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比较显示视盘出血的眼中脉络膜小凹最小视网膜神经纤维层宽度和视网膜神经纤维层变化率。

Comparison of Rate of Change between Bruch's Membrane Opening Minimum Rim Width and Retinal Nerve Fiber Layer in Eyes Showing Optic Disc Hemorrhage.

机构信息

Department of Ophthalmology, Gyeongsang National University Changwon Hospital, Gyeongsang National University, School of Medicine, Changwon, Gyeongsangnam-do, Republic of Korea; Institute of Health Sciences, School of Medicine, Gyeongsang National University, Jinju, Republic of Korea.

Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

出版信息

Am J Ophthalmol. 2020 Sep;217:27-37. doi: 10.1016/j.ajo.2020.03.051. Epub 2020 Apr 10.

Abstract

PURPOSE

To investigate and compare the longitudinal rate of change of Bruch's membrane opening minimum rim width (BMO-MRW) and peripapillary retinal nerve fiber layer (RNFL) thickness in eyes showing optic disc hemorrhage(DH).

DESIGN

Observational case series.

METHODS

A total of 82 subjects(82 eyes) showing DH who had undergone more than five reliable spectral-domain optical coherence tomography (OCT) tests were included. BMO-MRW and RNFL were measured with OCT at 3-month intervals. The rates of change in global and each Garway-Heath sector were calculated with a linear mixed-effects model after adjusting for age, sex, and BMO area.

RESULTS

The mean follow-up period was 21.57 ± 7.88 months with a mean number of 7.88 ± 2.39 OCT tests. Baseline demographics were age (58.37 ± 10.65 y); 46.3% were female; and the mean deviation was -4.41 ± 5.04 dB. The global rate of change in BMO-MRW was -3.507 ± 0.675 μm/y and in -1.404 ± 0.208 μm/y in RNFL. The rate of change was the greatest in the inferotemporal sector, which was -9.141 ± 1.254 μm/y in BMO-MRW and -4.204 ± 0.490 μm/y in the RNFL. The rate of change was significantly greater in BMO-MRW than in the RNFL in all sectors, except for the nasal sector (P < .05). Percentage of reduction was significantly greater in BMO-MRW than in RNFL in the inferotemporal and superotemporal sectors (P < .05).

CONCLUSIONS

BMO-MRW showed a significantly greater rate of change than RNFL in eyes showing DH, especially in the inferotemporal and superotemporal sectors in percentage of reduction. Thus, it may be more advantageous to detect glaucomatous progression earlier in BMO-MRW than in the RNFL in eyes showing DH that are more likely to progress.

摘要

目的

研究并比较显示视盘出血(DH)的眼的 Bruch 膜开口最小边缘宽度(BMO-MRW)和神经纤维层(RNFL)厚度的纵向变化率。

设计

观察性病例系列。

方法

共纳入 82 例(82 只眼)接受了超过 5 次可靠的光谱域光学相干断层扫描(OCT)检查的 DH 患者。使用 OCT 以 3 个月的间隔测量 BMO-MRW 和 RNFL。通过线性混合效应模型调整年龄、性别和 BMO 区域后,计算全球和每个 Garway-Heath 区的变化率。

结果

平均随访时间为 21.57 ± 7.88 个月,平均 OCT 检查次数为 7.88 ± 2.39 次。基线人口统计学特征为年龄(58.37 ± 10.65 岁);46.3%为女性;平均偏差为-4.41 ± 5.04 dB。BMO-MRW 的全球变化率为-3.507 ± 0.675 μm/y,RNFL 的变化率为-1.404 ± 0.208 μm/y。BMO-MRW 中变化最大的是下颞区,为-9.141 ± 1.254 μm/y,RNFL 为-4.204 ± 0.490 μm/y。除了鼻区外,所有区域的 BMO-MRW 变化率均明显大于 RNFL(P<.05)。在颞下和颞上区,BMO-MRW 的百分比减少率明显大于 RNFL(P<.05)。

结论

在显示 DH 的眼中,BMO-MRW 的变化率明显大于 RNFL,尤其是在颞下和颞上区,以百分比减少表示。因此,在更有可能进展的显示 DH 的眼中,BMO-MRW 可能比 RNFL 更早地检测到青光眼进展。

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