AIM：To assess peripapillary retinal nerve fiber layer（RNFL）and choroidal thickness obtained with enhanced depth imaging（EDI）mode compared with those obtained without EDI mode using Heidelberg Spectralis optical c...AIM：To assess peripapillary retinal nerve fiber layer（RNFL）and choroidal thickness obtained with enhanced depth imaging（EDI）mode compared with those obtained without EDI mode using Heidelberg Spectralis optical coherence tomography（OCT）.METHODS：Fifty eyes of 25 normal healthy subjects and32 eyes of 20 patients with different eye diseases were included in the study.All subjects underwent 3.4 mm diameter peripapillary circular OCT scan centered on the optic disc using both the conventional and the EDI OCT protocols.The visualization of RNFL and choroidoscleral junction was assessed using an ordinal scoring scale.The paired t-test,intraclass correlation coefficient（ICC）,95%limits of agreement（LoA）,and Bland and Altman plots were used to test the agreement of measurements.RESULTS：The visibility score of RNFL obtained with and without EDI was of no significant difference（P=0.532）,the visualization of choroidoscleral junction was better using EDI protocol than conventional protocol（P〈0.001）.Peripapillary RNFL thickness obtained with EDI was slightly thicker than that obtained without EDI（103.25±9.42μm vs 101.87±8.78μm,P=0.010）.The ICC of the two protocols was excellent with the value of 0.867 to 0.924,the 95%LoA of global RNFL thickness was between-10.0 to 7.4μm.Peripapillary choroidal thickness obtained with EDI was slightly thinner than that obtained without EDI（147.23±51.04μm vs 150.90±51.84μm,P〈0.001）.The ICC was also excellent with the value of 0.960 to 0.987,the 95%LoA of global choroidal thickness was between-12.5 to 19.8μm.CONCLUSION：Peripapillary circular OCT scan with or without EDI mode shows comparable results in the measurement of peripapillary RNFL and choroidal thickness.展开更多
AIM： To assess changes in peripapillary retinal nerve fiber layer （RNFL） thickness and visual field （VF） in patients with glaucoma after reduction of intraocular pressure （IOP）. METHODS： Thirty-five consecutiv...AIM： To assess changes in peripapillary retinal nerve fiber layer （RNFL） thickness and visual field （VF） in patients with glaucoma after reduction of intraocular pressure （IOP）. METHODS： Thirty-five consecutive patients with bilat-eral high tension glaucoma were included in the study. Thirty-five eyes underwent monocular deep sclerectomy （surgery group） and the medically treated fellow eyes served as controls （control group）. Quantitative analyses of the peripapillary RNFL thickness by optical coherence tomography （OCT） and global VF indices by automated perimetry were performed before surgery and six months after surgery in both eyes. The changes in RNFL thickness overall and by quadrant were evalu-ated and studied with respect to age, best-corrected visual acuity （BCVA）, preoperative global VF indices, postoperative IOP changes, and postoperative changes in global VF indices. Changes observed in RNFL thickness and VF indices were compared between eyes after surgery and fellow eyes. RESULTS： Six months after surgery, the overall IOP decreased from a baseline mean of 24.5 ± 3.2 mmHg to 11.5 ± 2.7 mmHg （P 〈 0.001） at the time of OCT testing. A signifcant increase in the overall mean RNFL thickness was observed after surgery （P 〈 0.001）. The preoperative VF mean deviation was significantly cor-related with a postoperative increase in the RNFL thick-ness （P 〈 0.075）. No correlation was found between RNFL thickness changes and age, BCVA, or changes in the global VF indices. There was no significant difference between eyes with an IOP reduction of more than 50% and those with a reduction in IOP less than 30% （ P = 0.312）.CONCLUSION： A signifcant increase in the peripapil-lary RNFL thickness was associated with IOP reduction by glaucoma filtration surgery as measured by OCT.展开更多
AIM:To assess the differences in average and sectoral peripapillary retinal nerve fiber layer(p RNFL)thickness using spectral domain optical coherence tomography(SD-OCT)in patients with non-arteritic anterior ischemic...AIM:To assess the differences in average and sectoral peripapillary retinal nerve fiber layer(p RNFL)thickness using spectral domain optical coherence tomography(SD-OCT)in patients with non-arteritic anterior ischemic neuropathy(NAION)compared with those with primary open angle glaucoma(POAG).METHODS:A comprehensive literature search of the Pub Med,Cochrane Library,and Embase databases were performed prior to October,2021.Studies that compared the p RNFL thickness in NAION eyes with that in POAG eyes with matched mean deviation of the visual fields were included.The weighted mean difference(WMD)with 95%confidence interval(CI)was used to pool continuous outcomes.RESULTS:Ten cross-sectional studies(11 datasets)comprising a total of 625 eyes(278 NAION eyes,347 POAG eyes)were included in the qualitative and quantitative analyses.The pooled results demonstrated that the superior p RNFL was significantly thinner in NAION eyes than in POAG eyes(WMD=-6.40,95%CI:-12.22 to-0.58,P=0.031),whereas the inferior p RNFL was significant thinner in POAG eyes than in NAION eyes(WMD=11.10,95%CI:7.06 to 15.14,P≤0.001).No difference was noted concerning the average,nasal,and temporal p RNFL thickness(average:WMD=1.45,95%CI:-0.75 to 3.66,P=0.196;nasal:WMD=-2.12,95%CI:-4.43 to 0.19,P=0.072;temporal:WMD=-1.24,95%CI:-3.96 to 1.47,P=0.370).CONCLUSION:SD-OCT based evaluation of inferior and superior p RNFL thickness can be potentially utilized to differentiate NAION from POAG,and help to understand the different pathophysiological mechanisms between these two diseases.Further longitudinal studies and studies using eight-quadrant or clock-hour classification method are required to validate the obtained findings.展开更多
Ethambutol is a common cause of drug-related optic neuropathy.Prediction of the onset of ethambutol-induced optic neuropathy and consequent drug withdrawal may be an effective method to stop visual loss.Previous studi...Ethambutol is a common cause of drug-related optic neuropathy.Prediction of the onset of ethambutol-induced optic neuropathy and consequent drug withdrawal may be an effective method to stop visual loss.Previous studies have shown that structural injury to the optic nerve occurred earlier than the damage to visual function.Therefore,we decided to detect structural biomarkers marking visual field loss in early stage ethambutol-induced optic neuropathy.The thickness of peripapillary retinal nerve fiber layer,macular thickness and visual sensitivity loss would be observed in 11 ethambutol-induced optic neuropathy patients（22 eyes） using optical coherence tomography.Twenty-four healthy age-and sex-matched participants（48 eyes） were used as controls.Results demonstrated that the temporal peripapillary retinal nerve fiber layer thickness and average macular thickness were thinner in patients with ethambutol-induced optic neuropathy compared with healthy controls.The average macular thickness was strongly positively correlated with central visual sensitivity loss（r2=0.878,P=0.000）.These findings suggest that optical coherence tomography can be used to efficiently screen patients.Macular thickness loss could be a potential factor for predicting the onset of ethambutol-induced optic neuropathy.展开更多
Background:The retina has been used to study the pathophysiology of multiple sclerosis(MS).Peripapillary retinal nerve fiber layer(pRNFL)thinning has been suggested as an ocular biomarker of neurodegeneration in MS.Th...Background:The retina has been used to study the pathophysiology of multiple sclerosis(MS).Peripapillary retinal nerve fiber layer(pRNFL)thinning has been suggested as an ocular biomarker of neurodegeneration in MS.The goal of this project was to determine the birefringence of the pRNFL by measuring the fiber birefringence using polarization sensitive optical coherence tomography(PS-OCT).Methods:Sixty-six MS patients without history of optic neuritis(age:39.9±11.0 yrs.old,53 females and 13 males)and 66 age-and gender-matched normal controls(age:40.7±11.4 yrs.old)were recruited.Custom built PS-OCT was used to measure phase retardation per unit depth(PR/UD,proportional to the birefringence)and pRNFL thickness in each quadrant of the pRNFL.In addition,clinical manifestation was used to correlate with the pRNFL birefringence.Results:The pRNFL was thinner in the temporal and inferior quadrants in MS patients compared with normal controls(P<0.05).The PR/UD of the pRNFL was significantly decreased in MS patients(P<0.05)in all quadrants except for the nasal quadrant.In both groups,the PR/UD from all four quadrants was not related to the averaged pRNFL thickness(P>0.05).In MS patients,the PR/UD was not related to the expanded disability status scale(EDSS)nor disease duration(r ranged from−0.17 to 0.02,P>0.05).Conclusion:This is the first study using PS-OCT to study the pRNFL birefringence in MS patients.Decreased birefringence of the pRNFL may indicate microtubule abnormality,and could be a potential biomarker for detecting early neurodegeneration in MS.展开更多
AIM:To assess the retinal vasculature alterations in indirect traumatic optic neuropathy(ITON)patients following craniofacial trauma by optic coherence tomography angiography(OCTA).METHODS:Patients diagnosed of monocu...AIM:To assess the retinal vasculature alterations in indirect traumatic optic neuropathy(ITON)patients following craniofacial trauma by optic coherence tomography angiography(OCTA).METHODS:Patients diagnosed of monocular ITON were recruited from August 2016 to May 2020.OCTA was performed using the Angio Vue OCT-A system for two cube scans centered at the optic nerve head and fovea.OCTA data included thicknesses of peripapillary retinal nerve fiber layer(RNFL)and macular ganglion cell complex(GCC),as well as proportion of capillary perfusion and data were analyzed for correlation with post-injury timepoints:within 7,8-30,31-90,and 91-365d.RESULTS:A total of 73 ITON patients were studied.Significant thinning of RNFL and GCC layers and attenuation of microvascular perfusion were observed in ITON eyes as compared to contralateral unaffected eyes(for most of the analyzed sectors and quadrants,P<0.05).Without respect to surgical intervention and vision recovery,the decrease in retinal layer thicknesses and microvascular perfusion was time-dependent,and most significant within three months(P<0.001).CONCLUSION:ITON presents with time-dependent thinning of retinal layers and attenuation of microvasculature,indicating possible degeneration of retinal ganglion cells due to reduced retinal blood supply.展开更多
基金Supported by Wenzhou Municipal Science and Technology Bureau(No.Y20150257)
文摘AIM：To assess peripapillary retinal nerve fiber layer（RNFL）and choroidal thickness obtained with enhanced depth imaging（EDI）mode compared with those obtained without EDI mode using Heidelberg Spectralis optical coherence tomography（OCT）.METHODS：Fifty eyes of 25 normal healthy subjects and32 eyes of 20 patients with different eye diseases were included in the study.All subjects underwent 3.4 mm diameter peripapillary circular OCT scan centered on the optic disc using both the conventional and the EDI OCT protocols.The visualization of RNFL and choroidoscleral junction was assessed using an ordinal scoring scale.The paired t-test,intraclass correlation coefficient（ICC）,95%limits of agreement（LoA）,and Bland and Altman plots were used to test the agreement of measurements.RESULTS：The visibility score of RNFL obtained with and without EDI was of no significant difference（P=0.532）,the visualization of choroidoscleral junction was better using EDI protocol than conventional protocol（P〈0.001）.Peripapillary RNFL thickness obtained with EDI was slightly thicker than that obtained without EDI（103.25±9.42μm vs 101.87±8.78μm,P=0.010）.The ICC of the two protocols was excellent with the value of 0.867 to 0.924,the 95%LoA of global RNFL thickness was between-10.0 to 7.4μm.Peripapillary choroidal thickness obtained with EDI was slightly thinner than that obtained without EDI（147.23±51.04μm vs 150.90±51.84μm,P〈0.001）.The ICC was also excellent with the value of 0.960 to 0.987,the 95%LoA of global choroidal thickness was between-12.5 to 19.8μm.CONCLUSION：Peripapillary circular OCT scan with or without EDI mode shows comparable results in the measurement of peripapillary RNFL and choroidal thickness.
文摘AIM： To assess changes in peripapillary retinal nerve fiber layer （RNFL） thickness and visual field （VF） in patients with glaucoma after reduction of intraocular pressure （IOP）. METHODS： Thirty-five consecutive patients with bilat-eral high tension glaucoma were included in the study. Thirty-five eyes underwent monocular deep sclerectomy （surgery group） and the medically treated fellow eyes served as controls （control group）. Quantitative analyses of the peripapillary RNFL thickness by optical coherence tomography （OCT） and global VF indices by automated perimetry were performed before surgery and six months after surgery in both eyes. The changes in RNFL thickness overall and by quadrant were evalu-ated and studied with respect to age, best-corrected visual acuity （BCVA）, preoperative global VF indices, postoperative IOP changes, and postoperative changes in global VF indices. Changes observed in RNFL thickness and VF indices were compared between eyes after surgery and fellow eyes. RESULTS： Six months after surgery, the overall IOP decreased from a baseline mean of 24.5 ± 3.2 mmHg to 11.5 ± 2.7 mmHg （P 〈 0.001） at the time of OCT testing. A signifcant increase in the overall mean RNFL thickness was observed after surgery （P 〈 0.001）. The preoperative VF mean deviation was significantly cor-related with a postoperative increase in the RNFL thick-ness （P 〈 0.075）. No correlation was found between RNFL thickness changes and age, BCVA, or changes in the global VF indices. There was no significant difference between eyes with an IOP reduction of more than 50% and those with a reduction in IOP less than 30% （ P = 0.312）.CONCLUSION： A signifcant increase in the peripapil-lary RNFL thickness was associated with IOP reduction by glaucoma filtration surgery as measured by OCT.
基金Supported by National Natural Science Foundation of China(No.82070967No.81770930)+1 种基金National Natural Science Foundation of Hunan Province Grant(No.2020jj4788)China Hunan Provincial Science and Technology Department(No.2020SK2086)。
文摘AIM:To assess the differences in average and sectoral peripapillary retinal nerve fiber layer(p RNFL)thickness using spectral domain optical coherence tomography(SD-OCT)in patients with non-arteritic anterior ischemic neuropathy(NAION)compared with those with primary open angle glaucoma(POAG).METHODS:A comprehensive literature search of the Pub Med,Cochrane Library,and Embase databases were performed prior to October,2021.Studies that compared the p RNFL thickness in NAION eyes with that in POAG eyes with matched mean deviation of the visual fields were included.The weighted mean difference(WMD)with 95%confidence interval(CI)was used to pool continuous outcomes.RESULTS:Ten cross-sectional studies(11 datasets)comprising a total of 625 eyes(278 NAION eyes,347 POAG eyes)were included in the qualitative and quantitative analyses.The pooled results demonstrated that the superior p RNFL was significantly thinner in NAION eyes than in POAG eyes(WMD=-6.40,95%CI:-12.22 to-0.58,P=0.031),whereas the inferior p RNFL was significant thinner in POAG eyes than in NAION eyes(WMD=11.10,95%CI:7.06 to 15.14,P≤0.001).No difference was noted concerning the average,nasal,and temporal p RNFL thickness(average:WMD=1.45,95%CI:-0.75 to 3.66,P=0.196;nasal:WMD=-2.12,95%CI:-4.43 to 0.19,P=0.072;temporal:WMD=-1.24,95%CI:-3.96 to 1.47,P=0.370).CONCLUSION:SD-OCT based evaluation of inferior and superior p RNFL thickness can be potentially utilized to differentiate NAION from POAG,and help to understand the different pathophysiological mechanisms between these two diseases.Further longitudinal studies and studies using eight-quadrant or clock-hour classification method are required to validate the obtained findings.
基金supported by the National High Technology Research and Development Program of China(863 Program),No.2015AA020511
文摘Ethambutol is a common cause of drug-related optic neuropathy.Prediction of the onset of ethambutol-induced optic neuropathy and consequent drug withdrawal may be an effective method to stop visual loss.Previous studies have shown that structural injury to the optic nerve occurred earlier than the damage to visual function.Therefore,we decided to detect structural biomarkers marking visual field loss in early stage ethambutol-induced optic neuropathy.The thickness of peripapillary retinal nerve fiber layer,macular thickness and visual sensitivity loss would be observed in 11 ethambutol-induced optic neuropathy patients（22 eyes） using optical coherence tomography.Twenty-four healthy age-and sex-matched participants（48 eyes） were used as controls.Results demonstrated that the temporal peripapillary retinal nerve fiber layer thickness and average macular thickness were thinner in patients with ethambutol-induced optic neuropathy compared with healthy controls.The average macular thickness was strongly positively correlated with central visual sensitivity loss（r2=0.878,P=0.000）.These findings suggest that optical coherence tomography can be used to efficiently screen patients.Macular thickness loss could be a potential factor for predicting the onset of ethambutol-induced optic neuropathy.
基金Supported by the National Multiple Sclerosis Society,NIH Center Grant P30 EY014801a grant from Research to Prevent Blindness(RPB).
文摘Background:The retina has been used to study the pathophysiology of multiple sclerosis(MS).Peripapillary retinal nerve fiber layer(pRNFL)thinning has been suggested as an ocular biomarker of neurodegeneration in MS.The goal of this project was to determine the birefringence of the pRNFL by measuring the fiber birefringence using polarization sensitive optical coherence tomography(PS-OCT).Methods:Sixty-six MS patients without history of optic neuritis(age:39.9±11.0 yrs.old,53 females and 13 males)and 66 age-and gender-matched normal controls(age:40.7±11.4 yrs.old)were recruited.Custom built PS-OCT was used to measure phase retardation per unit depth(PR/UD,proportional to the birefringence)and pRNFL thickness in each quadrant of the pRNFL.In addition,clinical manifestation was used to correlate with the pRNFL birefringence.Results:The pRNFL was thinner in the temporal and inferior quadrants in MS patients compared with normal controls(P<0.05).The PR/UD of the pRNFL was significantly decreased in MS patients(P<0.05)in all quadrants except for the nasal quadrant.In both groups,the PR/UD from all four quadrants was not related to the averaged pRNFL thickness(P>0.05).In MS patients,the PR/UD was not related to the expanded disability status scale(EDSS)nor disease duration(r ranged from−0.17 to 0.02,P>0.05).Conclusion:This is the first study using PS-OCT to study the pRNFL birefringence in MS patients.Decreased birefringence of the pRNFL may indicate microtubule abnormality,and could be a potential biomarker for detecting early neurodegeneration in MS.
基金Supported by the High-level Hospital Construction Project(No.303010406)Natural Science Foundation of Guangdong Province,China(No.2019A1515010361)。
文摘AIM:To assess the retinal vasculature alterations in indirect traumatic optic neuropathy(ITON)patients following craniofacial trauma by optic coherence tomography angiography(OCTA).METHODS:Patients diagnosed of monocular ITON were recruited from August 2016 to May 2020.OCTA was performed using the Angio Vue OCT-A system for two cube scans centered at the optic nerve head and fovea.OCTA data included thicknesses of peripapillary retinal nerve fiber layer(RNFL)and macular ganglion cell complex(GCC),as well as proportion of capillary perfusion and data were analyzed for correlation with post-injury timepoints:within 7,8-30,31-90,and 91-365d.RESULTS:A total of 73 ITON patients were studied.Significant thinning of RNFL and GCC layers and attenuation of microvascular perfusion were observed in ITON eyes as compared to contralateral unaffected eyes(for most of the analyzed sectors and quadrants,P<0.05).Without respect to surgical intervention and vision recovery,the decrease in retinal layer thicknesses and microvascular perfusion was time-dependent,and most significant within three months(P<0.001).CONCLUSION:ITON presents with time-dependent thinning of retinal layers and attenuation of microvasculature,indicating possible degeneration of retinal ganglion cells due to reduced retinal blood supply.
