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青光眼视锥的完整性:一项自适应光学扫描激光检眼镜检查研究

Tomoko Hasegawa and Sotaro Ooto and Kohei Takayama and Yukiko Makiyama and Tadamichi Akagi and Hanako O. Ikeda and Hideo Nakanishi and Kenji Suda and Hiroshi Yamada and Akihito Uji and Nagahisa Yoshimura

期刊名称:American Journal of Ophthalmology

卷期:2016年第171卷

摘要

目的:旨在调查青光眼光感受器的变化。设计:横断面研究。方法:这项研究包括35例原发性开角型青光眼患者的35只眼,患者至少3年前即有旁中心凹视野缺损,以及21名正常受试者的21只眼。剔除轴向长度≥26.0mm眼。所有受试者接受全面眼科检查,包括光谱域光学相干断层扫描(SDOCT)和原型自适应光学扫描激光眼底镜检查(AO-SLO)成像。结果:如AO-SLO测定所见,青光眼的视锥密度(分别为26468±3392个细胞/ m226147±2700个细胞/m2; P = 0.77;距离中心凹中心0.5 mm)或视锥空间结构(六边形Voronoi结构域比率:43.7%±4.4%:44.3%±4.9; P = 0.76;距离中心凹中心0.5mm)与正常眼无差别。此外,SDOCT显示,两组的感光器相关层厚度没有显着差异,并且所有正常和青光眼眼的光感受器椭圆区带是连续的。在具有垂直不对称的青光眼中,视锥密度,视锥空间组织或光感受器相关层厚度,受影响较大的一侧与受影响较小的一侧没有显着不同。在8只青光眼中(22.9%),黑暗,分区样区域包围AO-SLO视锥。结论:AO-SLOSDOCT显示青光眼视锥完整,甚至在视野和神经纤维缺损的区域也是如此。在AO-SLO中,内核层微囊性病变可能影响视锥嵌合体的影像。

Purpose To investigate photoreceptor changes in eyes with glaucoma. Design Cross-sectional study. Methods The study included 35 eyes of 35 patients with primary open-angle glaucoma who had suffered parafoveal visual field loss at least 3 years previously, as well as 21 eyes of 21 normal subjects. Eyes with an axial length 26.0 mm were excluded. All subjects underwent a full ophthalmologic examination, including spectral-domain optical coherence tomography (SDOCT) and prototype adaptive-optics scanning laser ophthalmoscopy (AO-SLO) imaging. Results As determined using AO-SLO, eyes with glaucoma did not differ significantly from normal eyes in terms of either cone density (26 468 ± 3392 cones/m2 vs 26 147 ± 2700 cones/m2, respectively; P = .77; measured 0.5 mm from the foveal center) or cone spatial organization (ratio of hexagonal Voronoi domain: 43.7% ± 4.4% vs 44.3% ± 4.9%; P = .76; measured 0.5 mm from the foveal center). Furthermore, SDOCT showed that the 2 groups did not differ significantly in terms of the photoreceptor-related layer thickness, and that the photoreceptor ellipsoid zone band was continuous in all normal and glaucoma eyes. In glaucoma eyes with vertically asymmetric severity, the more affected side did not significantly differ from the less affected side in terms of cone density, cone spatial organization, or photoreceptor-related layer thickness. In 8 eyes (22.9%) with glaucoma, dark, partition-like areas surrounded the cones on the AO-SLO. Conclusions Both AO-SLO and SDOCT showed cone integrity in eyes with glaucoma, even in areas with visual field and nerve fiber loss. In AO-SLO, microcystic lesions in the inner nuclear layer may influence images of the cone mosaic.


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