目的使用OCT评估正常眼与原发性开角型青光眼(primary open angle glaucoma,POAG)视盘(opticnerve head,ONH)的差异。方法选择具有青光眼性视神经损害或RNFL缺损、相应的视野缺损的开角型青光眼60例(60只眼),另选择正常眼60例(60只眼)...目的使用OCT评估正常眼与原发性开角型青光眼(primary open angle glaucoma,POAG)视盘(opticnerve head,ONH)的差异。方法选择具有青光眼性视神经损害或RNFL缺损、相应的视野缺损的开角型青光眼60例(60只眼),另选择正常眼60例(60只眼)作为正常对照组。对二组患者进行详细的眼科检查,并使用光学相干断层扫描仪(optical coherence tomography,OCT)测定视盘形态。OCT检查采用视盘扫描模式,评估数据包括视盘面积、视杯面积、盘沿面积、垂直盘沿面积(vertical integrated rim area,VIRA)、水平盘沿容积、平均杯盘比、水平和垂直杯盘比以及视杯容积。比较二组视盘参数,并比较平均误差(mean deviation,MD)和校正模型标准变异(correc-ted pattern standard deviation CPSD)与青光眼组的视盘参数有无相关。结果原发性开角型青和正常组之间视盘参数的比较具有显著性差异。正常眼、POAG比较分别为:视盘面积(211+/-0.5,2.62+/-0.4)mm2,(P<0.01),视杯面积(0.65+/-0.5,1.79+/-0.6)mm2,(P<0.01),盘沿面积(1.44+/-0.4,0.89+/-0.4)mm2,(P<0.01),VIRA(1.53+/-0.4,1.11+/-0.3)mm2,(P<0.01),盘沿容积(0.42+/-0.1,0.26+/-0.1)mm3,(P<0.061),杯盘比(0.31+/-0.2,0.62+/-0.2),(P<0.01)。结论OCT在开角型青光眼的早期诊断中具有重要价值。展开更多
AIM：To evaluate whether optical coherence tomography angiography（OCTA） can detect altered vessel density（VD） at the optic nerve head（ONH） in glaucoma patients.Special attention is paid to the accuracy of the OC...AIM：To evaluate whether optical coherence tomography angiography（OCTA） can detect altered vessel density（VD） at the optic nerve head（ONH） in glaucoma patients.Special attention is paid to the accuracy of the OCTA technique for distinguishing healthy from glaucomatous eyes.METHODS：A total of 171 eyes were examined by the OCTA system Angio Vue^TM（Optovue）：97 eyes diagnosed with glaucoma and 74 healthy control eyes.The papillary and peripapillary VD was measured.Furthermore,the VD was correlated with different structural and functional measurements.In order to test the accuracy of differentiation between eyes with and without glaucoma,we calculated the receiver operating characteristic curve（ROC） and the area under the curve（AUC）.RESULTS：The papillary and peripapillary VD in glaucomatous eyes was significantly lower than in healthy eyes（P〈0.05）.The VD of the nasal peripapillary sector was significantly lower than in the other sectors.The further the disease had progressed [measured by determining the thickness of the ganglion cell complex（GCC） and the retinal nerve fiber layer（RNFL）] the greater the VD reduction.The AUC discriminated well between glaucomatous and normal eyes（consensus classifier 94.2%）.CONCLUSION：OCTA allows non-invasive quantification of the peripapillary and papillary VD,which is significantly reduced in glaucomatous eyes and accurately distinguishes between healthy and diseased eyes.OCTA expands the spectrum of procedures for detecting and monitoring glaucoma.展开更多
AIM: To determine the discriminating performance of the macular ganglion cell-inner plexiform layer(GCIPL) parameters between all the consecutive stages of glaucoma(from healthy to moderate-to-severe glaucoma), and to...AIM: To determine the discriminating performance of the macular ganglion cell-inner plexiform layer(GCIPL) parameters between all the consecutive stages of glaucoma(from healthy to moderate-to-severe glaucoma), and to compare it with the discriminating performances of the peripapillary retinal nerve fiber layer(RNFL) parameters and optic nerve head(ONH) parameters.METHODS: Totally 147 eyes(40 healthy, 40 glaucoma suspects, 40 early glaucoma, and 27 moderate-to-severe glaucoma) of 133 subjects were included. Optical coherence tomography(OCT) was obtained using Cirrus HD-OCT 5000. The diagnostic performances of GC-IPL, RNFL, and ONH parameters were evaluated by determining the area under the curve(AUC) of the receiver operating characteristics. RESULTS: All GC-IPL parameters discriminated glaucoma suspect patients from subjects with healthy eyes and moderate-to-severe glaucoma from early glaucoma patients(P<0.017, for all). Also, minimum, inferotemporal and inferonasal GC-IPL parameters discriminated early glaucoma patients from glaucoma suspects, whereas no RNFL or ONH parameter could discriminate between the two. The best parameters to discriminate glaucoma suspects from subjects with healthy eyes were superonasal GC-IPL, superior RNFL and average c/d ratio(AUC=0.746, 0.810 and 0.746, respectively). Discriminating performances of all the parameters for early glaucoma vs glaucoma suspect comparison were lower than that of the other consecutive group comparisons, with the bestGC-IPL parameters being minimum and inferotemporal(AUC=0.669 and 0.662, respectively). Moreover, minimum GC-IPL, average RNFL, and rim area(AUC=0.900, 0.858, 0.768, respectively) were the best parameters for discriminating moderate-to-severe glaucoma patients from early glaucoma patients.CONCLUSION: GC-IPL parameters can discriminate glaucoma suspect patients from subjects with healthy eyes, and also all the consecutive stages of glaucoma from each other(from glaucoma suspect to moderate-tosevere glaucoma). Further, the discriminating performa展开更多
In this review, we summarize the progression of several parameters assessed by spectral-domain optical coherence tomography （SD-OCT） in recent years for the detection of glaucoma. Monitoring the progression of defec...In this review, we summarize the progression of several parameters assessed by spectral-domain optical coherence tomography （SD-OCT） in recent years for the detection of glaucoma. Monitoring the progression of defects in the retinal nerve fiber layer （RNFL） thickness is essential. Imaging and analysis of retinal ganglion cells （RGCs） and inner plexiform layer （IPL）, respectively, have been of great importance. Optic nerve head （ONH） topography obtained from 3D SD-OCT images is another crucial step. Other important assessments involve locating the Bruch＇s membrane opening （BMO）, estimating the optic disc size and rim area, and measuring the lamina cribrosa displacement. Still other parameters found in the past three years for glaucoma diagnosis comprise central retinal artery resistive index, optic disc perfusion in optical coherence tomography angiography （OCTA） study, peripapillary choroidal thickness, and choroidal area in SD-OCT. Recently, several more ocular fundus parameters have been found, and compared with the earlier parameters to judge the accuracy of diagnosis. While a few of these parameters have been widely used in clinical practice, a fair number are still in the experimental stage.展开更多
AIM: To analyze changes of the optic nerve head(ONH) and peripapillary region during intraocular pressure(IOP) elevation in patients using spectral domain optical coherence tomography(SD-OCT).METHODS: Both an optic di...AIM: To analyze changes of the optic nerve head(ONH) and peripapillary region during intraocular pressure(IOP) elevation in patients using spectral domain optical coherence tomography(SD-OCT).METHODS: Both an optic disc 200×200 cube scan and a high-definition 5-line raster scan were obtained from open angle glaucoma patients presented with monocular elevation of IOP(≥30 mm Hg) using SD-OCT. Additional baseline characteristics included age, gender, diagnosis,best-corrected visual acuity, refractive error, findings of slit lamp biomicroscopy, findings of dilated stereoscopic examination of the ONH and fundus, IOP, pachymetry findings, and the results of visual field.RESULTS: The 24 patients were selected and divided into two groups: group 1 patients had no history of IOP elevation or glaucoma(n =14), and group 2 patients did have history of IOP elevation or glaucoma(n =10). In each patient, the study eye with elevated IOP was classified into group H(high), and the fellow eye was classified into group L(low). The mean deviation(MD)differed significantly between groups H and L when all eyes were considered(P =0.047) and in group 2(P =0.042), not in group 1(P =0.893). Retinal nerve fiber layer(RNFL) average thickness(P =0.050), rim area(P =0.015),vertical cup/disc ratio(P =0.011), cup volume(P =0.028),inferior quadrant RNFL thickness(P =0.017), and clockhour(1, 5, and 6) RNFL thicknesses(P =0.050, 0.012, and0.018, respectively), cup depth(P =0.008), central prelaminar layer thickness(P =0.023), mid-inferior prelaminar layer thickness(P =0.023), and nasal retinal slope(P =0.034)were significantly different between the eyes with groups H and L.CONCLUSION:RNFLaveragethickness,rim area,vertical cup/disc ratio, cup volume, inferior quadrant RNFL thickness, and clock-hour(1, 5, and 6) RNFL thicknesses significantly changed during acute IOP elevation.展开更多
文摘目的使用OCT评估正常眼与原发性开角型青光眼(primary open angle glaucoma,POAG)视盘(opticnerve head,ONH)的差异。方法选择具有青光眼性视神经损害或RNFL缺损、相应的视野缺损的开角型青光眼60例(60只眼),另选择正常眼60例(60只眼)作为正常对照组。对二组患者进行详细的眼科检查,并使用光学相干断层扫描仪(optical coherence tomography,OCT)测定视盘形态。OCT检查采用视盘扫描模式,评估数据包括视盘面积、视杯面积、盘沿面积、垂直盘沿面积(vertical integrated rim area,VIRA)、水平盘沿容积、平均杯盘比、水平和垂直杯盘比以及视杯容积。比较二组视盘参数,并比较平均误差(mean deviation,MD)和校正模型标准变异(correc-ted pattern standard deviation CPSD)与青光眼组的视盘参数有无相关。结果原发性开角型青和正常组之间视盘参数的比较具有显著性差异。正常眼、POAG比较分别为:视盘面积(211+/-0.5,2.62+/-0.4)mm2,(P<0.01),视杯面积(0.65+/-0.5,1.79+/-0.6)mm2,(P<0.01),盘沿面积(1.44+/-0.4,0.89+/-0.4)mm2,(P<0.01),VIRA(1.53+/-0.4,1.11+/-0.3)mm2,(P<0.01),盘沿容积(0.42+/-0.1,0.26+/-0.1)mm3,(P<0.061),杯盘比(0.31+/-0.2,0.62+/-0.2),(P<0.01)。结论OCT在开角型青光眼的早期诊断中具有重要价值。
文摘AIM：To evaluate whether optical coherence tomography angiography（OCTA） can detect altered vessel density（VD） at the optic nerve head（ONH） in glaucoma patients.Special attention is paid to the accuracy of the OCTA technique for distinguishing healthy from glaucomatous eyes.METHODS：A total of 171 eyes were examined by the OCTA system Angio Vue^TM（Optovue）：97 eyes diagnosed with glaucoma and 74 healthy control eyes.The papillary and peripapillary VD was measured.Furthermore,the VD was correlated with different structural and functional measurements.In order to test the accuracy of differentiation between eyes with and without glaucoma,we calculated the receiver operating characteristic curve（ROC） and the area under the curve（AUC）.RESULTS：The papillary and peripapillary VD in glaucomatous eyes was significantly lower than in healthy eyes（P〈0.05）.The VD of the nasal peripapillary sector was significantly lower than in the other sectors.The further the disease had progressed [measured by determining the thickness of the ganglion cell complex（GCC） and the retinal nerve fiber layer（RNFL）] the greater the VD reduction.The AUC discriminated well between glaucomatous and normal eyes（consensus classifier 94.2%）.CONCLUSION：OCTA allows non-invasive quantification of the peripapillary and papillary VD,which is significantly reduced in glaucomatous eyes and accurately distinguishes between healthy and diseased eyes.OCTA expands the spectrum of procedures for detecting and monitoring glaucoma.
文摘AIM: To determine the discriminating performance of the macular ganglion cell-inner plexiform layer(GCIPL) parameters between all the consecutive stages of glaucoma(from healthy to moderate-to-severe glaucoma), and to compare it with the discriminating performances of the peripapillary retinal nerve fiber layer(RNFL) parameters and optic nerve head(ONH) parameters.METHODS: Totally 147 eyes(40 healthy, 40 glaucoma suspects, 40 early glaucoma, and 27 moderate-to-severe glaucoma) of 133 subjects were included. Optical coherence tomography(OCT) was obtained using Cirrus HD-OCT 5000. The diagnostic performances of GC-IPL, RNFL, and ONH parameters were evaluated by determining the area under the curve(AUC) of the receiver operating characteristics. RESULTS: All GC-IPL parameters discriminated glaucoma suspect patients from subjects with healthy eyes and moderate-to-severe glaucoma from early glaucoma patients(P<0.017, for all). Also, minimum, inferotemporal and inferonasal GC-IPL parameters discriminated early glaucoma patients from glaucoma suspects, whereas no RNFL or ONH parameter could discriminate between the two. The best parameters to discriminate glaucoma suspects from subjects with healthy eyes were superonasal GC-IPL, superior RNFL and average c/d ratio(AUC=0.746, 0.810 and 0.746, respectively). Discriminating performances of all the parameters for early glaucoma vs glaucoma suspect comparison were lower than that of the other consecutive group comparisons, with the bestGC-IPL parameters being minimum and inferotemporal(AUC=0.669 and 0.662, respectively). Moreover, minimum GC-IPL, average RNFL, and rim area(AUC=0.900, 0.858, 0.768, respectively) were the best parameters for discriminating moderate-to-severe glaucoma patients from early glaucoma patients.CONCLUSION: GC-IPL parameters can discriminate glaucoma suspect patients from subjects with healthy eyes, and also all the consecutive stages of glaucoma from each other(from glaucoma suspect to moderate-tosevere glaucoma). Further, the discriminating performa
基金Supported by the National Natural Science Foundation of China(No.81300755)the Key Project of the Natural Science Foundation of the Higher Educational Bureau of Anhui Province(No.KJ2013A147)
文摘In this review, we summarize the progression of several parameters assessed by spectral-domain optical coherence tomography （SD-OCT） in recent years for the detection of glaucoma. Monitoring the progression of defects in the retinal nerve fiber layer （RNFL） thickness is essential. Imaging and analysis of retinal ganglion cells （RGCs） and inner plexiform layer （IPL）, respectively, have been of great importance. Optic nerve head （ONH） topography obtained from 3D SD-OCT images is another crucial step. Other important assessments involve locating the Bruch＇s membrane opening （BMO）, estimating the optic disc size and rim area, and measuring the lamina cribrosa displacement. Still other parameters found in the past three years for glaucoma diagnosis comprise central retinal artery resistive index, optic disc perfusion in optical coherence tomography angiography （OCTA） study, peripapillary choroidal thickness, and choroidal area in SD-OCT. Recently, several more ocular fundus parameters have been found, and compared with the earlier parameters to judge the accuracy of diagnosis. While a few of these parameters have been widely used in clinical practice, a fair number are still in the experimental stage.
文摘AIM: To analyze changes of the optic nerve head(ONH) and peripapillary region during intraocular pressure(IOP) elevation in patients using spectral domain optical coherence tomography(SD-OCT).METHODS: Both an optic disc 200×200 cube scan and a high-definition 5-line raster scan were obtained from open angle glaucoma patients presented with monocular elevation of IOP(≥30 mm Hg) using SD-OCT. Additional baseline characteristics included age, gender, diagnosis,best-corrected visual acuity, refractive error, findings of slit lamp biomicroscopy, findings of dilated stereoscopic examination of the ONH and fundus, IOP, pachymetry findings, and the results of visual field.RESULTS: The 24 patients were selected and divided into two groups: group 1 patients had no history of IOP elevation or glaucoma(n =14), and group 2 patients did have history of IOP elevation or glaucoma(n =10). In each patient, the study eye with elevated IOP was classified into group H(high), and the fellow eye was classified into group L(low). The mean deviation(MD)differed significantly between groups H and L when all eyes were considered(P =0.047) and in group 2(P =0.042), not in group 1(P =0.893). Retinal nerve fiber layer(RNFL) average thickness(P =0.050), rim area(P =0.015),vertical cup/disc ratio(P =0.011), cup volume(P =0.028),inferior quadrant RNFL thickness(P =0.017), and clockhour(1, 5, and 6) RNFL thicknesses(P =0.050, 0.012, and0.018, respectively), cup depth(P =0.008), central prelaminar layer thickness(P =0.023), mid-inferior prelaminar layer thickness(P =0.023), and nasal retinal slope(P =0.034)were significantly different between the eyes with groups H and L.CONCLUSION:RNFLaveragethickness,rim area,vertical cup/disc ratio, cup volume, inferior quadrant RNFL thickness, and clock-hour(1, 5, and 6) RNFL thicknesses significantly changed during acute IOP elevation.
