼压稳定<22mmHg 的青光眼患者。使用谱域光学相干断层扫描术在术前和术后 3-6 个月测量 RNFL 厚度。术前眼压峰值为 37.4±10.8mmHg，术后平均眼压降至 14.8±3.5mmHg（p<0.001）。平均 RNFL 厚度从 75.6±17.7μm显著降低至 70.2±15.8μm（p<0.001）。亚组分析显示，仅术前眼压峰值≥中位数（37mmHg）的患者存在显著的 RNFL 变薄（9.7±6.6μm，p<0.001），与较高的术前眼压峰值相关（r=0.475，p=0.008）。尽管术后眼压稳定，但在术前眼压较高的患者中，青光眼手术后几个月内仍可见到 RNFL 变薄。
