Mocan Mehmet C, Machen Lindsay, Jang Inae, Cao Dingcai
J Pediatr Ophthalmol Strabismus. 2020 Mar 1;57(2):90-96. doi: 10.3928/01913913-20200117-02.
To evaluate the relationship between optic nerve cup-to-disc ratio and peripapillary retinal nerve fiber layer (RNFL) thickness in suspected pediatric glaucoma with large cup-to-disc ratios.
This was a retrospective study undertaken at a single academic institution. Eighty-six eyes of 43 patients who presented with large (≥ 0.5) cup-to-disc ratios in both eyes and without elevated intraocular pressure were evaluated using spectral-domain optical coherence tomography. Global and sectoral peripapillary RNFL thickness measurements, Bruch's membrane opening size, refractive error in spherical equivalents, and intraocular pressure levels were recorded for all patients. Cup-to-disc ratios were manually derived using digital fundus images (D-cup-to-disc ratio). Parameters were compared between gender or race by t tests or analysis of variance. The differences in the relationship among the clinical parameters between two eyes were assessed using generalized estimation equation modeling followed by Pearson's correlation analysis.
Forty-three patients (25 boys and 18 girls) with a mean age of 9.3 ± 2.7 years (range: 5 to 15 years) were included. The mean global peripapillary RNFL thickness and the D-cup-to-disc ratio of study eyes were 99.0 ± 9.2 µm and 0.66 ± 0.03, respectively. The peripapillary RNFL thickness was found to be correlated with refractive error (r = 0.404; P = .008) and Bruch's membrane opening size (r = 0.410; P = .008) but not with cup-to-disc ratios (r = 0.029; P = .858) or patient age (r = -0.044; P = .797).
In patients with suspected pediatric glaucoma who present with large cup-to-disc ratios, RNFL thickness does not correlate with the degree of optic nerve cupping. Myopic refractive errors and Bruch's membrane opening size need to be taken into consideration to prevent misinterpretation of peripapillary RNFL measurements. [J Pediatr Ophthalmol Strabismus. 2020;57(2):90-96.].
评估双眼杯盘比大的疑似儿童青光眼患者的视神经杯盘比与视乳头周围视网膜神经纤维层（RNFL）厚度之间的关系。
这是一项在单一学术机构进行的回顾性研究。对43例双眼杯盘比大（≥0.5）且眼压未升高的患者的86只眼睛进行了光谱域光学相干断层扫描评估。记录了所有患者的视乳头周围RNFL厚度的整体和扇形测量值、布鲁赫膜开口大小、等效球镜屈光不正和眼压水平。使用数字眼底图像手动得出杯盘比（D-杯盘比）。通过t检验或方差分析比较性别或种族之间的参数。使用广义估计方程模型，随后进行Pearson相关分析，评估两只眼睛之间临床参数关系的差异。
纳入了43例患者（25例男孩和18例女孩），平均年龄为9.3±2.7岁（范围：5至15岁）。研究眼的平均视乳头周围RNFL厚度和D-杯盘比分别为99.0±9.2µm和0.66±0.03。发现视乳头周围RNFL厚度与屈光不正（r = 0.404；P = 0.008）和布鲁赫膜开口大小（r = 0.410；P = 0.008）相关，但与杯盘比（r = 0.029；P = 0.858）或患者年龄（r = -0.044；P = 0.797）无关。
在双眼杯盘比大的疑似儿童青光眼患者中，RNFL厚度与视神经杯凹程度无关。为防止对视乳头周围RNFL测量结果的误判，需要考虑近视屈光不正和布鲁赫膜开口大小。[《小儿眼科与斜视杂志》。2020；57(2)：90-96。]
