目的:本研究的目的是使用谱域光学相干断层扫描技术评估营养缺乏性贫血(NDA)对乳头周围视网膜神经纤维层厚度(PPRNFLT)的影响,并确定其相关性。这是一个单一的中心,横截面,观察性研究。
方法:共115眼NDA患者(各50眼患有缺铁性贫血[IDA]和维生素B12缺乏性贫血[BDA],和15岁的叶酸缺乏性贫血[FDA])年龄在18-65岁之间,与50个年龄和性别匹配的健康对照的100只眼进行了比较。所有受试者都接受了全面的临床,眼科,和血液学评估,然后是PPRNFLT评估的平均总数,上级,劣等,鼻部,和时间象限。
结果:IDA患者的平均总数和所有四个象限的PPRNFLT,平均总数,劣等,鼻部,BDA患者的颞叶象限,对于平均总数,劣等,和鼻象限,在FDA患者中,显著低于对照组(P<0.05)。所有NDA患者的平均总PPRNFLT与其相关血液学参数显著相关(P<0.05),皮尔逊系数(r)分别为0.613、0.610、0.336、0.295、0.337、0.374和-0.509。血清血红蛋白(Hb),铁,铁蛋白,平均红细胞体积(MCV),平均细胞血红蛋白,平均红细胞血红蛋白浓度,和IDA中的总铁结合能力;分别为0.310、0.435和-0.386,血清Hb%,维生素B12和BDA中的MCV;Hb%为0.557、0.358和-0.294,叶酸,和MCV,分别,在FDA案例中。所有NDA患者的平均总视网膜神经纤维层变薄显示随着贫血严重程度的增加而进展。除了在非常严重的BDA中,记录了反比关系。
结论:我们的研究表明,所有NDA患者的PPRNFLT均明显变薄(IDA中的总数和所有四个象限;总数,劣等,鼻部,和时间在BDA中;和总计,劣等,和FDA的鼻部)与其相关血液学参数密切相关。早期检测这对于预防潜在的致盲后遗症和区分青光眼和其他神经眼科疾病可能是至关重要的。
OBJECTIVE: The purpose of this
study was to evaluate the effect of nutritional-deficiency anemia (NDA) on peripapillary retinal nerve fiber layer thickness (PPRNFLT) using spectral-domain optical coherence tomography and to determine any correlation arising thereof. This was a single-center, cross-sectional, observational
study.
METHODS: A total 115 eyes of 115 NDA patients (50 of each with iron-deficiency anemia [IDA] and Vitamin B12-deficiency anemia [BDA], and 15 with folic acid-deficiency anemia [FDA]) aged 18-65 years were compared with a total 100 eyes of 50 age- and sex-matched healthy controls. All subjects underwent comprehensive clinical, ophthalmic, and hematological evaluation, followed by PPRNFLT assessment for the mean total, superior, inferior, nasal, and temporal quadrants.
RESULTS: PPRNFLT for the mean total and all four quadrants in IDA patients, for the mean total, inferior, nasal, and temporal quadrants in BDA patients, and for the mean total, inferior, and nasal quadrants, in FDA patients, was significantly lower as compared to the controls (P < 0.05). The mean total PPRNFLT of all NDA patients correlated significantly (P < 0.05) with their relevant hematological parameters with Pearson\'s coefficient (r) value of 0.613, 0.610, 0.336, 0.295, 0.337, 0.374, and - 0.509, respectively, for serum haemoglobin (Hb), iron, ferritin, mean corpuscular volume (MCV), mean cell hemoglobin, mean corpuscular hemoglobin concentration, and total iron binding capacity in IDA; 0.310, 0.435, and - 0.386, respectively, for serum Hb%, Vitamin B12, and MCV in BDA; and 0.557, 0.358, and - 0.294 for Hb%, folate, and MCV, respectively, in FDA cases. Mean total retinal nerve fiber layer thinning of all NDA patients showed progression with the increasing severity grades of anemia, except in very severe BDA where an inverse relationship was documented.
CONCLUSIONS: Our
study revealed that PPRNFLT is significantly thinner in all NDA patients (total and all four quadrants in IDA; total, inferior, nasal, and temporal in BDA; and total, inferior, and nasal in FDA) correlating well with their relevant hematological parameters. Early detection of this may be crucial in preventing potential blinding sequelae and differentiating glaucomatous and other neuro-ophthalmic disorders.