目的:使用变化分析软件(CAS)表征视网膜神经纤维层(RNFL)早期患者的青光眼进展,用于跟踪RNFL变薄。
方法:我们回顾性分析了92例早期青光眼患者的92只眼。根据对假性剥脱性青光眼(PEG)和原发性开角型青光眼(POAG)的诊断,将患者分为两个亚组。对所有患者进行了完整的眼科检查。此外,对每位患者进行自动视野检查.此外,傅里叶域光学相干断层扫描(OCT)用于测量RNFL和中央角膜厚度。使用OCT设备的CAS,我们计算了每位患者的年度总RNFL和青光眼RNFL减薄率。
结果:共有44名PEG和48名POAG患者被纳入研究。对这些患者的右眼测量结果进行分析和比较。两组患者年龄差异无统计学意义,性别,以及每年的就诊次数(每次p>0.05)。然而,基线时(91.39±10.71和96.9±8.6µm)和末次访视时(85.2±15.76µm和91.56±9.58µm)的平均RNFL厚度在两组间差异有统计学意义(分别为p=0.043,p=0.039).此外,两组之间的年度RNFL减薄率(1.43±0.81µm和1.07±0.32µm)差异有统计学意义(p=0.009).
结论:早期PEG患者的青光眼性RNFL年损失率(1.23µm)高于POAG患者(0.87µm)。然而,尽管有这些损失率,在这些患者的视野检查中未检测到暗点.因此,在早期青光眼患者的随访中使用CAS是监测青光眼进展的有用替代方法.此外,这种方法可用于特殊人群青光眼的诊断和随访的未来研究(例如,病理性近视或高度远视者)未包含在规范数据库中。
OBJECTIVE: To characterize glaucoma progression in early-stage patients with retinal nerve fiber layer (RNFL) using the change analysis software (CAS), which was utilized to track RNFL thinning.
METHODS: We retrospectively analyzed 92 eyes of 92 patients with early-stage glaucoma. Patients were divided into two subgroups based on their diagnosis of pseudoexfoliation glaucoma (PEG) and primary open-angle glaucoma (POAG). A complete ophthalmologic examination was performed on all patients. Additionally, automated perimetry was conducted on each patient. Furthermore, Fourier-domain optical coherence tomography (OCT) was employed to measure RNFL and central corneal thickness. Using the OCT device\'s CAS, we computed the annual rate of total and glaucomatous RNFL thinning for each patient.
RESULTS: A total of 44 PEG and 48 POAG patients were included in the study. The right eye measurements of these patients were analyzed and compared. The two groups were not significantly different in age, gender, and the number of visits per year (p > 0.05, for each). However, the difference between the mean RNFL thickness at baseline (91.39 ± 10.71 and 96.9 ± 8.6 µm) and at the last visit (85.2 ± 15.76 µm and 91.56 ± 9.58 µm) was statistically significant between the two groups (p = 0.043, p = 0.039, respectively). Additionally, the difference in annual RNFL thinning rates (1.43 ± 0.81 µm and 1.07 ± 0.32 µm) between the two groups was statistically significant (p = 0.009).
CONCLUSIONS: The annual rate of glaucomatous RNFL loss in early-stage PEG patients (1.23 µm) was higher than in POAG patients (0.87 µm). However, despite these loss rates, scotoma was not detected in the visual field tests of these patients. Therefore, using CAS in the follow-up of early-stage glaucoma patients is a useful alternative for monitoring glaucomatous progression. Furthermore, this method can be utilized in future research for the diagnosis and follow-up of glaucoma in special populations (e.g., those with pathological myopia or high hyperopia) that are not included in normative databases.