Department of Ophthalmology, National Institute of Diabetes and Endocrinology, National Organization for Teaching Hospitals and Institutes, Cairo, Egypt.
Department of Ophthalmology, Faculty of Medicine, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt.
Int Ophthalmol. 2021 Jul;41(7):2405-2415. doi: 10.1007/s10792-021-01795-0. Epub 2021 Apr 29.
To quantitatively analyze α-zone and β-zone peripapillary atrophy (PPA) in patients having early primary open-angle glaucoma (POAG) using fundus autofluorescence (FAF) in conjunction with spectral domain optical coherence tomography, colored photography and perimetry.
This is an observational cross-sectional case-control study.
This study included 100 eyes (54 patients) of early to moderate POAG and 100 normal eyes (50 subjects). Ophthalmological examination, OCT for the optic nerve and FAF were performed. The extent of α-PPA and β-PPA was measured.
The extent of α-PPA and β-PPA as measured by FAF had higher values in POAG group as compared to control group (p values 0.003 and ≤ 0.001 for the total nasal and temporal extents, respectively). However, the nasal alpha and temporal beta zones showed more values in POAG patients as compared to normal controls (p values 0.002 and 0.024). The difference between the total extents of either zones alone was not significant. B-scan OCT was able to positively detect both zones. Detecting the alpha zone was significantly higher in the control group, while beta zone detection was significantly higher in the POAG group (p values ≤ 0.001).
The sensitivity of alpha zone detection was equal using colored photographs, FAF and B-scan OCT. FAF showed superior results in estimating the beta zone extent although OCT was more accurate in the anatomical delineation of Bruch's membrane and RPE termination. The nasal alpha and temporal beta zone extents could be taken as early indices for evaluating early glaucomatous optic neuropathy.
利用眼底自发荧光（FAF）联合频域光相干断层扫描、彩色摄影和视野检查，定量分析早期原发性开角型青光眼（POAG）患者的α-区和β-区视盘周围萎缩（PPA）。
这是一项观察性的横断面病例对照研究。
本研究纳入了 100 只眼（54 例）早期至中度 POAG 患者眼和 100 只正常眼（50 例）。进行了眼科检查、视神经 OCT 和 FAF。测量了α-PPA 和β-PPA 的范围。
FAF 测量的α-PPA 和β-PPA 范围在 POAG 组较对照组更高（总鼻侧和颞侧范围的 p 值分别为 0.003 和≤0.001）。然而，与正常对照组相比，POAG 患者的鼻侧α区和颞侧β区更大（p 值分别为 0.002 和 0.024）。单独两个区域的总范围之间的差异无统计学意义。B 扫描 OCT 能够阳性检测到两个区域。对照组检测到α区的敏感性明显更高，而 POAG 组检测到β区的敏感性明显更高（p 值均≤0.001）。
彩色照片、FAF 和 B 扫描 OCT 检测α区的敏感性相同。FAF 虽然在估计β区范围方面具有优势，但 OCT 在 Bruch 膜和 RPE 终止的解剖描绘方面更为准确。鼻侧α区和颞侧β区范围可作为评估早期青光眼性视神经病变的早期指标。
