早期青光眼与非青光眼性视神经病变之间视网膜神经纤维层和神经节细胞-内丛状层的不同损伤模式。
Different damage patterns of retinal nerve fiber layer and ganglion cell-inner plexiform layer between early glaucoma and non-glaucomatous optic neuropathy.
作者信息
Xiao Hui, Liu Xing, Lian Ping, Liao Ling-Ling, Zhong Yi-Min
机构信息
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China.
出版信息
Int J Ophthalmol. 2020 Jun 18;13(6):893-901. doi: 10.18240/ijo.2020.06.06. eCollection 2020.
AIM
To compare the damage pattern of the peripapillary retinal nerve fiber layer (pRNFL) and the macular ganglion cell-inner plexiform layer (mGCIPL) between early glaucomatous and non-glaucomatous optic neuropathy (EGON and NGON).
METHODS
It is a cross-sectional study. Thirty-eight healthy controls, 74 EGONs and 70 NGONs with comparable average pRNFL loss were included. The NGON group included 23 eyes of optic neuritis (ON), 13 eyes of hereditary optic neuropathy (HON), 19 eyes of toxic optic neuropathy (TON) and 15 eyes of compressive neuropathy (CON). The sectoral pRNFL and mGCIPL thickness obtained by high definition optical coherence tomography were analyzed.
RESULTS
Compared to normal controls, the pRNFL thickness in all quadrants showed a decrease in both EGON and NGON group (<0.001), but the average pRNFL thickness of EGON group was not different to that of NGON group (=0.94). The inferior and superior pRNFL was thinner in EGON group compared to NGON group (<0.001). The temporal pRNFL was thinner in NGON group compared to EGON group (<0.001). No statistically significant difference was found in nasal pRNFL between EGON and NGON. While the nasal pRNFL was thinner in CON than other three types of NGON (=0.01), no statistically significant difference was found in other three quadrantal pRNFL among the four types of NGON (>0.05). The mGCIPL of EGON and NGON group were thinner than control group (<0.001). In EGON group the severest sites of mGCIPL reduction was located at inferotemporal and inferior sectors. While, compared to EGON group, the average mGCIPL of NGON group were significantly thinner, especially in superonasal and inferonasal sectors (<0.001).
CONCLUSION
The damage pattern of pRNFL and mGCIPL caused by glaucoma is distinct from other NGON such as ON, TON, HON and CON, and this characteristic damage pattern is helpful in differentiating early glaucoma from other NGON.
目的
比较早期青光眼性和非青光眼性视神经病变（EGON和NGON）患者视乳头周围视网膜神经纤维层（pRNFL）和黄斑神经节细胞-内丛状层（mGCIPL）的损伤模式。
方法
这是一项横断面研究。纳入38名健康对照者、74例EGON患者和70例平均pRNFL损失程度相当的NGON患者。NGON组包括23只视神经炎（ON）患眼、13只遗传性视神经病变（HON）患眼、19只中毒性视神经病变（TON）患眼和15只压迫性神经病变（CON）患眼。对通过高分辨率光学相干断层扫描获得的扇形pRNFL和mGCIPL厚度进行分析。
结果
与正常对照组相比，EGON组和NGON组所有象限的pRNFL厚度均降低（<0.001），但EGON组的平均pRNFL厚度与NGON组无差异（=0.94）。与NGON组相比，EGON组的下方和上方pRNFL更薄（<0.001）。与EGON组相比，NGON组的颞侧pRNFL更薄（<0.001）。EGON组和NGON组的鼻侧pRNFL无统计学显著差异。虽然CON组的鼻侧pRNFL比其他三种类型的NGON更薄（=0.01），但四种类型的NGON在其他三个象限的pRNFL中未发现统计学显著差异（>0.05）。EGON组和NGON组的mGCIPL均比对照组更薄（<0.001）。在EGON组中，mGCIPL减少最严重的部位位于颞下和下方扇形区域。然而，与EGON组相比，NGON组的平均mGCIPL明显更薄，尤其是在鼻上和鼻下扇形区域（<0.001）。
结论
青光眼引起的pRNFL和mGCIPL损伤模式与ON、TON、HON和CON等其他NGON不同，这种特征性损伤模式有助于早期青光眼与其他NGON的鉴别。
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