Ucgul Atilgan Cemile, Hondur Gozde, Citirik Mehmet
Ulucanlar Eye Training and Research Hospital, Ankara, Turkey.
J Glaucoma. 2023 Jan 1;32(1):19-26. doi: 10.1097/IJG.0000000000002102. Epub 2022 Aug 11.
The macular and peripapillary structural and vascular alterations in elderly patients with age-related choroidal atrophy may mimic glaucomatous degeneration.
To evaluate the peripapillary retinal nerve fiber layer (pRNFL), macular nerve fiber layer (mNFL), ganglion cell layer (mGCL), inner plexiform layer (mIPL) thicknesses, and choroidal vascularity index (CVI) values in patients with age-related choroidal atrophy (ARCA) and to compare with the those of age and sex-matched healthy controls.
The cross-sectional, observational study included 95 eyes of 95 patients. The patients were divided into 2 groups according to subfoveal choroidal thickness (sCT) values. Forty eight eyes with sCT<125 µm constituted ARCA group (group 1), and 47 eyes with sCT>125 µm constituted control group (group 2). Peripapillary RNFL, mNFL, mGCL, mIPL, sCT values and fundus autofluorescence images were acquired with spectral domain-optical coherence tomography. Enhanced depth imaging mode spectral domain-optical coherence tomography images were binarized to show the luminal and stromal areas of choroid. CVI (%) was defined as the ratio of the luminal area to the total choroidal area with defined borders.
The mean age was 78.47±6.07 years in group 1 and 76.95±6.68 years in group 2. The mean, superior and inferior quadrants pRNFL thicknesses were significantly lower in group 1 than in group 2 ( P <0.05 for all). The mean mNFL, mGCL, mIPL thickness values were also statistically lower in group 1 than group 2 ( P <0.05 for all). The CVI value was 61.29±4.52 in group 1, and 64.81±3.80 in group 2 ( P <0.001).
The patients with ARCA had decreased pRNFL, inner macular layer thickness and CVI values when compared with healthy control eyes. These findings should be considered in the differential diagnosis and the follow up of eyes with glaucoma.
评估年龄相关性脉络膜萎缩(ARCA)患者的视乳头周围视网膜神经纤维层(pRNFL)、黄斑神经纤维层(mNFL)、神经节细胞层(mGCL)、内网状层(mIPL)厚度以及脉络膜血管指数(CVI)值,并与年龄和性别匹配的健康对照者进行比较。
这项横断面观察性研究纳入了95例患者的95只眼。根据黄斑中心凹下脉络膜厚度(sCT)值将患者分为2组。sCT<125 µm的48只眼构成ARCA组(第1组),sCT>125 µm的47只眼构成对照组(第2组)。使用谱域光学相干断层扫描获取视乳头周围RNFL、mNFL、mGCL、mIPL、sCT值以及眼底自发荧光图像。对增强深度成像模式谱域光学相干断层扫描图像进行二值化处理,以显示脉络膜的管腔和基质区域。CVI(%)定义为管腔面积与具有明确边界的脉络膜总面积之比。
第1组的平均年龄为78.47±6.07岁,第2组为76.95±6.68岁。第1组的平均、上方和下方象限pRNFL厚度显著低于第2组(均P<0.05)。第1组的平均mNFL、mGCL、mIPL厚度值在统计学上也低于第2组(均P<0.05)。第1组的CVI值为61.29±4.52,第2组为64.81±3.80(P<0.001)。
与健康对照眼相比,ARCA患者的pRNFL、黄斑内层厚度和CVI值降低。在青光眼的鉴别诊断和眼部随访中应考虑这些发现。
中国视网膜脉络膜成像研究(PRCIS):年龄相关性脉络膜萎缩老年患者的黄斑和视乳头周围结构及血管改变可能类似青光眼性退变。