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开角型青光眼患者接受SDM激光视力保护治疗后视网膜神经纤维层和神经节细胞复合体层的渐进性增厚

Progressive Thickening of Retinal Nerve Fiber and Ganglion Cell Complex Layers Following SDM Laser Vision Protection Therapy in Open-Angle Glaucoma.

作者信息

Luttrull Jeffrey K, Tzekov Radouil, Bhavan Sathy V

机构信息

Ventura County Retina Vitreous Medical Group, 3160 Telegraph Rd, Suite 230, Ventura, CA, 93003, USA.

Ventura County Retina Vitreous Medical Group, Ventura, California, USA.

出版信息

Ophthalmol Ther. 2024 Nov;13(11):2903-2918. doi: 10.1007/s40123-024-01029-3. Epub 2024 Sep 19.

DOI:10.1007/s40123-024-01029-3
PMID:39298093
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11493924/
Abstract

INTRODUCTION

This work aims to determine the effect on nerve fiber layer (NFL) and ganglion cell complex (GCC) thickness trends in eyes with open-angle glaucoma (OAG) treated with Vision Protection Therapy™ (VPT).

METHODS

A retrospective analysis of spectral-domain optical coherence tomography (OCT) measured NFL and GCC thickness trends was performed, excluding eyes with poor-quality scans and principal diagnoses other than OAG. This study compares eyes with OAG managed conventionally with IOP control alone (controls) to eyes managed with the addition of VPT (VPT eyes). The direction (+ or -) and magnitude (microns/year) of the OCT trends were the study endpoints.

RESULTS

Seventy-eight control eyes of 40 patients and 61 VPT-treated eyes of 39 patients were included in the study. Positive NFL trends were noted in 5% of control eyes vs. 71% of VPT eyes (p < 0.0001). Positive GCC trends were noted in 8% of control eyes vs. 43% of VPT eyes (p < 0.0001). Mean NFL trends (µm/year) were - 0.692 for controls vs. 0.347 for VPT (p < 0.0001). Mean GCC trends (µm/year) were - 0.554 for controls vs. - 0.148 for VPT (p = 0.0175).

CONCLUSIONS

The addition of VPT to the conventional management of OAG resulted in highly significant improvements in NFL and GCC trends, indicating a reversal of key indicators of glaucoma severity and progression.

摘要

引言

本研究旨在确定视力保护疗法（VPT）对开角型青光眼（OAG）患者神经纤维层（NFL）和神经节细胞复合体（GCC）厚度变化趋势的影响。

方法

对光谱域光学相干断层扫描（OCT）测量的NFL和GCC厚度变化趋势进行回顾性分析，排除扫描质量差的眼睛以及除OAG以外的主要诊断。本研究将仅通过眼压控制进行传统治疗的OAG患者的眼睛（对照组）与添加VPT进行治疗的眼睛（VPT组）进行比较。OCT变化趋势的方向（+或 -）和幅度（微米/年）为研究终点。

结果

本研究纳入了40例患者的78只对照眼和39例患者的61只VPT治疗眼。5%的对照眼中观察到NFL呈正向变化趋势，而VPT组眼中这一比例为71%（p < 0.0001）。8%的对照眼中观察到GCC呈正向变化趋势，而VPT组眼中这一比例为43%（p < 0.0001）。对照组的平均NFL变化趋势（μm/年）为 -0.692，而VPT组为0.347（p < 0.0001）。对照组的平均GCC变化趋势（μm/年）为 -0.554，而VPT组为 -0.148（p = 0.0175）。

结论

在OAG的传统治疗中添加VPT可使NFL和GCC的变化趋势得到显著改善，这表明青光眼严重程度和进展的关键指标出现了逆转。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/063c/11493924/5d1f3f5ea8c2/40123_2024_1029_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/063c/11493924/5ff04d95f185/40123_2024_1029_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/063c/11493924/01e589de6ab7/40123_2024_1029_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/063c/11493924/2f0cfe2861bb/40123_2024_1029_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/063c/11493924/71aa9f0d8513/40123_2024_1029_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/063c/11493924/5d1f3f5ea8c2/40123_2024_1029_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/063c/11493924/5ff04d95f185/40123_2024_1029_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/063c/11493924/01e589de6ab7/40123_2024_1029_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/063c/11493924/2f0cfe2861bb/40123_2024_1029_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/063c/11493924/71aa9f0d8513/40123_2024_1029_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/063c/11493924/5d1f3f5ea8c2/40123_2024_1029_Fig5_HTML.jpg

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