乙胺丁醇诱导的视神经病变中视盘周围视网膜神经纤维层和视网膜神经节细胞层的结构损伤模式分析。
Analysis of structural injury patterns in peripapillary retinal nerve fibre layer and retinal ganglion cell layer in ethambutol-induced optic neuropathy.
机构信息
Department of Ophthalmology, Zhejiang Hospital of Intergrated Traditional Chinese and Western Medicine, 208 Huancheng Road East, Zhejiang, 310003, Hangzhou, People's Republic of China.
出版信息
BMC Ophthalmol. 2021 Mar 10;21(1):132. doi: 10.1186/s12886-021-01881-y.
BACKGROUND
We investigated structural injury patterns in the peripapillary retinal nerve fibre layer (p-RNFL) and ganglion cell inner plexiform layer (GCIPL) caused by ethambutol treatment.
METHODS
Sixty-four patients undergoing ethambutol treatment at Zhejiang Chinese Medicine and Western Medicine Integrated Hospital were recruited. Fourteen (14) exhibited visual dysfunction (abnormal group), and the remaining 50 had no visual dysfunction (subclinical group). The thickness of the p-RNFL, total macular retina layer and GCIPL were measured using Cirrus-HD Optical coherence tomography (Cirrus-HD OCT, Cirrus high-definition optical coherence tomography), and compared with 60 healthy, age-matched controls.
RESULTS
The p-RNFL thickness was similar in both subclinical and control groups. When compared with the control group, p-RNFL thickness in the abnormal group was significantly increased in the inferior and superior quadrants (GEE, P = 0.040, P = 0.010 respectively). In contrast with the subclinical group, p-RNFL thickness in the inferior quadrant was increased in the abnormal group (GEE, P = 0.047). The GCIPL thickness in the inferonasal and inferior sectors was significantly deceased in the subclinical group when compared with controls (GEE, P = 0.028, P = 0.047, respectively). The average and minimum value of GCIPL thickness, and thickness in the superonasal, inferior, inferotemporal, superotemporal and superior sectors were significantly decreased in the abnormal group when compared with controls (GEE, P = 0.016, P = 0.001, P = 0.028, P = 0.010, P = 0.012, P = 0.015, P = 0.010, respectively). The cube average macular thickness (CAMT) in the abnormal group was significantly thinner than controls (GEE, P = 0.027).
CONCLUSIONS
GCIPL measurements using Cirrus-HD OCT detected retinal ganglion cell layer loss following ethambutol treatment, before visual dysfunction occurred.
背景
我们研究了乙胺丁醇治疗引起的视盘周围视网膜神经纤维层（p-RNFL）和神经节细胞内丛状层（GCIPL）的结构损伤模式。
方法
在浙江中医药大学附属中西医结合医院接受乙胺丁醇治疗的 64 名患者入选。14 名患者出现视觉功能障碍（异常组），其余 50 名患者无视觉功能障碍（亚临床组）。使用 Cirrus-HD 光学相干断层扫描仪（Cirrus-HD OCT）测量 p-RNFL、全黄斑视网膜层和 GCIPL 的厚度，并与 60 名年龄匹配的健康对照进行比较。
结果
亚临床组和对照组的 p-RNFL 厚度相似。与对照组相比，异常组的下方和上方象限的 p-RNFL 厚度明显增加（GEE，P=0.040，P=0.010）。与亚临床组相比，异常组的下方象限的 p-RNFL 厚度增加（GEE，P=0.047）。与对照组相比，亚临床组的鼻下和下方象限的 GCIPL 厚度明显减少（GEE，P=0.028，P=0.047）。与对照组相比，异常组的 GCIPL 的平均和最小厚度以及鼻上、下方、下颞、上颞和上方象限的厚度明显减少（GEE，P=0.016，P=0.001，P=0.028，P=0.010，P=0.012，P=0.015，P=0.010）。异常组的平均黄斑厚度（CAMT）明显小于对照组（GEE，P=0.027）。
结论
使用 Cirrus-HD OCT 进行 GCIPL 测量可以在乙胺丁醇治疗后出现视觉功能障碍之前检测到视网膜神经节细胞层的损失。
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