目的:为了比较黄斑神经节细胞内网状层(GCIPL)的厚度,视网膜神经纤维层(RNFL)厚度,视神经头(ONH)参数,谱域光学相干断层扫描(SD-OCT)测量视网膜血管密度(VD),中度,重度原发性闭角型青光眼(PACG)和正常眼。
方法:收集70只PACG眼和20只正常眼进行回顾性分析。PACG的眼睛被进一步分离成早期,中度,或使用增强青光眼分期系统(GSS2)的严重PACG眼。GCIPL厚度,RNFL厚度,ONH参数,通过SD-OCT测量视网膜VD,计算各组间的差异和同一组内的相关性.
结果:GCIPL厚度的下时区和超时区,ONH的边缘区域,早期PACG眼视网膜VD的平均和下部分与正常和视盘区相比均显著降低(均P<0.05),杯盘比(C/D),杯容积均显著增高(均P<0.05);但RNFL在早期和中度PACG均无显著变化。在严重的群体中,与其他三组相比,GCIPL和RNFL厚度明显变薄,视网膜VD降低,C/D和杯体积增加(均P<0.01)。在早期PACG亚组中,视网膜VD与GCIPL厚度呈显著正相关(除鼻上段和鼻下段,r=0.573~0.641,均P<0.05),RNFL厚度的优越部门(r=0.055,P=0.049)。中度PACG眼视网膜VD与上段RNFL厚度呈显著正相关(r=0.650,P=0.022),和时间扇区的RNFL厚度(r=0.740,P=0.006)。在严重的PACG眼中,GCIPL和RNFL厚度均不与视网膜VD相关。
结论:在PACG眼中,ONH损伤和视网膜VD丢失比RNFL厚度丢失更早出现。随着PACG疾病从早期发展到中度,视网膜VD和RNFL厚度之间的相关性增加。
OBJECTIVE: 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.
CONCLUSIONS: 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.