探讨视功能损害患者术前视网膜神经纤维层(RNFL)厚度与术后1年视野恢复(VF)及视力恢复(VA)的关系。
纳入了16例交叉压迫患者的29只眼和14例对照受试者的14只眼。所有通过经蝶入路进行chiasmal减压手术的患者均在手术前和手术后1年以最佳矫正视力进行前瞻性评估(BCVA,logmar),标准自动视野检查(SAP)的平均偏差(MD)值和光学相干断层扫描的RNFL厚度。根据术前平均RNFL厚度将具有交叉压迫的眼睛分为两组:≥100µm(第1组)和<100µm(第2组)。术前平均RNFL厚度与视觉预后参数(VF,VA)进行了分析。
术前平均RNFL厚度为115.92±8.97µm,84.0±8.85µm,第一组为114.21±7.75µm(n=15只眼),第2组(n=14只眼)和对照组(n=14只眼),分别。术前平均BCVA在第1组为0.15±0.3,在第2组为0.41±0.39。术后第1组的平均BCVA增加至0.03±0.1,但第2组没有变化。第1组术前MD值为-6.10±5.54,术后为-2.59±2.23(p=0.014),而第2组术前为-18.97±4.14,术后为-18.57±4.51(p=0.24)。
本研究提示术前平均RNFL厚度较低与远期视力预后较差相关。术前测量RNFL厚度可能有助于预测伴有视力障碍的chi裂病变患者减压术后VF和VA的恢复。
To investigate the relationship between preoperative retinal nerve fiber layer (RNFL) thickness and the recovery of visual field (VF) and visual acuity (VA) 1 year after surgery in chiasmal compression patients presenting with visual impairment.
Twenty-nine eyes of 16 patients with chiasmal compression and 14 eyes of 14 control subjects were enrolled. All patients undergoing chiasmal decompression surgery via a transsphenoidal approach were prospectively evaluated before and 1 year after surgery with best corrected visual acuity (BCVA, logMAR), mean deviation (MD) value with standard automated perimetry (SAP) and RNFL thickness with optical coherence tomography. Eyes with chiasmal compression were divided into two groups according to the mean preoperative RNFL thickness: ≥ 100 µm (Group 1) and < 100 µm (Group 2). The relationship between the mean preoperative RNFL thickness and visual prognosis parameters (VF, VA) was analyzed.
The mean preoperative RNFL thickness was 115.92 ± 8.97 µm, 84.0 ± 8.85 µm, and 114.21 ± 7.75 µm in Group 1 (n = 15 eyes), Group 2 (n = 14 eyes) and the control group (n = 14 eyes), respectively. The mean preoperative BCVA was 0.15 ± 0.3 in Group 1, and 0.41 ± 0.39 in Group 2. The mean BCVA increased to 0.03 ± 0.1 in Group 1 in the postoperative period but did not change in Group 2. MD value was - 6.10 ± 5.54 in the preoperative period and - 2.59 ± 2.23 in the postoperative period for Group 1 (p = 0.014), while it was - 18.97 ± 4.14 in the preoperative period and - 18.57 ± 4.51 in the postoperative period in Group 2 (p = 0.24).
This study suggests that lower mean preoperative RNFL thickness was associated with poorer long-term visual prognosis. Preoperative RNFL thickness measurements may be helpful in predicting the recovery of VF and VA after decompression surgery in patients with chiasmal lesion presenting with visual impairment.