Newman N M, Stevens R A, Heckenlively J R
Br J Ophthalmol. 1987 Jan;71(1):21-6. doi: 10.1136/bjo.71.1.21.
We present examples of nerve fibre layer changes in diseases thought to affect primarily the outer retinal layers. These disease processes include cone-rod dystrophies, rod-cone dystrophies, juvenile macular degeneration (Stargardt's disease) and fundus flavimaculatis, vitelliform macular dystrophy, and Leber's congenital amaurosis. All were associated with alterations in the retinal nerve fibre layer, either diffuse or focal. The presence of these nerve fibre layer changes raises the question of transsynaptic degeneration and of possible primary or associated disease of other retinal cells than the receptors-namely, bipolar, amacrine, Mueller, or ganglion cells--in these disease of the outer retinal layer. Involvement of the nerve fibre layer also indicates the need to examine patients with defects in the nerve fibre layer by electroretinograms and other tests for outer retinal layer disease when no obvious optic nerve disease is present.
我们展示了一些主要影响视网膜外层疾病中神经纤维层变化的例子。这些疾病过程包括视锥视杆营养不良、视杆视锥营养不良、青少年黄斑变性（斯塔加特病）和黄斑黄褐症、卵黄状黄斑营养不良以及莱伯先天性黑矇。所有这些疾病都与视网膜神经纤维层的改变有关，这些改变可以是弥漫性的或局灶性的。这些神经纤维层变化的存在引发了关于跨突触变性以及在这些外层视网膜疾病中除了感受器之外的其他视网膜细胞（即双极细胞、无长突细胞、米勒细胞或神经节细胞）是否存在原发性或相关性疾病的问题。神经纤维层受累还表明，当不存在明显的视神经疾病时，有必要通过视网膜电图和其他针对外层视网膜疾病的检查来检查神经纤维层有缺陷的患者。
