AIM:To assess the performance of macular ganglion cell-inner plexiform layer thickness(mGCIPLT)and 10-2 visual field(VF)parameters in detecting early glaucoma and evaluating the severity of advanced glaucoma.METHODS:T...AIM:To assess the performance of macular ganglion cell-inner plexiform layer thickness(mGCIPLT)and 10-2 visual field(VF)parameters in detecting early glaucoma and evaluating the severity of advanced glaucoma.METHODS:Totally 127 eyes from 89 participants(36 eyes of 19 healthy participants,45 eyes of 31 early glaucoma patients and 46 eyes of 39 advanced glaucoma patients)were included.The relationships between the optical coherence tomography(OCT)-derived parameters and VF sensitivity were determined.Patients with early glaucoma were divided into eyes with or without central 10°of the VF damages(CVFDs),and the diagnostic performances of OCT-derived parameters were assessed.RESULTS:In early glaucoma,the mGCIPLT was significantly correlated with 10-2 VF pattern standard deviation(PSD;with average mGCIPLT:β=-0.046,95%CI,-0.067 to-0.024,P<0.001).In advanced glaucoma,the mGCIPLT was related to the 24-2 VF mean deviation(MD;with average mGCIPLT:β=0.397,95%CI,0.199 to 0.595,P<0.001),10-2 VF MD(with average mGCIPLT:β=0.762,95%CI,0.485 to 1.038,P<0.001)and 24-2 VF PSD(with average mGCIPLT:β=0.244,95%CI,0.124 to 0.364,P<0.001).Except for the minimum and superotemporal mGCIPLT,the decrease of mGCIPLT in early glaucomatous eyes with CVFDs was more severe than that of early glaucomatous eyes without CVFDs.The area under the curve(AUC)of the average mGCIPLT(AUC=0.949,95%CI,0.868 to 0.982)was greater than that of the average circumpapillary retinal nerve fiber layer thickness(cpRNFLT;AUC=0.827,95%CI,0.674 to 0.918)and rim area(AUC=0.799,95%CI,0.610 to 0.907)in early glaucomatous eyes with CVFDs versus normal eyes.CONCLUSION:The 10-2 VF and mGCIPLT parameters are complementary to 24-2 VF,cpRNFLT and ONH parameters,especially in detecting early glaucoma with CVFDs and evaluating the severity of advanced glaucoma in group level.展开更多
AIM: To evaluate the patterns of macular ganglion cell-inner plexiform layer(GCIPL) loss in normal tension glaucoma(NTG) and primary open angle glaucoma(POAG) in a detailed, disease severity-matched way;and to assess ...AIM: To evaluate the patterns of macular ganglion cell-inner plexiform layer(GCIPL) loss in normal tension glaucoma(NTG) and primary open angle glaucoma(POAG) in a detailed, disease severity-matched way;and to assess the diagnostic capabilities of GCIPL thickness parameters in discriminating NTG or POAG from normal subjects.METHODS: A total of 157 eyes of 157 subjects, including 57 normal eyes, 51 eyes with POAG and 49 eyes with NTG were enrolled and strictly matched in age, refraction, and disease severity between POAG and NTG groups. The average, minimum, superotemporal, superior, superonasal, inferonasal, inferior, and inferotemporal GCIPL thickness, and the average, superior, temporal, inferior, and nasal retinal nerve fiber layer(RNFL) thickness were obtained by Cirrus optical coherence tomography(OCT). The diagnostic capabilities of OCT parameters were assessed by area under receiver operating characteristic(AUROC) curves. RESULTS: Among all the OCT thickness parameters, no statistical significant difference between NTG group and POAG group was found(all P>0.05). In discriminating NTG or POAG from normal subjects, the average and inferior RNFL thickness, and the minimum GCIPL thickness had better diagnostic capabilities. There was no significant difference in AUROC curve between the best GCIPL thickness parameter(minimum GCIPL) and the best RNFL thickness parameter in discriminating NTG(inferior RNFL;P=0.076) and indiscriminating POAG(average RNFL;P=0.913) from normal eyes.CONCLUSION: Localized GCIPL loss, especially in the inferior and inferotemporal sectors, is more common in NTG than in POAG. Among all the GCIPL thickness parameters, the minimum GCIPL thickness has the best diagnostic performance in differentiating NTG or POAG from normal subjects, which is comparable to that of the average and inferior RNFL thickness.展开更多
AIM:To evaluate retinal nerve fiber layer(RNFL)thickness analysis of peripapillary optic nerve head(PONH) and macula as well as ganglion cell-inner plexiform layer(GCIPL) thickness in obese children.· METH...AIM:To evaluate retinal nerve fiber layer(RNFL)thickness analysis of peripapillary optic nerve head(PONH) and macula as well as ganglion cell-inner plexiform layer(GCIPL) thickness in obese children.· METHODS:Eighty-five children with obesity and 30 controls were included in the study.The thicknesses of the PONH and macula of each subject's right eye were measured by high-resolution spectral-domain optic coherence tomography(OCT).· RESULTS:The RNFL thicknesses of central macular and PONH were similar between the groups(all P 〉0.05).The GCIPL thickness was also similar between the groups.However,the RNFL thickness of temporal outer macula were 261.7±13.7 and 268.9±14.3 μm for the obesity and the control group,respectively(P =0.034).· CONCLUSION:Obesity may cause a reduction in temporal outer macular RNFL thickness.展开更多
AIM:To compare the damage pattern of the peripapillary retinal nerve fiber layer(pRNFL)and the macular ganglion cell-inner plexiform layer(mGCIPL)between early glaucomatous and non-glaucomatous optic neuropathy(EGON a...AIM:To compare the damage pattern of the peripapillary retinal nerve fiber layer(pRNFL)and the macular ganglion cell-inner plexiform layer(mGCIPL)between early glaucomatous and non-glaucomatous optic neuropathy(EGON and NGON).METHODS:It is a cross-sectional study.Thirty-eight healthy controls,74 EGONs and 70 NGONs with comparable average pRNFL loss were included.The NGON group included 23 eyes of optic neuritis(ON),13 eyes of hereditary optic neuropathy(HON),19 eyes of toxic optic neuropathy(TON)and 15 eyes of compressive neuropathy(CON).The sectoral pRNFL and mGCIPL thickness obtained by high definition optical coherence tomography were analyzed.RESULTS:Compared to normal controls,the pRNFL thickness in all quadrants showed a decrease in both EGON and NGON group(P<0.001),but the average pRNFL thickness of EGON group was not different to that of NGON group(P=0.94).The inferior and superior pRNFL was thinner in EGON group compared to NGON group(P<0.001).The temporal pRNFL was thinner in NGON group compared to EGON group(P<0.001).No statistically significant difference was found in nasal pRNFL between EGON and NGON.While the nasal pRNFL was thinner in CON than other three types of NGON(P=0.01),no statistically significant difference was found in other three quadrantal pRNFL among the four types of NGON(P>0.05).The mGCIPL of EGON and NGON group were thinner than control group(P<0.001).In EGON group the severest sites of mGCIPL reduction was located at inferotemporal and inferior sectors.While,compared to EGON group,the average mGCIPL of NGON groupwere significantly thinner,especially in superonasal and inferonasal sectors(P<0.001).CONCLUSION:The damage pattern of pRNFL and mGCIPL caused by glaucoma is distinct from other NGON such as ON,TON,HON and CON,and this characteristic damage pattern is helpful in differentiating early glaucoma from other NGON.展开更多
AIM: To determine the thickness of the retinal ganglion cell-inner plexiform layer(GCIPL) and the retinal nerve fiber layer(RNFL) in patients with neuromyelitis optica(NMO).METHODS: We conducted a cross-sectio...AIM: To determine the thickness of the retinal ganglion cell-inner plexiform layer(GCIPL) and the retinal nerve fiber layer(RNFL) in patients with neuromyelitis optica(NMO).METHODS: We conducted a cross-sectional study that included 30 NMO patients with a total of 60 eyes. Based on the presence or absence of optic neuritis(ON), subjects were divided into either the NMO-ON group(30 eyes) or the NMO-ON contra group(10 eyes). A detailed ophthalmologic examination was performed for each group; subsequently, the GCIPL and the RNFL were measured using highdefinition optical coherence tomography(OCT). RESULTS: In the NMO-ON group, the mean GCIPL thickness was 69.28±21.12 μm, the minimum GCIPL thickness was 66.02±10.02 μm, and the RNFL thickness were 109.33±11.23, 110.47±3.10, 64.92±12.71 and 71.21±50.22 μm in the superior, inferior, temporal and nasal quadrants, respectively. In the NMO-ON contra group, the mean GCIPL thickness was 85.12±17.09 μm, the minimum GCIPL thickness was 25.39±25.1 μm, and the RNFL thicknesses were 148.33±23.22, 126.36±23.45, 82.21±22.30 and 83.36±31.28 μm in the superior, inferior, temporal and nasal quadrants, respectively. In the control group, the mean GCIPL thickness was 86.98±22.37 μm, the minimum GCIPL thickness was 85.28±10.75 μm, and the RNFL thicknesses were 150.22±22.73, 154.79±60.23, 82.33±7.01 and 85.62±13.81 μm in the superior, inferior, temporal and nasal quadrants, respectively. The GCIPL and RNFL were thinner in the NMO-ON contra group than in the control group(P〈0.05); additionally, the RNFL was thinner in the inferior quadrant in the NMO-ON group than in the control group(P〈0.05). Significant correlations were observed between the GCIPL and RNFL thickness measurements as well as between thickness measurements and the two visual field parameters of mean deviation(MD) and corrected pattern standard deviation(PSD) in the NMO-ON group(P〈0.05). CONCLUSION: The thickness of the GCIPL and RNFL, as measured using OCT, may indicate optic nerve damage in patients with NMO.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 performance of GC-IPL thicknesses is comparable to that.展开更多
The integrity of retinal ganglion cells is tightly associated with diabetic macular degeneration that leads to damage and death of retinal ganglion cells,affecting vision.The major clinical treatments for diabetic mac...The integrity of retinal ganglion cells is tightly associated with diabetic macular degeneration that leads to damage and death of retinal ganglion cells,affecting vision.The major clinical treatments for diabetic macular edema are anti-vascular endothelial growth factor drugs and laser photocoagulation.However,although the macular thickness can be normalized with each of these two therapies used alone,the vision does not improve in many patients.This might result from the incomplete recovery of retinal ganglion cell injury.Therefore,a prospective,non-randomized,controlled clinical trial was designed to investigate the effect of anti-vascular endothelial growth factor drugs combined with laser photocoagulation on the integrity of retinal ganglion cells in patients with diabetic macular edema and its relationship with vision recovery.In this trial,150 patients with diabetic macular edema will be equally divided into three groups according to therapeutic methods,followed by treatment with anti-vascular endothelial growth factor drugs,laser photocoagulation therapy,and their combination.All patients will be followed up for 12 months.The primary outcome measure is retinal ganglion cell-inner plexiform layer thickness at 12 months after treatment.The secondary outcome measures include retinal ganglion cell-inner plexiform layer thickness before and 1,3,6,and 9 months after treatment,retinal nerve fiber layer thickness,best-corrected visual acuity,macular area thickness,and choroidal thickness before and 1,3,6,9,and 12 months after treatment.Safety measure is the incidence of adverse events at 1,3,6,9,and 12 months after treatment.The study protocol hopes to validate the better efficacy and safety of the combined treatment in patients with diabetic macula compared with the other two monotherapies alone during the 12-month follow-up period.The trial is designed to focus on clarifying the time-effect relationship between imaging measures related to the integrity of retinal ganglion cells and best-corrected visual acuity.The trial protocol was approved by the Medical Ethics Committee of the Affiliated Hospital of Beihua University with approval No.(2023)(26)on April 25,2023,and was registered with the Chinese Clinical Trial Registry(registration number:ChiCTR2300072478,June 14,2023,protocol version:2.0).展开更多
AIM:To compare the macular ganglion cell-inner plexiform layer(GCIPL)thickness,retinal nerve fiber layer(RNFL)thickness,optic nerve head(ONH)parameters,and retinal vessel density(VD)measured by spectral-domain optical...AIM:To compare the macular ganglion cell-inner plexiform layer(GCIPL)thickness,retinal nerve fiber layer(RNFL)thickness,optic nerve head(ONH)parameters,and retinal vessel density(VD)measured by spectral-domain optical coherence tomography(SD-OCT)and analyze the correlations between them in the early,moderate,severe primary angle-closure glaucoma(PACG)and normal eyes.METHODS:Totally 70 PACG eyes and 20 normal eyes were recruited for this retrospective analysis.PACG eyes were further separated into early,moderate,or severe PACG eyes using the Enhanced Glaucoma Staging System(GSS2).The GCIPL thickness,RNFL thickness,ONH parameters,and retinal VD were measured by SD-OCT,differences among the groups and correlations within the same group were calculated.RESULTS:The inferior and superotemporal sectors of the GCIPL thickness,rim area of ONH,average and inferior sector of the retinal VD were significantly reduced(all P<0.05)in the early PACG eyes compared to the normal and the optic disc area,cup to disc ratio(C/D),and cup volume were significantly higher(all P<0.05);but the RNFL was not significant changes in early and moderate PACG.In severe group,the GCIPL and RNFL thickness were obvious thinning with retinal VD were decreasing as well as C/D and cup volume increasing than other three groups(all P<0.01).In the early PACG subgroup,there were significant positive correlations between retinal VD and GCIPL thickness(except superonasal and inferonasal sectors,r=0.573 to 0.641,all P<0.05),superior sectors of RNFL thickness(r=0.055,P=0.049).More obvious significant positive correlations were existed in moderate PACG eyes between retinal VD and superior sectors of RNFL thickness(r=0.650,P=0.022),and temporal sectors of RNFL thickness(r=0.740,P=0.006).In the severe PACG eyes,neither GCIPL nor RNFL thickness was associated with retinal VD.CONCLUSION:The ONH damage and retinal VD loss appears earlier than RNFL thickness loss in PACG eyes.As the PACG disease progressed from the early to the moderate stage,the correlations between the retinal VD and RNFL thickness increases.展开更多
AIM: To evaluate the diagnostic ability of macular ganglion cell-inner plexiform layer(GCIPL) thickness o b t a i n e d b y s p e c t r a l-d o m a i n o p t i c a l c o h e r e n c e tomography(SD-OCT) in discriminat...AIM: To evaluate the diagnostic ability of macular ganglion cell-inner plexiform layer(GCIPL) thickness o b t a i n e d b y s p e c t r a l-d o m a i n o p t i c a l c o h e r e n c e tomography(SD-OCT) in discriminating non-highly myopic eyes with preperimetric glaucoma(PPG) from highly myopic healthy eyes. METHODS: A total of 254 eyes, including 76 normal controls(NC), 116 eyes with high myopia(HM) and 62 non-highly myopic eyes with PPG were enrolled. The diagnostic ability of OCT parameters was accessed by the areas under the receiver operating characteristic(AUROC) curve in two distinguishing groups: PPG eyes with nonglaucomatous eyes including NC and HM(Group 1), and PPG eyes with HM eyes(Group 2). Differences in diagnostic performance between GCIPL and RNFL parameters were evaluated. RESULTS: The minimum(AUROC curve of 0.782), inferotemporal(0.758) and inferior(0.705) GCIPL thickness were the top three GCIPL parameters in discriminating PPG from non-glaucomatous eyes, all of which had statistically significant lower diagnostic ability than average RNFL thickness(0.847). In discriminating PPG from HM, the best GCIPL parameter was minimum(0.689), statistically significant lower in diagnostic ability than average RNFL thickness(0.789) and three other RNFL thickness parameters of temporal and inferotemporal clock-hour sectors. CONCLUSION: The minimum GCIPL thickness is the best GCIPL parameter to detect non-highly myopic PPG from highly myopic eyes, whose diagnostic ability is inferiorto that of average RNFL thickness and RNFL thickness of several temporal and inferotemporal clock-hour sectors. The average RNFL thickness is recommended for discriminating PPG from highly myopic healthy eyes in current clinical practice in a Chinese population.展开更多
BACKGROUND Ethambutol-induced optic neuropathy(EON)most commonly manifests as bilateral symmetrical loss of vision and often cause serious and irreversible visual impairment because of the lack of early detection and ...BACKGROUND Ethambutol-induced optic neuropathy(EON)most commonly manifests as bilateral symmetrical loss of vision and often cause serious and irreversible visual impairment because of the lack of early detection and effective treatment.We followed a case of EON with rare binocular asymmetric clinical manifestations and observed the changes of visual function and retinal structure after drug withdrawal,so as to further understand the clinical characteristics of this disease.CASE SUMMARY A 54-year-old man complained of gradual visual decline in the left eye.The patient presented with best-corrected visual acuity of 20/20 in the right eye and 20/50 in the left eye.Color vision examination revealed difficulty in reading green color plates in the left eye.The visual field manifested as concentric contraction in the left eye.After nearly a month of drug withdrawal,the right eye had a similar decline in visual function.At the last visit,19 mo after drug withdrawal,the visual function significantly recovered in both eyes.During follow-up optical coherence tomography(OCT)examination,both eyes manifested the thickness of the retinal nerve fiber layer from mild thickening to thinning and finally temporal atrophy,and the ganglion cell-inner plexiform layer showed significant thinning.The difference was that a reversible structural disorder in the outer retina of the nasal macula was detected in the left eye by macular high-definition OCT.CONCLUSION Nephropathy and high blood pressure,which damage the retinal microcirculation,may cause damage to the outer layer of the retina.Ethambutol may influence photoreceptor as well as retinal ganglion cells.展开更多
Optical coherence tomography(OCT)is an ocular imaging technique that can complement the neuro-ophthalmic assessment,and inform our understanding regarding functional consequences of neuroaxonal injury in the afferent ...Optical coherence tomography(OCT)is an ocular imaging technique that can complement the neuro-ophthalmic assessment,and inform our understanding regarding functional consequences of neuroaxonal injury in the afferent visual pathway.Indeed,OCT has emerged as a surrogate end-point in the diagnosis and follow up of several demyelinating syndromes of the central nervous system(CNS),including optic neuritis(ON)associated with:multiple sclerosis(MS),neuromyelitis optica spectrum disorder(NMOSD),and anti-myelin oligodendrocyte glycoprotein(MOG)antibodies.Recent advancements in enhanced depth imaging(EDI)OCT have distinguished this technique as a new gold standard in the diagnosis of optic disc drusen(ODD).Moreover,OCT may enhance our ability to distinguish cases of papilledema from pseudopapilledema caused by ODD.In the setting of idiopathic intracranial hypertension(IIH),OCT has shown benefit in tracking responses to treatment,with respect to reduced retinal nerve fiber layer(RNFL)measures and morphological changes in the angling of Bruch’s membrane.Longitudinal follow up of OCT measured ganglion cell-inner plexiform layer thickness may be of particular value in managing IIH patients who have secondary optic atrophy.Causes of compressive optic neuropathies may be readily diagnosed with OCT,even in the absence of overt visual field defects.Furthermore,OCT values may offer some prognostic value in predicting post-operative outcomes in these patients.Finally,OCT can be indispensable in differentiating optic neuropathies from retinal diseases in patients presenting with vision loss,and an unrevealing fundus examination.In this review,our over-arching goal is to highlight the potential role of OCT,as an ancillary investigation,in the diagnosis and management of various optic nerve disorders.展开更多
基金National Natural Science Foundation of China(No.81860170).
文摘AIM:To assess the performance of macular ganglion cell-inner plexiform layer thickness(mGCIPLT)and 10-2 visual field(VF)parameters in detecting early glaucoma and evaluating the severity of advanced glaucoma.METHODS:Totally 127 eyes from 89 participants(36 eyes of 19 healthy participants,45 eyes of 31 early glaucoma patients and 46 eyes of 39 advanced glaucoma patients)were included.The relationships between the optical coherence tomography(OCT)-derived parameters and VF sensitivity were determined.Patients with early glaucoma were divided into eyes with or without central 10°of the VF damages(CVFDs),and the diagnostic performances of OCT-derived parameters were assessed.RESULTS:In early glaucoma,the mGCIPLT was significantly correlated with 10-2 VF pattern standard deviation(PSD;with average mGCIPLT:β=-0.046,95%CI,-0.067 to-0.024,P<0.001).In advanced glaucoma,the mGCIPLT was related to the 24-2 VF mean deviation(MD;with average mGCIPLT:β=0.397,95%CI,0.199 to 0.595,P<0.001),10-2 VF MD(with average mGCIPLT:β=0.762,95%CI,0.485 to 1.038,P<0.001)and 24-2 VF PSD(with average mGCIPLT:β=0.244,95%CI,0.124 to 0.364,P<0.001).Except for the minimum and superotemporal mGCIPLT,the decrease of mGCIPLT in early glaucomatous eyes with CVFDs was more severe than that of early glaucomatous eyes without CVFDs.The area under the curve(AUC)of the average mGCIPLT(AUC=0.949,95%CI,0.868 to 0.982)was greater than that of the average circumpapillary retinal nerve fiber layer thickness(cpRNFLT;AUC=0.827,95%CI,0.674 to 0.918)and rim area(AUC=0.799,95%CI,0.610 to 0.907)in early glaucomatous eyes with CVFDs versus normal eyes.CONCLUSION:The 10-2 VF and mGCIPLT parameters are complementary to 24-2 VF,cpRNFLT and ONH parameters,especially in detecting early glaucoma with CVFDs and evaluating the severity of advanced glaucoma in group level.
基金Supported by National Natural Science Foundation of China(No.81800879)Natural Science Foundation of Guangdong Province(No.2017A030310372)+2 种基金Fundamental Research Funds of the State Key Laboratory of Ophthalmology,China(No.2018KF04 No.2017QN05)Sun Yat-Sen University Clinical Research 5010 Program(No.2014016)
文摘AIM: To evaluate the patterns of macular ganglion cell-inner plexiform layer(GCIPL) loss in normal tension glaucoma(NTG) and primary open angle glaucoma(POAG) in a detailed, disease severity-matched way;and to assess the diagnostic capabilities of GCIPL thickness parameters in discriminating NTG or POAG from normal subjects.METHODS: A total of 157 eyes of 157 subjects, including 57 normal eyes, 51 eyes with POAG and 49 eyes with NTG were enrolled and strictly matched in age, refraction, and disease severity between POAG and NTG groups. The average, minimum, superotemporal, superior, superonasal, inferonasal, inferior, and inferotemporal GCIPL thickness, and the average, superior, temporal, inferior, and nasal retinal nerve fiber layer(RNFL) thickness were obtained by Cirrus optical coherence tomography(OCT). The diagnostic capabilities of OCT parameters were assessed by area under receiver operating characteristic(AUROC) curves. RESULTS: Among all the OCT thickness parameters, no statistical significant difference between NTG group and POAG group was found(all P>0.05). In discriminating NTG or POAG from normal subjects, the average and inferior RNFL thickness, and the minimum GCIPL thickness had better diagnostic capabilities. There was no significant difference in AUROC curve between the best GCIPL thickness parameter(minimum GCIPL) and the best RNFL thickness parameter in discriminating NTG(inferior RNFL;P=0.076) and indiscriminating POAG(average RNFL;P=0.913) from normal eyes.CONCLUSION: Localized GCIPL loss, especially in the inferior and inferotemporal sectors, is more common in NTG than in POAG. Among all the GCIPL thickness parameters, the minimum GCIPL thickness has the best diagnostic performance in differentiating NTG or POAG from normal subjects, which is comparable to that of the average and inferior RNFL thickness.
基金partially presented at the 7~(th) Mediteretina Club International Meeting,April 17-20,2014,Istanbul
文摘AIM:To evaluate retinal nerve fiber layer(RNFL)thickness analysis of peripapillary optic nerve head(PONH) and macula as well as ganglion cell-inner plexiform layer(GCIPL) thickness in obese children.· METHODS:Eighty-five children with obesity and 30 controls were included in the study.The thicknesses of the PONH and macula of each subject's right eye were measured by high-resolution spectral-domain optic coherence tomography(OCT).· RESULTS:The RNFL thicknesses of central macular and PONH were similar between the groups(all P 〉0.05).The GCIPL thickness was also similar between the groups.However,the RNFL thickness of temporal outer macula were 261.7±13.7 and 268.9±14.3 μm for the obesity and the control group,respectively(P =0.034).· CONCLUSION:Obesity may cause a reduction in temporal outer macular RNFL thickness.
基金Supported by the Natural Science Foundation of Guangdong Province,China(No.2017A030313649)Sun Yatsen University Clinical Research 5010 Program(No.2014016)。
文摘AIM:To compare the damage pattern of the peripapillary retinal nerve fiber layer(pRNFL)and the macular ganglion cell-inner plexiform layer(mGCIPL)between early glaucomatous and non-glaucomatous optic neuropathy(EGON and NGON).METHODS:It is a cross-sectional study.Thirty-eight healthy controls,74 EGONs and 70 NGONs with comparable average pRNFL loss were included.The NGON group included 23 eyes of optic neuritis(ON),13 eyes of hereditary optic neuropathy(HON),19 eyes of toxic optic neuropathy(TON)and 15 eyes of compressive neuropathy(CON).The sectoral pRNFL and mGCIPL thickness obtained by high definition optical coherence tomography were analyzed.RESULTS:Compared to normal controls,the pRNFL thickness in all quadrants showed a decrease in both EGON and NGON group(P<0.001),but the average pRNFL thickness of EGON group was not different to that of NGON group(P=0.94).The inferior and superior pRNFL was thinner in EGON group compared to NGON group(P<0.001).The temporal pRNFL was thinner in NGON group compared to EGON group(P<0.001).No statistically significant difference was found in nasal pRNFL between EGON and NGON.While the nasal pRNFL was thinner in CON than other three types of NGON(P=0.01),no statistically significant difference was found in other three quadrantal pRNFL among the four types of NGON(P>0.05).The mGCIPL of EGON and NGON group were thinner than control group(P<0.001).In EGON group the severest sites of mGCIPL reduction was located at inferotemporal and inferior sectors.While,compared to EGON group,the average mGCIPL of NGON groupwere significantly thinner,especially in superonasal and inferonasal sectors(P<0.001).CONCLUSION:The damage pattern of pRNFL and mGCIPL caused by glaucoma is distinct from other NGON such as ON,TON,HON and CON,and this characteristic damage pattern is helpful in differentiating early glaucoma from other NGON.
基金Supported by Science and Technology Bureau Project Fund of Wenzhou, China (No.Y20160460)
文摘AIM: To determine the thickness of the retinal ganglion cell-inner plexiform layer(GCIPL) and the retinal nerve fiber layer(RNFL) in patients with neuromyelitis optica(NMO).METHODS: We conducted a cross-sectional study that included 30 NMO patients with a total of 60 eyes. Based on the presence or absence of optic neuritis(ON), subjects were divided into either the NMO-ON group(30 eyes) or the NMO-ON contra group(10 eyes). A detailed ophthalmologic examination was performed for each group; subsequently, the GCIPL and the RNFL were measured using highdefinition optical coherence tomography(OCT). RESULTS: In the NMO-ON group, the mean GCIPL thickness was 69.28±21.12 μm, the minimum GCIPL thickness was 66.02±10.02 μm, and the RNFL thickness were 109.33±11.23, 110.47±3.10, 64.92±12.71 and 71.21±50.22 μm in the superior, inferior, temporal and nasal quadrants, respectively. In the NMO-ON contra group, the mean GCIPL thickness was 85.12±17.09 μm, the minimum GCIPL thickness was 25.39±25.1 μm, and the RNFL thicknesses were 148.33±23.22, 126.36±23.45, 82.21±22.30 and 83.36±31.28 μm in the superior, inferior, temporal and nasal quadrants, respectively. In the control group, the mean GCIPL thickness was 86.98±22.37 μm, the minimum GCIPL thickness was 85.28±10.75 μm, and the RNFL thicknesses were 150.22±22.73, 154.79±60.23, 82.33±7.01 and 85.62±13.81 μm in the superior, inferior, temporal and nasal quadrants, respectively. The GCIPL and RNFL were thinner in the NMO-ON contra group than in the control group(P〈0.05); additionally, the RNFL was thinner in the inferior quadrant in the NMO-ON group than in the control group(P〈0.05). Significant correlations were observed between the GCIPL and RNFL thickness measurements as well as between thickness measurements and the two visual field parameters of mean deviation(MD) and corrected pattern standard deviation(PSD) in the NMO-ON group(P〈0.05). CONCLUSION: The thickness of the GCIPL and RNFL, as measured using OCT, may indicate optic nerve damage in patients with NMO.
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 performance of GC-IPL thicknesses is comparable to that.
基金supported by Science and Technology Research Project of Jilin Provincial Department of Education,No.JJKH20220072KJ(to XL)Science and Technology Development Program of Jilin Province,No.20200201495JC(to YL)。
文摘The integrity of retinal ganglion cells is tightly associated with diabetic macular degeneration that leads to damage and death of retinal ganglion cells,affecting vision.The major clinical treatments for diabetic macular edema are anti-vascular endothelial growth factor drugs and laser photocoagulation.However,although the macular thickness can be normalized with each of these two therapies used alone,the vision does not improve in many patients.This might result from the incomplete recovery of retinal ganglion cell injury.Therefore,a prospective,non-randomized,controlled clinical trial was designed to investigate the effect of anti-vascular endothelial growth factor drugs combined with laser photocoagulation on the integrity of retinal ganglion cells in patients with diabetic macular edema and its relationship with vision recovery.In this trial,150 patients with diabetic macular edema will be equally divided into three groups according to therapeutic methods,followed by treatment with anti-vascular endothelial growth factor drugs,laser photocoagulation therapy,and their combination.All patients will be followed up for 12 months.The primary outcome measure is retinal ganglion cell-inner plexiform layer thickness at 12 months after treatment.The secondary outcome measures include retinal ganglion cell-inner plexiform layer thickness before and 1,3,6,and 9 months after treatment,retinal nerve fiber layer thickness,best-corrected visual acuity,macular area thickness,and choroidal thickness before and 1,3,6,9,and 12 months after treatment.Safety measure is the incidence of adverse events at 1,3,6,9,and 12 months after treatment.The study protocol hopes to validate the better efficacy and safety of the combined treatment in patients with diabetic macula compared with the other two monotherapies alone during the 12-month follow-up period.The trial is designed to focus on clarifying the time-effect relationship between imaging measures related to the integrity of retinal ganglion cells and best-corrected visual acuity.The trial protocol was approved by the Medical Ethics Committee of the Affiliated Hospital of Beihua University with approval No.(2023)(26)on April 25,2023,and was registered with the Chinese Clinical Trial Registry(registration number:ChiCTR2300072478,June 14,2023,protocol version:2.0).
基金Supported by the Youth National Natural Science Foundation of China(No.81700800,No.81800800)the Natural Science Foundation of Shandong Province(No.ZR2017MH008)Taishan Scholar Project of Shandong Province(No.tsqn201812151)。
文摘AIM:To compare the macular ganglion cell-inner plexiform layer(GCIPL)thickness,retinal nerve fiber layer(RNFL)thickness,optic nerve head(ONH)parameters,and retinal vessel density(VD)measured by spectral-domain optical coherence tomography(SD-OCT)and analyze the correlations between them in the early,moderate,severe primary angle-closure glaucoma(PACG)and normal eyes.METHODS:Totally 70 PACG eyes and 20 normal eyes were recruited for this retrospective analysis.PACG eyes were further separated into early,moderate,or severe PACG eyes using the Enhanced Glaucoma Staging System(GSS2).The GCIPL thickness,RNFL thickness,ONH parameters,and retinal VD were measured by SD-OCT,differences among the groups and correlations within the same group were calculated.RESULTS:The inferior and superotemporal sectors of the GCIPL thickness,rim area of ONH,average and inferior sector of the retinal VD were significantly reduced(all P<0.05)in the early PACG eyes compared to the normal and the optic disc area,cup to disc ratio(C/D),and cup volume were significantly higher(all P<0.05);but the RNFL was not significant changes in early and moderate PACG.In severe group,the GCIPL and RNFL thickness were obvious thinning with retinal VD were decreasing as well as C/D and cup volume increasing than other three groups(all P<0.01).In the early PACG subgroup,there were significant positive correlations between retinal VD and GCIPL thickness(except superonasal and inferonasal sectors,r=0.573 to 0.641,all P<0.05),superior sectors of RNFL thickness(r=0.055,P=0.049).More obvious significant positive correlations were existed in moderate PACG eyes between retinal VD and superior sectors of RNFL thickness(r=0.650,P=0.022),and temporal sectors of RNFL thickness(r=0.740,P=0.006).In the severe PACG eyes,neither GCIPL nor RNFL thickness was associated with retinal VD.CONCLUSION:The ONH damage and retinal VD loss appears earlier than RNFL thickness loss in PACG eyes.As the PACG disease progressed from the early to the moderate stage,the correlations between the retinal VD and RNFL thickness increases.
基金Supported by National Natural Science Foundation of China (No.81800879)Natural Science Foundation of Guangdong Province (No.2017A030310372)+1 种基金Fundamental Research Funds of the State Key Laboratory of Ophthalmology, China (No.2017QN05)Sun Yat-sen University Clinical Research 5010 Program (No.2014016)
文摘AIM: To evaluate the diagnostic ability of macular ganglion cell-inner plexiform layer(GCIPL) thickness o b t a i n e d b y s p e c t r a l-d o m a i n o p t i c a l c o h e r e n c e tomography(SD-OCT) in discriminating non-highly myopic eyes with preperimetric glaucoma(PPG) from highly myopic healthy eyes. METHODS: A total of 254 eyes, including 76 normal controls(NC), 116 eyes with high myopia(HM) and 62 non-highly myopic eyes with PPG were enrolled. The diagnostic ability of OCT parameters was accessed by the areas under the receiver operating characteristic(AUROC) curve in two distinguishing groups: PPG eyes with nonglaucomatous eyes including NC and HM(Group 1), and PPG eyes with HM eyes(Group 2). Differences in diagnostic performance between GCIPL and RNFL parameters were evaluated. RESULTS: The minimum(AUROC curve of 0.782), inferotemporal(0.758) and inferior(0.705) GCIPL thickness were the top three GCIPL parameters in discriminating PPG from non-glaucomatous eyes, all of which had statistically significant lower diagnostic ability than average RNFL thickness(0.847). In discriminating PPG from HM, the best GCIPL parameter was minimum(0.689), statistically significant lower in diagnostic ability than average RNFL thickness(0.789) and three other RNFL thickness parameters of temporal and inferotemporal clock-hour sectors. CONCLUSION: The minimum GCIPL thickness is the best GCIPL parameter to detect non-highly myopic PPG from highly myopic eyes, whose diagnostic ability is inferiorto that of average RNFL thickness and RNFL thickness of several temporal and inferotemporal clock-hour sectors. The average RNFL thickness is recommended for discriminating PPG from highly myopic healthy eyes in current clinical practice in a Chinese population.
基金Supported by the Hangzhou Science and Technology Development Project,No.20170533B70.
文摘BACKGROUND Ethambutol-induced optic neuropathy(EON)most commonly manifests as bilateral symmetrical loss of vision and often cause serious and irreversible visual impairment because of the lack of early detection and effective treatment.We followed a case of EON with rare binocular asymmetric clinical manifestations and observed the changes of visual function and retinal structure after drug withdrawal,so as to further understand the clinical characteristics of this disease.CASE SUMMARY A 54-year-old man complained of gradual visual decline in the left eye.The patient presented with best-corrected visual acuity of 20/20 in the right eye and 20/50 in the left eye.Color vision examination revealed difficulty in reading green color plates in the left eye.The visual field manifested as concentric contraction in the left eye.After nearly a month of drug withdrawal,the right eye had a similar decline in visual function.At the last visit,19 mo after drug withdrawal,the visual function significantly recovered in both eyes.During follow-up optical coherence tomography(OCT)examination,both eyes manifested the thickness of the retinal nerve fiber layer from mild thickening to thinning and finally temporal atrophy,and the ganglion cell-inner plexiform layer showed significant thinning.The difference was that a reversible structural disorder in the outer retina of the nasal macula was detected in the left eye by macular high-definition OCT.CONCLUSION Nephropathy and high blood pressure,which damage the retinal microcirculation,may cause damage to the outer layer of the retina.Ethambutol may influence photoreceptor as well as retinal ganglion cells.
文摘Optical coherence tomography(OCT)is an ocular imaging technique that can complement the neuro-ophthalmic assessment,and inform our understanding regarding functional consequences of neuroaxonal injury in the afferent visual pathway.Indeed,OCT has emerged as a surrogate end-point in the diagnosis and follow up of several demyelinating syndromes of the central nervous system(CNS),including optic neuritis(ON)associated with:multiple sclerosis(MS),neuromyelitis optica spectrum disorder(NMOSD),and anti-myelin oligodendrocyte glycoprotein(MOG)antibodies.Recent advancements in enhanced depth imaging(EDI)OCT have distinguished this technique as a new gold standard in the diagnosis of optic disc drusen(ODD).Moreover,OCT may enhance our ability to distinguish cases of papilledema from pseudopapilledema caused by ODD.In the setting of idiopathic intracranial hypertension(IIH),OCT has shown benefit in tracking responses to treatment,with respect to reduced retinal nerve fiber layer(RNFL)measures and morphological changes in the angling of Bruch’s membrane.Longitudinal follow up of OCT measured ganglion cell-inner plexiform layer thickness may be of particular value in managing IIH patients who have secondary optic atrophy.Causes of compressive optic neuropathies may be readily diagnosed with OCT,even in the absence of overt visual field defects.Furthermore,OCT values may offer some prognostic value in predicting post-operative outcomes in these patients.Finally,OCT can be indispensable in differentiating optic neuropathies from retinal diseases in patients presenting with vision loss,and an unrevealing fundus examination.In this review,our over-arching goal is to highlight the potential role of OCT,as an ancillary investigation,in the diagnosis and management of various optic nerve disorders.