Detection of Retinal Glial Cell Activation in Glaucoma by Time Domain Optical Coherence Tomography
Detection of Retinal Glial Cell Activation in Glaucoma by Time Domain Optical Coherence Tomography
复制标题
DOI：
10.1055/s-0031-1281857
复制
发表时间：
2012-04-01
影响因子：
0.8
通讯作者：
Orguel, S.
中科院分区：
文献类型：
--
作者：
Grieshaber, M. C.;Moramarco, F.;Orguel, S.
背景：在青光眼患者中已发现活化的视网膜星形胶质细胞和穆勒细胞(ARAM)。这项研究探讨了光学相干断层扫描(OCT)是否可以检测到假定的ARAM，并评估了它们与视网膜神经纤维层(RNFL)厚度的关系。患者和方法：单中心观察研究，包括35名年龄匹配的健康对照组和19名年龄在45-82岁之间的原发性开角型青光眼(POAG)患者。推测ARAM的定义是斑点状、离散的闪闪发光但透明的黄斑改变。用无红光摄影记录视网膜，以评估ARAM的分布，并与OCT测量的中心凹周围RNFL厚度进行比较。使用线性混合效应模型检验ARAM患者和非ARAM患者之间的差异。结果：ARAM患者中未发现ARAM。正常对照组中心凹周围RNFL平均厚度(34.01 SD+/-22.24)与POAG伴ARAM组(30.86微米SD+/-15.09；P=0.36)和无ARAM组(33.19微米SD+/-19.87；P=0.46)相比，差异无统计学意义。此外，POAG患者RNFL厚度的中位数与对照组相似(29微米)，但略薄(分别为27微米的ARAM和非ARAM)。在对POAG患者合并ARAM的亚组分析中，ARAM区的RNFL的受试者内标准差(SD10.12)显著低于非ARAM区(SD17.30)(p<；0.001)。结论：虽然两组间的平均RNFL厚度和中位数RNFL厚度相似，但ARAM区的RNFL厚度的变异性显著低于非ARAM区，提示ARAM可能掩盖POAG患者的RNFL丢失。
Background: Activated retinal astrocytes and Muller cells (ARAM) have been found in glaucoma patients. This study investigated whether presumed ARAM can be detected by optical coherence tomography (OCT), and assessed their relationship to the retinal nerve fiber layer (RNFL) thickness.Patients and Methods: Single-center observational study involving 35 age-matched healthy controls and 19 patients with primary open-angle glaucoma (POAG) between 45-82 years of age. Presumed ARAM was defined as patchy, discrete glittering but transparent changes of the macula. The retina was documented by red-free photography to assess distribution of ARAM, and compared to the RNFL thickness measured around the fovea by OCT. A linear mixed effects model was used to detect a difference between eyes with ARAM versus eyes without ARAM.Results: ARAM was not found in healthy subjects. The mean RNFL around the fovea was not significantly thicker in healthy controls (34.01 SD +/- 22.24) than in POAG patients with ARAM (30.86 microns SD +/- 15.09; p = 0.36) or without ARAM (33.19 microns SD +/- 19.87; p = 0.46). Furthermore, the median RNFL thickness was similar to the control group (29 microns) but slightly thinner in POAG patients (each 27 microns with ARAM and without ARAM). In a subgroup analysis of POAG patients with ARAM, the within subject standard deviation of RNFL was significantly lower in areas with ARAM (SD 10.12) than in areas without ARAM (SD 17.30) (p < 0.001).Conclusions: Although the mean and median RNFL thickness was comparable between the groups, the variability of the RNFL thickness was significantly lower in areas with ARAM than in areas without ARAM suggesting that ARAM may mask RNFL loss in POAG patients.