Enhanced Depth Imaging Optical Coherence Tomography of Deep Optic Nerve Complex Structures in Glaucoma
Enhanced Depth Imaging Optical Coherence Tomography of Deep Optic Nerve Complex Structures in Glaucoma
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DOI：
10.1016/j.ophtha.2011.07.012
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发表时间：
2012-01-01
期刊：
影响因子：
13.7
通讯作者：
Ritch, Robert
中科院分区：
文献类型：
--
作者：
Park, Sung Chul;De Moraes, Carlos Gustavo V.;Ritch, Robert
目的：评估增强深度成像（EDI）光学相干断层扫描（OCT）评价视神经复合体深部结构的有效性设计：前瞻性观察性研究。参与者：73例确诊的青光眼患者方法：从每位参与者的双眼获得ONC的连续水平和垂直EDI OCT图像。研究深层ONC结构，包括筛板（LC）、睫状后短动脉（SPCA）、视网膜中央动脉（CRA）、视网膜中央静脉（CRV）、视神经周围的视乳头周围脉络膜和巩膜以及蛛网膜下腔的可见性和形态学特征。主要指标：EDI OCT图像中识别的深层ONC结构。纳入的139只眼的视野平均偏差为-11.8 +/- 8.6 dB（范围，-28.70至-2.01 dB）。在中央椎板区的所有眼睛和在神经视网膜和巩膜缘或血管结构下方的周边中的91只（65%）眼睛中，确定了前椎板表面。106眼（76%）可见不同形状和大小的LC孔，主要位于LC的中央和颞部。在EDI OCT图像中，将视盘照片上观察到的局部LC病变确定为局灶性LC缺损（LC组织部分缺失）。确定所有患眼CRA和CRV的位置。在LC中，CRA保持了口径一致的直线形状，但CRV（和支流）呈现出更不规则的形状。120只眼（86%）显示了SPCA及其穿过巩膜导小管的分支或两者。25只眼（18%）视神经周围蛛网膜下腔清晰度不同，其中17只眼高度近视伴广泛的视乳头旁萎缩。在2只眼（1%）高度近视眼中发现了临床上未被识别的脉络膜内空洞或脉络膜裂。结论：增强型深度成像OCT能够显示青光眼患者中各种各样的深层ONC结构，可能有助于检测、概念化和理解青光眼中ONC的基本和复杂的体内解剖和病理特征。在参考文献之后可以找到专有或商业披露。Ophthalmology 2012; 119：3-9（C）2012，美国眼科学会。
Objective: To assess the usefulness of enhanced depth imaging (EDI) optical coherence tomography (OCT) for evaluating deep structures of the optic nerve complex (ONC; optic nerve head and peripapillary structures) in glaucoma.Design: Prospective, observational study.Participants: Seventy-three established glaucoma patients (139 eyes) with a range of glaucomatous damage.Methods: Serial horizontal and vertical EDI OCT images of the ONC were obtained from both eyes of each participant. Deep ONC structures, including the lamina cribrosa (LC), short posterior ciliary artery (SPCA), central retinal artery (CRA), central retinal vein (CRV), peripapillary choroid and sclera, and subarachnoid space around the optic nerve, were investigated for their visibility and morphologic features.Main Outcome Measures: Deep ONC structures identified in EDI OCT images.Results: Visual field mean deviation of 139 included eyes was -11.8 +/- 8.6 dB (range, -28.70 to -2.01 dB). The anterior laminar surface was identified in all eyes in the central laminar area and in 91 (65%) eyes in the periphery beneath the neuroretinal and scleral rims or vascular structures. The LC pores with various shapes and sizes were visualized in 106 (76%) eyes, mainly in the central and temporal areas of the LC. Localized LC lesions seen on optic disc photographs were identified as focal LC defects (partial loss of LC tissue) in the EDI OCT images. The locations of the CRA and CRV were identified in all eyes. In the LC, the CRA maintained a straight shape with a consistent caliber, but the CRV (and tributaries) assumed a more irregular shape. The SPCAs, their branches through the emissary canals in the sclera, or both were visualized in 120 (86%) eyes. The subarachnoid space around the optic nerve was identified with varying degrees of clarity in 25 eyes (18%): 17 had high myopia and extensive parapapillary atrophy. Intrachoroidal cavitation or choroidal schisis, which had been unrecognized clinically, was identified in 2 eyes (1%) with high myopia.Conclusions: Enhanced depth imaging OCT was able to visualize a wide variety of deep ONC structures in glaucoma patients and may be helpful in detecting, conceptualizing, and understanding basic and complicated in vivo anatomic and pathologic features of the ONC in glaucoma.Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references. Ophthalmology 2012; 119: 3-9 (C) 2012 by the American Academy of Ophthalmology.