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膝状体后病变后视野模式导致视网膜神经节细胞复合体变薄的比较研究

Comparative study of retinal ganglion cell complex thinning by visual field patterns following post-geniculate lesions.

作者信息

Kurokawa Toshio, Kobayashi Rumi, Ueda Naoko, Ohi Takekazu

机构信息

Department of Ophthalmology, Kyoto Hakuaikai Hospital, 1 Keshiyama, Kamigamo, Kita-ku, Kyoto, 603-8041, Japan.

Department of Neurology, Neuro-rehabilitation Kitaoji Hospital, Kyoto, Japan.

出版信息

Jpn J Ophthalmol. 2025 Mar;69(2):268-278. doi: 10.1007/s10384-025-01174-7. Epub 2025 Apr 9.

DOI:10.1007/s10384-025-01174-7
PMID:40199802
Abstract

PURPOSE

To investigate the relationship between retinal ganglion cell complex (GCC) thinning following post-geniculate lesions and the time elapsed since cerebrovascular disorder (CVD) onset.

STUDY DESIGN

Retrospective study.

METHODS

Forty-seven patients with hemianopic visual field defects (VFD) due to post-geniculate lesions were retrospectively enrolled from our clinical optical coherence tomography (OCT) database. GCC thickness was measured using spectral-domain OCT, with a 6 mm circle centered on the fovea divided into hemianopic and unaffected sides. The decline rate (DR) was calculated as the percentage reduction in GCC thickness on the hemianopic side relative to the unaffected side.

RESULTS

Patients were grouped based on VFD patterns: complete homonymous hemianopia (A), homonymous hemianopia with macular sparing (B), homonymous scotomatous defects (C), superior quadrantanopia (D), and inferior quadrantanopia (E). A positive correlation (r = 0.581, p < 0.001) was found between the time elapsed since CVD onset and DR. More than 5% DR was observed in 29 of 47 cases (61.7%). Significant differences were noted between group A (specifically, the temporal lobe lesion) and group B (p = 0.0183), as well as between group A and group C (p = 0.0378).

CONCLUSION

A significant correlation was observed between DR and the time elapsed. Several factors, such as lesion location, type, size, and the involvement of gray or white matter, influence retrograde trans-synaptic degeneration (RTSD). Our findings suggest that RTSD is influenced by the distance from the lateral geniculate nucleus (LGN).

摘要

目的

研究膝状体后病变后视网膜神经节细胞复合体(GCC)变薄与脑血管疾病(CVD)发病后经过的时间之间的关系。

研究设计

回顾性研究。

方法

从我们的临床光学相干断层扫描(OCT)数据库中回顾性纳入47例因膝状体后病变导致偏盲性视野缺损(VFD)的患者。使用光谱域OCT测量GCC厚度,以黄斑为中心的6mm圆分为偏盲侧和未受影响侧。下降率(DR)计算为偏盲侧GCC厚度相对于未受影响侧减少的百分比。

结果

根据VFD模式对患者进行分组:完全同侧偏盲(A)、黄斑保留的同侧偏盲(B)、同侧暗点缺损(C)、上象限盲(D)和下象限盲(E)。发现CVD发病后经过的时间与DR之间存在正相关(r = 0.581,p < 0.001)。47例中有29例(61.7%)观察到DR超过5%。A组(特别是颞叶病变)与B组之间(p = 0.0183)以及A组与C组之间(p = 0.0378)存在显著差异。

结论

观察到DR与经过的时间之间存在显著相关性。几个因素,如病变位置、类型、大小以及灰质或白质的受累情况,影响逆行跨突触变性(RTSD)。我们的研究结果表明,RTSD受距外侧膝状体核(LGN)距离的影响。

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Neurology. 2020 Jan 21;94(3):e323-e329. doi: 10.1212/WNL.0000000000008738. Epub 2019 Dec 17.
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Occipital tip injury with homonymous central scotoma: OCT-NFL and RGC correlation.枕叶尖端损伤伴同向性中心暗点:光学相干断层扫描视网膜神经纤维层(OCT-NFL)与视网膜神经节细胞(RGC)的相关性
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Sectoral analysis of the retinal nerve fiber layer thinning and its association with visual field loss in homonymous hemianopia caused by post-geniculate lesions using spectral-domain optical coherence tomography.
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Graefes Arch Clin Exp Ophthalmol. 2016 Apr;254(4):745-56. doi: 10.1007/s00417-015-3181-1. Epub 2015 Oct 7.
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Corresponding Ganglion Cell Atrophy in Patients With Postgeniculate Homonymous Visual Field Loss.膝状体后同向性视野缺损患者的相应神经节细胞萎缩
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