[1]孟照洋,王艳玲,王佳琳,等.开角型青光眼患者视盘及脉络膜变化分析[J].眼科新进展,2018,38(9):861-864.[doi:10.13389/j.cnki.rao.2018.0203]
　MENG Zhao-Yang,WANG Yan-Ling,WANG Jia-Lin,et al.Choroid structure changes and optic disc analysis in open-angle glaucoma patients[J].Recent Advances in Ophthalmology,2018,38(9):861-864.[doi:10.13389/j.cnki.rao.2018.0203]
点击复制

开角型青光眼患者视盘及脉络膜变化分析/HTML
分享到：

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
38卷
期数:
2018年9期
页码:
861-864
栏目:
应用研究
出版日期:
2018-09-05

文章信息/Info

Title:
Choroid structure changes and optic disc analysis in open-angle glaucoma patients
作者:
孟照洋; 王艳玲; 王佳琳; 汪晓磊
100050　北京市，首都医科大学附属北京友谊医院眼科
Author(s):
MENG Zhao-Yang; WANG Yan-Ling; WANG Jia-Lin; WANG Xiao-Lei
Department of Ophthalmology，Beijing Friendship Hospital，Capital Medical University，Beijing 100050，China
关键词:
开角型青光眼; 脉络膜厚度; 神经纤维层厚度; 视盘
Keywords:
open-angle glaucoma; choroid thickness; retinal nerve fiber layer thickness; optic disc
分类号:
R775.1
DOI:
10.13389/j.cnki.rao.2018.0203
文献标志码:
A
摘要:
目的　通过频域OCT检查探讨开角型青光眼（open-angle glaucoma，OAG）患者视网膜及脉络膜各参数的变化。方法　回顾性病例对照研究。临床检查确诊为OAG的19例（30眼）患者为OAG组，健康人15名（30眼）为对照组。采用频域OCT的EDI模式测量2组视盘周围神经纤维层厚度、视盘周围脉络膜厚度及黄斑中心凹处神经纤维层厚度、黄斑中心凹处脉络膜厚度，并作对比。结果　OAG组受检眼6方位视盘周围神经纤维层厚度均明显低于对照组，差异均有统计学意义（均为P＜0.05）；5方位（颞上方、颞侧、鼻上方、鼻侧及鼻下方）视盘周围脉络膜厚度均明显低于对照组（均为P＜0.05），尤其以鼻侧及鼻下方变薄更明显。OAG组黄斑处神经纤维层厚度［（11.27±1.93）μm］及黄斑中心凹处脉络膜厚度［（217.37±11.46）μm］与正常对照组［（11.57±1.65）μm、(215.65±12.42)μm］相比，差异均无统计学意义（均为P>0.05）;两组间黄斑部直径3 mm的内环鼻侧、颞侧区域和直径6 mm的外环鼻侧、颞侧区域脉络膜厚度差异均无统计学意义（均为P>0.05）。结论　OAG患者与正常人相比，视盘周围脉络膜厚度减少，且视盘鼻侧及鼻下方脉络膜厚度变薄更为显著，可能与脉络膜血供减少造成的青光眼缺血性损伤相关。OAG患者黄斑部脉络膜厚度并未发生明显变化。
Abstract:
Objective　To investigate the changes of retinal and choroid parameters in open-angle glaucoma patients by using the enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT).Methods　A retrospective case-control study was conducted in 19 patients (30 eyes) with open-angle glaucoma (OAG) and 15 normal controls (30 eyes),who were enrolled in this study.EDI-OCT was used to measure the peripheral nerve fiber layer thickness (pRNFLT),peripheral choroidal thickness (pCT),the macular nerve fiber layer thickness (RNFLT) and macular choroidal thickness(mCT).The OCT parameters of the two groups were compared.Results　The pRNFLT in 6 sections in the OAG group were significantly lower than the control group (all P<0.05)；the pCT in 5 sections (superior temporal,temporal,superior nasal,nasal and inferior nasal section) in the OAG group were significantly lower than those of the control group (all P<0.05),especially thinner on the nasal and inferior nasal section.The RNFLT and mCT was (11.27±1.93)μm and (217.37±11.46)μm in the OAG group,and (11.57±1.65)μm and (215.65±12.42)μm in the normal control group,respectively,and the difference was not statistically significant (both P>0.05);There was no significant difference in the choroidal thickness on the nasal and temporal section of inner regional around a diameter of 3 mm and the nasal and temporal section of outer regional around a diameter of 6 mm (all P>0.05).Conclusion　Compared with normal people,patients with OAG have thinner pCT and the thinning of the choroid in the nasal side and inferior nasal section of optic disc may be more significant,and this may be related to the loss of glaucoma ischemic injury caused by the decrease of choroid blood supply.There wis no significant change in the mCT in OAG patients.

参考文献/References:

［1］　QUIGLEY H A，BROMAN A T.The number of people with glaucoma worldwide in 2010 and 2020［J］.Br J Ophthalmol，2006，90（3）：262-267.
［2］　KOUNTOURAS J，ZAVOS C，CHATZOPOULOS D.Primary open-angle glaucoma：pathophysiology and treatment［J］.Lancet，2004，364（9442）：1311-1312.
［3］　GALASSI F，SODI A，UCCI F，RENIERI G，PIERI B，BACCINI M.Ocular hemodynamics and glaucoma prognosis：a color Doppler imaging study［J］.Arch Ophthalmol，2003，121（12）：1711-1715.
［4］　ALM A，BILL A.Ocular and optic nerve blood flow at normal and increased intraocular pressures in monkeys （Macaca irus）：a study with radioactively labelled microspheres including flow determinations in brain and some other tissues［J］.Exp Eye Res，1973，15（1）：15-29.
［5］　PARVER L M，AUKER C，CARPENTER D O.Choroidal blood flow as a heat dissipating mechanism in the macula［J］.Am J Ophthalmol，1980，89（5）：641-646.
［6］　CIOFFI G A，WANG L，FORTUNE B，CULL G，DONG J，BUI B，et al.Chronic ischemia induces regional axonal damage in experimental primate optic neuropathy［J］.Arch Ophthalmol，2004，122（10）：1517-1525.
［7］　DUIJM H F，TJ V D B，GREVE E L.Choroidal haemodynamics in glaucoma［J］.Br J Ophthalmol，1997，81（9）：735-742.
［8］　YIN Z Q，VAEGA N，MILLAR T J，BEAUMONT P，SARKS S.Widespread choroidal insufficiency in primary open-angle glaucoma［J］.J Glaucoma，1997，6（1）：23-32.
［9］　GRUNWALD J E，PILZT J，HARIPRASAD S M，DUPONT J.Optic nerve and choroidal circulation in glaucoma［J］.Invest Ophthalmol Vis Sci，1998，39 （12）：23-29.
［10］　HAYREH S S.The blood supply of the optic nerve head and the evaluation of it-myth and reality［J］.Prog Retin Eye Res，2001，20（5）：563-593.
［11］　HIROOKA K，TENKUMO K，FUJIWARA A，BABA T，SATO S，SHIRAGA F.Evaluation of peripapillary choroidal thickness in patients with normal-tension glaucoma［J］.BMC Ophthalmol，2012，12（1）：1-6.
［12］　USUI S，IKUNO Y，MIKI A，MATSUSHITA K，YASUNO Y，NISHDA K.Evaluation of the choroidal thickness using high-penetration optical coherence tomography with long wavelength in highly myopic normal-tension glaucoma［J］.Am J Ophthalmol，2012，153（1）：10-16.
［13］　PARK H Y，LEE N Y，SHIN H Y，PARK C K.Analysis of macular and peripapillary choroidal thickness in glaucoma patients by enhanced depth imaging optical coherence tomography［J］.J Glaucoma，2014，23（4）：225.
［14］　HIROOKA K，FUJIWARA A，SHIRAGAMI C，BABA T，SHIRAGA F.Relationship between progression of visual field damage and choroidal thickness in eyes with normal-tension glaucoma［J］.Clin Exp Ophthalmol，2012，40（6）：576-582.
［15］　PABLO L E，BAMBO M P，CAMEO B，FERRANDEZ B，GUERRI N，POLO V，et al.The use of zonal analysis of peripapillary choroidal thickness in primary open-angle glaucoma［J］.Jpn J Ophthalmol，2017，62（3）：1-7.
［16］　MAUL E A，FRIEDMAN D S，CHANG D S，BOLAND M V，RAMULU P Y，JAMPEL H D，et al.Choroidal thickness measured by spectral domain optical coherence tomography：Factors affecting thickness in glaucoma patients［J］.Ophthalmology，2011，118（8）：1571-1579.
［17］　HAMID H，NAVEED N，SASAN M，ELENA B，JAY R，GINA Y L，et al.Peripapillary and macular choroidal thickness in glaucoma［J］.J Ophthalmic Vis Res，2014，9（2）：154-161.
［18］　EHRLICH J R，PETERSON J，PARLITSIS G，KAY K Y，KISS S，RADCLIFFE N M.Peripapillary choroidal thickness in glaucoma measured with optical coherence tomography［J］.Exp Eye Res，2011，92（3）：189-194.
［19］　SUH W，CHO H K，KEE C.Evaluation of peripapillary choroidal thickness in unilateral normal-tension glaucoma［J］.Jpn J Ophthalmol，2014，58（1）：62.
［20］　ROBERTS K F，ARTES P H，O’LEARY N，REIS A S，SHARPE G P，HUTCHISON D M，et al.Peripapillary choroidal thickness in healthy controls and patients with focal，diffuse，and sclerotic glaucomatous optic disc damage［J］.Arch Ophthalmol，2012，130（8）：980.
［21］　JIANG R，WANG Y X，WEI W B，XU L，JONAS J B.Peripapillary choroidal thickness in adult Chinese：The Beijing Eye Study［J］.Invest Ophthalmol Vis Sci，2015，56（6）：4045.
［22］　GUPTA P，JING T，MARZILIANO P，BASKARAN M，CHEUNG G C，LAMOUREUX E L，et al.Peripapillary choroidal thickness assessed using automated choroidal segmentation software in an Asian population［J］.Br J Ophthalmol，2015，99（7）：920.
［23］　GOHARIAN I，SEHI M.Is there any role for the choroid in glaucoma［J］?J Glaucoma，2016，25（5）：452-458.
［24］　TAN C S，OUYANG Y，RUIZ H，SADDA S R.Diurnal variation of choroidal thickness in normal，healthy subjects measured by spectral domain optical coherence tomography［J］.Invest Ophthalmol Vis Sci，2012，53（1）：261.
［25］　MWANZA J C，HOCHBERG J T，BANITT M R，FEUER W J，BUDENZ D L.Lack of association between glaucoma and macular choroidal thickness measured with enhanced depth-imaging optical coherence tomography［J］.Invest Ophthalmol Vis Sci，2011，52（6）：3430-3435.

相似文献/References:

[1]马恩普 赵小钊 董良 刘苏冰.Nd:YAG激光房角穿刺治疗非穿透性小梁手术后高眼压[J].眼科新进展,2012,32(9):000.
[2]韩光杰,周和政,张文强,等.Ex-PRESS引流钉植入术与小梁切除术治疗开角型青光眼的早期疗效比较[J].眼科新进展,2014,34(8):758.[doi:10.13389/j.cnki.rao.2014.0208]
　HAN Guang-Jie,ZHOU He-Zheng,ZHANG Wen-Qiang,et al.Comparison of therapeutic effect in early stage between Ex-PRESS implantation and trabeculectomy for open angle glaucoma[J].Recent Advances in Ophthalmology,2014,34(9):758.[doi:10.13389/j.cnki.rao.2014.0208]
[3]张春巍,高效曼,李睿姝,等. 应用三维光学相干断层成像术测量正常人脉络膜厚度及其影响因素的研究[J].眼科新进展,2015,35(3):274.[doi:10.13389/j.cnki.rao.2015.0073]
　ZHANG Chun-Wei,GAO Xiao-Man,LI Rui-Shu,et al. Assessment of choroidal thickness in hezdthy eyes using deep range imaging optical coherence tomography[J].Recent Advances in Ophthalmology,2015,35(9):274.[doi:10.13389/j.cnki.rao.2015.0073]
[4]罗铭,李红阳,马胜生,等. 青少年高度近视眼的脉络膜厚度改变[J].眼科新进展,2015,35(5):449.[doi:10.13389/j.cnki.rao.2015.0122]
　LUO Ming,LI Hong-Yang,MA Sheng-Sheng,et al. Changes of choroidal thickness in adolescent high myopia[J].Recent Advances in Ophthalmology,2015,35(9):449.[doi:10.13389/j.cnki.rao.2015.0122]
[5]景作乾,柳力敏,陈蕾. 应用EDI-SDOCT观察全视网膜光凝对糖尿病视网膜病变黄斑区脉络膜厚度的影响[J].眼科新进展,2015,35(9):839.[doi:10.13389/j.cnki.rao.2015.0229]
　JING Zuo-Qian,LIU Li-Min,CHEN Le. Effects observation of panretinal photocoagulation on macular choroidal thickness of diabetic retinopathy by EDI-SDOCT[J].Recent Advances in Ophthalmology,2015,35(9):839.[doi:10.13389/j.cnki.rao.2015.0229]
[6]邵晓蕾,周秀珍,秦波.青少年屈光不正人群中脉络膜厚度的研究[J].眼科新进展,2015,35(10):968.[doi:10.13389/j.cnki.rao.2015.0264]
　SHAO Xiao-Lei,ZHOU Xiu-Zhen,QIN Bo.Analysis of choroidal thickness in juvenile ametropia[J].Recent Advances in Ophthalmology,2015,35(9):968.[doi:10.13389/j.cnki.rao.2015.0264]
[7]郭春英,乔丽君,张婧,等.急性前葡萄膜炎黄斑中心凹下脉络膜厚度的改变[J].眼科新进展,2015,35(12):1152.[doi:10.13389/j.cnki.rao.2015.0315]
　GUO Chun-Ying,QIAO Li-Jun,ZHANG Jing,et al.Changes of subfoveal choroidal thickness in acute anterior uveitis[J].Recent Advances in Ophthalmology,2015,35(9):1152.[doi:10.13389/j.cnki.rao.2015.0315]
[8]滕娟,王云鹏,陈梅珠.糖尿病患者微量白蛋白尿对其脉络膜厚度的影响[J].眼科新进展,2016,36(3):237.[doi:10.13389/j.cnki.rao.2016.0063]
　TENG Juan,WANG Yun-Peng,CHEN Mei-Zhu.Effects of microalbuminuria on choroidal thickness in diabetic patients[J].Recent Advances in Ophthalmology,2016,36(9):237.[doi:10.13389/j.cnki.rao.2016.0063]
[9]赵露,洪慧,谢国丽,等.玻璃体内注射雷珠单抗对湿性年龄相关性黄斑变性患者脉络膜厚度及睫状后动脉血流的影响[J].眼科新进展,2016,36(8):745.[doi:10.13389/j.cnki.rao.2016.0198]
　ZHANG Lu,HONG Hui,XIE Guo-Li,et al.Effects of intravitreal ranibizumab injection on subfoveal choroidal thickness and posterior ciliary artery hemodynamics in patients with wet age-related macular degeneration[J].Recent Advances in Ophthalmology,2016,36(9):745.[doi:10.13389/j.cnki.rao.2016.0198]
[10]郁艳萍,刘武.脉络膜厚度与特发性黄斑裂孔和黄斑前膜关系的研究进展[J].眼科新进展,2016,36(9):898.[doi:10.13389/j.cnki.rao.2016.0241]
　YU Yan-Ping,LIU Wu.Research progress on relationship between choroidal thickness and idiopathic macular hole , epiretinal membrane[J].Recent Advances in Ophthalmology,2016,36(9):898.[doi:10.13389/j.cnki.rao.2016.0241]

更新日期/Last Update: 2018-08-31