Retinal Ganglion Cell Layer Thinning Within One Month of Presentation for Non-Arteritic Anterior Ischemic Optic Neuropathy.
Retinal Ganglion Cell Layer Thinning Within One Month of Presentation for Non-Arteritic Anterior Ischemic Optic Neuropathy.
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DOI：
10.1167/iovs.15-18736
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发表时间：
2016-07-01
影响因子：
4.4
通讯作者：
Kardon R
中科院分区：
文献类型：
--
作者：
Kupersmith MJ;Garvin MK;Wang JK;Durbin M;Kardon R
光学相干断层扫描显示慢性视神经损伤时视网膜神经节细胞层（GCL）和视网膜神经纤维层（RNFL）变薄。急性视神经损伤，如急性非动脉炎性前部缺血性视神经病变（NAION），肿胀掩盖了RNFL变薄的早期表现，这可能用于评估治疗。我们假设GCL加内丛状层（IPL）厚度和变薄轨迹的测量将显示其是早期永久性神经元损伤的更早和更准确的生物标志物。我们前瞻性研究了29例急性NAION患眼，采用标准自动视野检查和光谱域（SD）光学相干断层扫描进行了6个月的研究。我们使用三维层分割（方法1）和商业专有（方法2）来计算黄斑GCL+IPL的组合厚度，并使用方法2来计算视乳头周围RNFL厚度。就诊时，NAION患眼的平均GCL+IPL厚度（78.7 μm ± 8.9）与未受影响的对侧患眼（83 μm ± 6.4）无差异，使用方法1，而方法2（66.8 μm ± 18.7）在34%的NAION患眼中失败。在1至2个月时，与基线相比，12%的RNFL丢失，而68%的NAION眼睛GCL+IPL变薄。神经节细胞层加内网状层减少在1至2个月时最大（19.6 μm ± 12.6），3个月后最小程度恶化。神经节细胞层和内丛状层变薄与每个检查时间的视力和平均偏差呈中度至高度显着相关。视网膜神经纤维层直到3个月才变薄。神经节细胞层加内丛状层是急性不受影响，并提供了一个可靠的测量视网膜神经元结构使用三维分割。变薄在发病后1至2个月内发生，这在RNFL肿胀消退之前。这表明GCL+IPL测量比RNFL厚度更好地用作NAION早期结构丢失的生物标志物。
Optical coherence tomography reveals retinal ganglion cell layer (GCL) and retinal nerve fiber layer (RNFL) thinning in chronic optic nerve injury. With acute optic nerve injury, as in acute nonarteritic anterior ischemic optic neuropathy (NAION), swelling obscures early demonstration of RNFL thinning, which might be used to evaluate therapies. We hypothesized that measurement of GCL plus inner plexiform layer (IPL) thickness and trajectory of thinning would show it is an earlier and more accurate biomarker of early permanent neuronal injury. We prospectively studied 29 acute NAION eyes with standard automated perimetry and spectral domain (SD) optical coherence tomography for 6 months. We used a three-dimensional layer segmentation (method 1) and a commercial proprietary (method 2), to compute the combined thickness of macular GCL+IPL and method 2 to compute peripapillary RNFL thickness. At presentation, the mean GCL+IPL thickness (78.7 μm ± 8.9) for NAION eyes, did not differ from unaffected fellow eyes (83 μm ± 6.4), using method 1 while method 2 (66.8 μm ± 18.7) failed in 34% of NAION eyes. At 1 to 2 months, 12% had RNFL loss compared to baseline, while 68% of NAION eyes had GCL+IPL thinning. The ganglion cell layer plus inner plexiform layer reduction was greatest at 1 to 2 months (19.6 μm ± 12.6) and was minimally worse after month 3. Ganglion cell layer plus inner plexiform layer thinning showed moderate to strong significant correlation with the visual acuity and mean deviation at each exam time. The retinal nerve fiber layer was not thinned until month 3. Ganglion cell layer plus inner plexiform layer is acutely unaffected and provides a reliable measure of retinal neuronal structure using three-dimensional segmentation. Thinning develops within 1 to 2 months of onset, which is prior to RNFL swelling resolution. This suggests GCL+IPL measurement is better than the RNFL thickness to use as biomarker of early structural loss in NAION.
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影响因子：
11.2
作者：
Trip, SA;Schlottmann, PG;Miller, DH
通讯作者：
Miller, DH
影响因子：
17.8
作者：
Hood DC;Raza AS;de Moraes CG;Liebmann JM;Ritch R
通讯作者：
Ritch R
影响因子：
4.1
作者：
Gonul, Saban;Koktekir, Bengu Ekinci;Gedik, Sansal
通讯作者：
Gedik, Sansal
影响因子：
--
作者：
Raza, Ali S.;Cho, Jungsuk;de Moraes, Carlos G. V.;Wang, Min;Zhang, Xian;Kardon, Randy H.;Liebmann, Jeffrey M.;Ritch, Robert;Hood, Donald C.
通讯作者：
Hood, Donald C.
影响因子：
11.2
作者：
Costello, F;Coupland, S;Kardon, RH
通讯作者：
Kardon, RH