Purpose To investigate the structur e-function relationship between optical coherence tomograp hy(OCT)macular retinal and peripapillary nerve fib er layer(NFL)thick-ness and automated visual field(VF)findings.Design C...Purpose To investigate the structur e-function relationship between optical coherence tomograp hy(OCT)macular retinal and peripapillary nerve fib er layer(NFL)thick-ness and automated visual field(VF)findings.Design Cross-sectional observational stu dy.Methods Retrospective institutional study where 150conse cutive eyes(101sub-jects)from a glaucoma service were included.All the participants had full ophthalmic ev aluation,VF testing and prototype OCT scanning at the sam e visit.Orthogonal OCT macular analysis was obtained to maximize the sam-pling of the area of interest.Pearso n age-adjusted corre-lation was determined between macul ar retinal thickness and peripapillary NFL thickness.Ar ea under the receiver operator characteristics(AROC)curves for the association between macular retinal thickness a nd peripapillary NFL thickness and VF findings were calcu lated in a subgroup of eyes without VF defect and eyes wit h VF defect con-fined to one hemifield.Results The c orrelation between macular retinal and peripapillary N FL measurements ranged between r=0.27to 0.54for quadrants,0.44to0.55for hemiretina,and 0.52for the overall mean.Areas under the receiver operator characteristics for macular thickness were higher in areas corre sponding to the VF defect location than the noncorresp onding locations.Areas under the receiver operator characteristics for peripapillaryNFL thickness were higher than for th e macular retinal thickness.Including both macular r etinal thickness and peripapillary NFL thickness measur ements in the logistic regression model yielded AROCs (range:0.69-0.77)similar to those found for the peripapillary NFL alone.Conclusion Macular retinal thickness,as measured by OCT,was capable of detecting glaucomatous damage and corresponded with peripapillary NFL thickness;however,peripapillary NFL thickness had hig her sensitivity and specificity for the detection of VF a bnormalities.展开更多
Purpose: To analyze retinal nerve fiber layer (RNFL) thickness in eyes with or without visual field (VF) defects after indocyanine green-assisted vitrectomy for idiopathic macular holes using optical coherence tomogra...Purpose: To analyze retinal nerve fiber layer (RNFL) thickness in eyes with or without visual field (VF) defects after indocyanine green-assisted vitrectomy for idiopathic macular holes using optical coherence tomography (OCT) and to investigate the relationship between postoperative VF defects and RNFL damage. Design: Retrospective interventional case series. Participants: Thirty-four eyes of 32 patients with idiopathic macular holes that underwent vitrectomy between January 2001 and March 2003 were included in this study. Eyes were divided into 3 groups according to the occurrence of postoperative VF defects and the use of indocyanine green for internal limiting membrane peeling during surgery: 11 eyes with VF defects after indocyanine green-assisted vitrectomy (group 1),9 eyes without VF defects despite the use of indocyanine green (group 2),and 14 eyes without VF defects that underwent vitrectomy without indocyanine green (group 3). Methods: Retinal nerve fiber layer thickness in each of 4 quadrants (superior,inferior,nasal,temporal)was measured with OCT. Main OutcomeMeasure: Retinal nerve fiber layer thickness around the optic disc. Results: The mean RNFL thickness in 3 of 4 quadrants (superior,nasal,inferior) in group 1 was significantly less than that in the corresponding quadrant in groups 2 and 3 (P < 0.01). In the temporal quadrant,there was a significant difference between groups 1 and 3 (P=0.02),but not between groups 1 and 2. The RNFL thickness in group 1 was significantly less in 3 quadrants in operated eyes than in fellow eyes (P< 0.05). Conclusions: The RNFL thickness was reduced in eyes with VF defects after indocyanine green-assisted vitrectomy for macular holes,suggesting that the postoperativeVF defectsmay have been caused by RNFL damage relating to the use of indocyanine green.展开更多
Objective: To compare the prevalence of structural and psychophysical abnormalities in normal eyes and eyes with glaucomatous optic neuropathy (GON) and normal standard automated perimetry (SAP). Methods: Complete exa...Objective: To compare the prevalence of structural and psychophysical abnormalities in normal eyes and eyes with glaucomatous optic neuropathy (GON) and normal standard automated perimetry (SAP). Methods: Complete examination,SAP,short-wavelength automated perimetry (SWAP),frequency doubling technology (FDT),scanning laser polarimetry (GDx-VCC),and optical coherence tomography (OCT) of the peripapillary retinal nerve fiber layer (RNFL),optic disc,and macula were performed. Glaucomatous optic neuropathy was defined as cup-disc asymmetry between fellow eyes of greater than 0.2,rim thinning,notching,excavation,or RNFL defect. All eyes had normal SAP. Abnormal measurements on OCT,GDx-VCC,SWAP,and FDT were defined as those outside 95% normal limits. Eyes were stratified into 3 groups based on the OCT-generated vertical cup-disc ratio: mild,moderate,and advanced cupping (cup-disc ratio of < 0.4,0.4-0.7,and >0.7,respectively). Receiver operating characteristic curves were developed to assess sensitivity and specificity of structural and functional assessments. Results: Forty-seven eyes of 47patients (25 with GON and 22 normal) were enrolled (mean± SD age,58± 16 years; range,25-83 years). Compared with normal eyes,eyes with GON had significantly worse mean deviation and pattern standard deviation by means of SWAP and FDT (P=.02-.05); OCT-derived mean and superior and inferior RNFL thickness (P=.008,< .001,and .05,respectively); mean macular thickness (P=.01),rim volume,rim area,cup-disc ratio,and cup area (all P< .001); and GDx-VCC nerve fiber indicator and inferior average (P=.03). There was a significantly (P=.008,.002,.003,and .01,respectively) greater prevalence of abnormalities identified by SWAP,FDT,OCT and GDx-VCC in eyes with advanced cupping (43% ,43% ,57% ,and 57% ,respectively) compared with mild cupping (0% ) and moderate cupping (9% ,5% ,19% ,and 33% ,respectively). Conclusions: Eyes with GON and normal results of SAP have significantly greater structural and psychophysical abnormalities than do normal eyes evaluated by means of OCT,GDx-VCC,SWAP,and FDT. Eyes with increased vertical cup-disc ratio are more likely to manifest such abnormalities on advanced diagnostic testing.展开更多
文摘Purpose To investigate the structur e-function relationship between optical coherence tomograp hy(OCT)macular retinal and peripapillary nerve fib er layer(NFL)thick-ness and automated visual field(VF)findings.Design Cross-sectional observational stu dy.Methods Retrospective institutional study where 150conse cutive eyes(101sub-jects)from a glaucoma service were included.All the participants had full ophthalmic ev aluation,VF testing and prototype OCT scanning at the sam e visit.Orthogonal OCT macular analysis was obtained to maximize the sam-pling of the area of interest.Pearso n age-adjusted corre-lation was determined between macul ar retinal thickness and peripapillary NFL thickness.Ar ea under the receiver operator characteristics(AROC)curves for the association between macular retinal thickness a nd peripapillary NFL thickness and VF findings were calcu lated in a subgroup of eyes without VF defect and eyes wit h VF defect con-fined to one hemifield.Results The c orrelation between macular retinal and peripapillary N FL measurements ranged between r=0.27to 0.54for quadrants,0.44to0.55for hemiretina,and 0.52for the overall mean.Areas under the receiver operator characteristics for macular thickness were higher in areas corre sponding to the VF defect location than the noncorresp onding locations.Areas under the receiver operator characteristics for peripapillaryNFL thickness were higher than for th e macular retinal thickness.Including both macular r etinal thickness and peripapillary NFL thickness measur ements in the logistic regression model yielded AROCs (range:0.69-0.77)similar to those found for the peripapillary NFL alone.Conclusion Macular retinal thickness,as measured by OCT,was capable of detecting glaucomatous damage and corresponded with peripapillary NFL thickness;however,peripapillary NFL thickness had hig her sensitivity and specificity for the detection of VF a bnormalities.
文摘Purpose: To analyze retinal nerve fiber layer (RNFL) thickness in eyes with or without visual field (VF) defects after indocyanine green-assisted vitrectomy for idiopathic macular holes using optical coherence tomography (OCT) and to investigate the relationship between postoperative VF defects and RNFL damage. Design: Retrospective interventional case series. Participants: Thirty-four eyes of 32 patients with idiopathic macular holes that underwent vitrectomy between January 2001 and March 2003 were included in this study. Eyes were divided into 3 groups according to the occurrence of postoperative VF defects and the use of indocyanine green for internal limiting membrane peeling during surgery: 11 eyes with VF defects after indocyanine green-assisted vitrectomy (group 1),9 eyes without VF defects despite the use of indocyanine green (group 2),and 14 eyes without VF defects that underwent vitrectomy without indocyanine green (group 3). Methods: Retinal nerve fiber layer thickness in each of 4 quadrants (superior,inferior,nasal,temporal)was measured with OCT. Main OutcomeMeasure: Retinal nerve fiber layer thickness around the optic disc. Results: The mean RNFL thickness in 3 of 4 quadrants (superior,nasal,inferior) in group 1 was significantly less than that in the corresponding quadrant in groups 2 and 3 (P < 0.01). In the temporal quadrant,there was a significant difference between groups 1 and 3 (P=0.02),but not between groups 1 and 2. The RNFL thickness in group 1 was significantly less in 3 quadrants in operated eyes than in fellow eyes (P< 0.05). Conclusions: The RNFL thickness was reduced in eyes with VF defects after indocyanine green-assisted vitrectomy for macular holes,suggesting that the postoperativeVF defectsmay have been caused by RNFL damage relating to the use of indocyanine green.
文摘Objective: To compare the prevalence of structural and psychophysical abnormalities in normal eyes and eyes with glaucomatous optic neuropathy (GON) and normal standard automated perimetry (SAP). Methods: Complete examination,SAP,short-wavelength automated perimetry (SWAP),frequency doubling technology (FDT),scanning laser polarimetry (GDx-VCC),and optical coherence tomography (OCT) of the peripapillary retinal nerve fiber layer (RNFL),optic disc,and macula were performed. Glaucomatous optic neuropathy was defined as cup-disc asymmetry between fellow eyes of greater than 0.2,rim thinning,notching,excavation,or RNFL defect. All eyes had normal SAP. Abnormal measurements on OCT,GDx-VCC,SWAP,and FDT were defined as those outside 95% normal limits. Eyes were stratified into 3 groups based on the OCT-generated vertical cup-disc ratio: mild,moderate,and advanced cupping (cup-disc ratio of < 0.4,0.4-0.7,and >0.7,respectively). Receiver operating characteristic curves were developed to assess sensitivity and specificity of structural and functional assessments. Results: Forty-seven eyes of 47patients (25 with GON and 22 normal) were enrolled (mean± SD age,58± 16 years; range,25-83 years). Compared with normal eyes,eyes with GON had significantly worse mean deviation and pattern standard deviation by means of SWAP and FDT (P=.02-.05); OCT-derived mean and superior and inferior RNFL thickness (P=.008,< .001,and .05,respectively); mean macular thickness (P=.01),rim volume,rim area,cup-disc ratio,and cup area (all P< .001); and GDx-VCC nerve fiber indicator and inferior average (P=.03). There was a significantly (P=.008,.002,.003,and .01,respectively) greater prevalence of abnormalities identified by SWAP,FDT,OCT and GDx-VCC in eyes with advanced cupping (43% ,43% ,57% ,and 57% ,respectively) compared with mild cupping (0% ) and moderate cupping (9% ,5% ,19% ,and 33% ,respectively). Conclusions: Eyes with GON and normal results of SAP have significantly greater structural and psychophysical abnormalities than do normal eyes evaluated by means of OCT,GDx-VCC,SWAP,and FDT. Eyes with increased vertical cup-disc ratio are more likely to manifest such abnormalities on advanced diagnostic testing.
