peripapillary nerve fiber layer

  • 文章类型: Journal Article
    背景:髓磷脂少突胶质细胞糖蛋白抗体相关疾病(MOGAD)包括各种年龄依赖性临床表型,可能是单相的,多相,或慢性。视神经炎(ON)是一种常见的表现,常与其他MOGAD表型结合出现,特别是在年幼的孩子。尽管视网膜神经纤维层(RNFL)有永久性结构损伤,儿童经常经历完全的视觉恢复。
    目的:独立于ON病史分析MOGAD的进展及对患儿视觉系统的影响。
    方法:这项回顾性研究包括符合特定标准的儿童:髓鞘少突胶质细胞糖蛋白(MOG)免疫球蛋白G(IgG)血清阳性,MOGAD的急性表现,和书面的一般同意。主要观察指标为整体乳头周围视网膜神经纤维层(pRNFL)厚度,以及近距离和远距离视力,使用描述性统计分析。
    结果:我们确定了10例患者,首次事件的中位年龄为7.7岁:7例患者表现为急性播散性脑脊髓炎(ADEM)(ON5/7,ADEM仅1/7,横贯性脊髓炎(TM)1/7),2具有隔离ON,1例患有视神经脊髓炎谱系障碍(NMOSD)样表型的ON患者。在ON患者中,5/8受到双边影响,3例最初诊断为单侧ON,但随后累及对方眼。没有先前ON的患者均未显示视力下降,如果评估,pRNFL的减少。
    结论:我们队列中大多数儿童MOGAD-ON患者表现为急性眼膜缺损和视盘水肿。所有患者视力完全恢复,独立于复发或初始视力丧失的数量。在没有进一步复发的情况下,pRNFL厚度降低了几个月,并在12个月后稳定在降低的水平。MOGAD可能对视觉系统没有亚临床/“沉默”影响,因为没有ON的患者视力和pRNFL没有受到影响。
    BACKGROUND: Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) comprises various age-dependent clinical phenotypes and may be monophasic, multiphasic, or chronic. Optic neuritis (ON) is a common manifestation and frequently appears in combination with other MOGAD phenotypes, particularly in young children. Despite permanent structural damage to the retinal nerve fiber layer (RNFL), children often experience complete visual recovery.
    OBJECTIVE: To analyze the progression and impact of MOGAD on the visual system of pediatric patients independently of the history of ON.
    METHODS: This retrospective study included children who met specific criteria: myelin oligodendrocyte glycoprotein (MOG) immunoglobulin G (IgG) seropositivity, acute presentation of MOGAD, and written general consent. Main outcome measures were global peripapillary retinal nerve fiber layer (pRNFL) thickness, and near and distance visual acuity, analyzed using descriptive statistics.
    RESULTS: We identified 10 patients with median age of 7.7 years at first event: 7 patients manifested with acute disseminated encephalomyelitis (ADEM) (with ON 5/7, ADEM only 1/7, with transverse myelitis (TM) 1/7), 2 with isolated ON, and 1 patient with neuromyelitis optica spectrum disorder (NMOSD)-like phenotype with ON. Among ON patients, 5/8 were affected bilaterally, with 3 initially diagnosed with unilateral ON but experiencing subsequent involvement of the fellow eye. None of the patients without previous ON showed a deterioration of visual acuity and, if evaluated, a reduction of the pRNFL.
    CONCLUSIONS: Most pediatric MOGAD-ON patients in our cohort presented with acute vison loss and optic disc edema. All patients achieved complete visual recovery, independent of number of relapses or initial visual loss. The pRNFL thickness decreased for several months and stabilized at reduced levels after 12 months in the absence of further relapses. MOGAD may not have subclinical/\'silent\' effects on the visual system, as visual acuity and pRNFL were not affected in patients without ON.
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  • 文章类型: Journal Article
    目的:本研究的目的是评估儿童青光眼(CG)和健康受试者的乳头周围血管指数。
    方法:在此前瞻性中,Unicenter,观察性横断面研究,纳入了CG患者以及年龄和性别匹配的健康受试者.我们比较了光学相干断层扫描(OCT)中的视网膜神经纤维层(RNFL)测量,乳头周围血管密度(PVD),CG患者和对照组之间的OCT血管造影(OCT-A)的浅表血管丛通量指数(FI)。
    结果:我们包括39例(68只眼)CG患者和50例(95只眼)健康受试者。乳头周围RNFL厚度,血管密度,CG组的通量指数明显低于对照组。CG患者的平均PVD为0.52±0.043%,与0.55±0.014%相比,在健康受试者中p<0.0001。CG患者和健康受试者的平均FI为0.32±0.054和0.37±0.028,p<0.0001,分别。PVD和FI在上级,劣等,CG和时间部门明显较低。乳头周围RNFL厚度显示出更高的ROC曲线下面积(AUROC),可区分健康眼和CG眼,并且与PVD显着不同(0.797,95CI0.726-0.869;p<0.0001vs.0.664,95CI0.574-0.752;p0.00037),第0.012页。
    结论:PVD和FI在CG中显示出较低的值,并且与RNFL厚度测量相关,但诊断能力低于RNFL厚度测量。我们的结果揭示了儿童青光眼患者微血管损害的发病机理可能存在差异。
    OBJECTIVE: The aim of this study concerns the evaluation of peripapillary vessel indices in childhood glaucoma (CG) and healthy subjects.
    METHODS: In this prospective, unicenter, observational cross-sectional study, patients with CG and age and sex-matched healthy subjects were included. We compared retinal nerve fiber layer (RNFL) measurements in optical coherence tomography (OCT), peripapillary vessel density (PVD), and the flux index (FI) of the superficial vascular plexus from OCT angiography (OCT-A) between CG patients and control groups.
    RESULTS: We included 39 patients (68 eyes) with CG and 50 (95 eyes) healthy subjects. The peripapillary RNFL thickness, vessel density, and flux index were significantly lower in the CG group than in the control group. The mean PVD of CG patients was 0.52 ± 0.043%, compared with 0.55 ± 0.014%, p < 0.0001 in healthy subjects. The mean FI was 0.32 ± 0.054 versus 0.37 ± 0.028, p < 0.0001, in CG patients and healthy subjects, respectively. PVD and FI in the superior, inferior, and temporal sectors were significantly lower in CG. The peripapillary RNFL thickness showed a higher area under the ROC curve (AUROC) for discriminating healthy and CG eyes and was significantly different than the PVD (0.797, 95%CI 0.726-0.869; p < 0.0001 vs. 0.664, 95%CI 0.574-0.752; p 0.00037), p 0.012.
    CONCLUSIONS: PVD and FI show lower values in CG and correlate with RNFL thickness measurement but have lower diagnostic ability than RNFL thickness measurement. Our results reveal possible differences in the pathogenesis of microvascular compromise in childhood glaucoma patients.
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  • 文章类型: Journal Article
    BACKGROUND: To describe objectively the possible structural changes of the macula and optic nerve head in the free eyes of unilateral cured retinoblastoma patients and, also after enucleation using spectral domain optical coherence tomography.
    METHODS: A cross sectional study involving 60 patients subdivided into three groups; 15 unilateral RB patients in whom enucleation was indicated as a sole treatment performed earlier in life [(study group (I)], 15 unilateral RB patients who had completely regressed disease with a preserved eye [(study group (II)] and 30 age and sex matched healthy controls. The remaining and free eyes in study groups and right eyes of control group had full ophthalmological examination, static automated perimetry and optical coherence tomography of the macula and optic nerve head.
    RESULTS: In study group (II); a significant thinning of total macula, central fovea, ganglion cell layer (GCL), ganglion cell complex (GCC), and some sectors of outer nuclear layer (P- values ≤0.05) was found with no significant difference in peripapillary nerve fiber layer (pRNFL) thickness and optic nerve head parameters compared to the control group and the study group (I). A significantly thickened total macula, GCL, GCC, and pRNFL in study group (I) compared to study group (II). Thickened pRNFL was significantly correlated to standard automated perimetry pattern deviations. No significant difference was found between study group (I) and control group.
    CONCLUSIONS: Retinoblastoma eyes characterized by thinning of central fovea, GCL, GCC compared to the control group. After unilateral enucleation, increased GCC and pRNFL thicknesses were detected compared to retinoblastoma group.
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