Quantitative analysis of axonal loss in band atrophy of the optic nerve using scanning laser polarimetry
Quantitative analysis of axonal loss in band atrophy of the optic nerve using scanning laser polarimetry
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DOI：
10.1136/bjo.87.1.32
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发表时间：
2003-01-01
影响因子：
4.1
通讯作者：
Ostroscki, MR
中科院分区：
文献类型：
--
作者：
Monteiro, MLR;Medeiros, FA;Ostroscki, MR
目的：用扫描激光偏振仪测量视交叉压迫所致带状萎缩患者的轴突损失（GDx，Laser Diagnostic Technologies，Inc，San Diego，CA，USA），并评估该仪器识别视网膜神经纤维层（RNFL）损失的这种模式的能力。来自17名连续患者的19只眼，由于视交叉压迫导致视神经带状萎缩和永久性颞侧偏盲，并对17名年龄和性别相匹配的健康人的19只眼睛进行了前瞻性研究。所有患者均接受眼科检查，包括Goldmann视野检查和使用扫描激光偏振仪评估RNFL。比较两组视盘周围RNFL平均厚度。GDx软件提供的偏离正常分析的诊断性能也assessed.Results：视乳头周围RNFL厚度（平均值（SD））的眼睛带状萎缩分别为47.9（7.63）妈妈，37.1（8.48）妈妈，57.0（9.31）妈妈，和37.2（8.86）妈妈在上级，颞，下，鼻区，分别。总平均值为43.7（12.0）妈妈。在对照组中，相应值分别为71.1（12.2）mum、40.4（10.9）mum、85.4（14.0）mum和49.8（10.1）mum。总平均测量值为67.9（11.2）μ m。视神经萎缩眼的测量结果与对照组相比，除颞叶外，其余各区域均存在显著差异。GDx软件提供的正常分析的偏差未能确定大多数的异常，在颞和鼻区的带状atrophy.Conclusions患者：扫描激光偏振能够识别轴突损失的上级，下，和鼻区，但未能检测到它在颞区的视盘，尽管事实上，这方面明显改变了债券萎缩的眼睛。当使用GDx软件分析时，该检查还显示出检测鼻区域轴突损失的灵敏度较差。这项研究的结果强调，使用扫描激光偏振法的RNFL评价应谨慎解释的眼睛疾病，导致轴突损失主要是在鼻和颞区的视盘的研究。
Aims: To measure axonal loss in patients with band atrophy from optic chiasm compression using scanning laser polarimetry (GDx, Laser Diagnostic Technologies, Inc, San Diego, CA, USA) and to evaluate the ability of this instrument to identify this pattern of retinal nerve fibre layer (RNFL) loss.Methods: 19 eyes from 17 consecutive patients with band atrophy of the optic nerve and permanent temporal hemianopia due to chiasmal compression, and 19 eyes from an age and sex matched control group of 17 healthy individuals were prospectively studied. All patients were submitted to an ophthalmic examination including Goldmann perimetry and evaluation of the RNFL using scanning laser polarimetry. Mean RNFL thickness around the optic disc were compared between the two groups. The diagnostic performance of the deviation from normal analysis provided by the GDx software was also assessed.Results: The peripapillary RNFL thickness (mean (SD)) of eyes with band atrophy was 47.9 (7.63) mum, 37.1 (8.48) mum, 57.0 (9.31) mum, and 37.2 (8.86) mum in the superior, temporal, inferior, and nasal regions, respectively. The total average was 43.7 (12.0) mum. In the control group, the corresponding values were 71.1 (12.2) mum, 40.4 (10.9) mum, 85.4 (14.0) mum, and 49.8 (10.1) mum. The total average measured 67.9 (11.2) mum. The measurements from eyes with optic atrophy were significantly different from those in the control group in all regions but the temporal. The deviation from normal analysis provided by the GDx software failed to identify the majority of abnormalities in the temporal and nasal regions of patients with band atrophy.Conclusions: Scanning laser polarimetry was able to identify axonal loss in the superior, inferior, and nasal regions, but failed to detect it in the temporal region of the optic disc, despite the fact that this area was clearly altered in eyes with bond atrophy. This examination also showed poor sensitivity to detect axonal loss in the nasal region when GDx software analysis was used. The results of this study emphasise that RNFL evaluation using scanning laser polarimetry should be interpreted with caution in the study of eye diseases that lead to axonal loss predominantly in the nasal and temporal areas of the optic disc.