Department of Ophthalmology and Visual Sciences, University of Wisconsin Madison, Madison, Wisconsin, USA
Department of Ophthalmology, Massachusetts Eye and Ear, Harvard University, Boston, Massachusetts, USA.
Br J Ophthalmol. 2020 Nov;104(11):1524-1527. doi: 10.1136/bjophthalmol-2019-314570. Epub 2020 Feb 12.
BACKGROUND/AIMS: To assess the effect of partial posterior vitreous detachment (pPVD) on spectral-domain optical coherence tomography (OCT) peripapillary retinal nerve fibre layer thickness (RNFL) measurements.
Spectral-domain OCT RNFL thickness measurements were obtained from 684 consecutive patients who were seen in the Massachusetts Eye and Ear Glaucoma Service. Of these patients, we compared RNFL thickness measurements between 101 eyes of 101 glaucoma suspects who met inclusion criteria (55 eyes with and 46 eyes without pPVD).
Among all 684 patients, 253 (37%) had pPVD in at least one eye. Among a subset of 101 eyes of 101 glaucoma suspects, average RNFL thickness was greater in eyes with compared to eyes without pPVD (p=0.02). Measurements were significantly greater in the inferior (p=0.004) and superior quadrants (p=0.008), but not in the nasal (p=0.10) and temporal quadrants (p=0.25). The difference in average RNFL thickness remained significant (p=0.05) even when corrected for expected age-related decline in RNFL thickness.
Over a third of patients were found on peripapillary spectral-domain OCT to have a pPVD, which was associated with greater RNFL thickness measurements. Judicious clinical interpretation of this finding on spectral-domain OCT RNFL thickness scans should be factored into the assessment of glaucoma suspects.
背景/目的：评估部分玻璃体后脱离（pPVD）对频域光相干断层扫描（OCT）视盘周围视网膜神经纤维层（RNFL）厚度测量的影响。
从在马萨诸塞眼耳青光眼服务处就诊的 684 例连续患者中获得频域 OCT RNFL 厚度测量值。在这些患者中，我们比较了符合纳入标准的 101 例青光眼疑似患者的 101 只眼中的 RNFL 厚度测量值（55 只眼有 pPVD，46 只眼无 pPVD）。
在所有 684 例患者中，253 例（37%）至少一只眼有 pPVD。在 101 例青光眼疑似患者的 101 只眼中，pPVD 眼的平均 RNFL 厚度大于无 pPVD 眼（p=0.02）。在下象限（p=0.004）和上象限（p=0.008）测量值明显更大，但在鼻侧（p=0.10）和颞侧（p=0.25）象限则无差异。即使校正了 RNFL 厚度与年龄相关的预期下降，平均 RNFL 厚度的差异仍然显著（p=0.05）。
在频域 OCT 视盘周围，超过三分之一的患者存在 pPVD，这与 RNFL 厚度测量值增加有关。在评估青光眼疑似患者时，应将频谱 OCT RNFL 厚度扫描中这一发现的谨慎临床解释纳入考虑。
