Dhar Sanjay Kumar, Raji K, Sandeep Shankar
Classified Specialist (Ophthalmology/ Paediatric Ophthalmology & Squint), Army Hospital (R&R), Delhi Cantt, 110010, India.
Senior Advisor, (Ophthalmology & VR Surgery), Army Hospital (R&R), Delhi Cantt, 110010, India.
Med J Armed Forces India. 2021 Jan;77(1):63-69. doi: 10.1016/j.mjafi.2020.01.004. Epub 2020 Apr 29.
Glaucoma is an important and common optic neuropathy characterized by progressive loss of retinal ganglion cells and associated morphological changes to the optic nerve and retinal nerve fiber layer (RNFL). The most common assessment of visual function in glaucoma uses perimetric measurements of visual sensitivity. Only few studies have evaluated the binocular function in patients with glaucoma. This study was taken up to establish the correlation of RNFL thickness, in glaucoma, with near and distance stereopsis.
This pilot, cross-sectional observational study included 100 diagnosed cases of glaucoma and 100 normal participants as controls, studied over a period of one year. The records of all the participants were checked, and only established cases of glaucoma after fulfilling the inclusion and exclusion criteria were included. Analysis of the RNFL using spectral-domain optical coherence tomography was carried out. All the participants were thereafter evaluated for stereoacuity by near (at 40 inches) and distance (at 3 meter) Randot stereoacuity charts.
There was a negative correlation between the RNFL thickness and the absolute value of streoacuity (-0.303 for distance versus -0.101 for near in cases and -0.308 for distance and -0.416 for near in control group), decreasing the actual functional stereoacuity, therefore the cases with lower RNFL thickness had lower stereoacuity both for distance and near, however it was statistically significant only for distance (p=0.002).
Functional aspects, such as stereoacuity, may also be affected in the glaucoma because of decrease in RNFL thickness. Therefore, binocular status should also be evaluated in cases of glaucoma.
青光眼是一种重要且常见的视神经病变,其特征为视网膜神经节细胞进行性丧失以及视神经和视网膜神经纤维层(RNFL)的相关形态学改变。青光眼视觉功能最常见的评估方法是对视敏度进行视野测量。仅有少数研究评估了青光眼患者的双眼功能。本研究旨在确定青光眼患者RNFL厚度与近、远立体视之间的相关性。
这项前瞻性横断面观察性研究纳入了100例确诊的青光眼病例和100名正常参与者作为对照,研究为期一年。检查了所有参与者的记录,仅纳入符合纳入和排除标准的确诊青光眼病例。使用光谱域光学相干断层扫描对RNFL进行分析。此后,所有参与者均通过近(40英寸处)和远(3米处)的Randot立体视锐度图评估立体视敏度。
RNFL厚度与立体视锐度绝对值之间存在负相关(病例组中远距离为-0.303,近距离为-0.101;对照组中远距离为-0.308,近距离为-0.416),这降低了实际的功能性立体视锐度,因此RNFL厚度较低的病例在远距离和近距离的立体视锐度均较低,不过仅在远距离上具有统计学意义(p = 0.002)。
由于RNFL厚度降低,青光眼患者的功能性方面,如立体视锐度,也可能受到影响。因此,青光眼病例也应评估双眼状态。