High-Resolution Imaging of Retinal Nerve Fiber Bundles in Glaucoma Using Adaptive Optics Scanning Laser Ophthalmoscopy
High-Resolution Imaging of Retinal Nerve Fiber Bundles in Glaucoma Using Adaptive Optics Scanning Laser Ophthalmoscopy
复制标题
DOI：
10.1016/j.ajo.2012.11.016
复制
发表时间：
2013-05-01
影响因子：
4.2
通讯作者：
Yoshimura, Nagahisa
中科院分区：
文献类型：
--
作者：
Takayama, Kohei;Ooto, Sotaro;Yoshimura, Nagahisa
目的：通过自适应光学（AO）扫描激光检眼镜（AO SLO）观察青光眼视网膜神经纤维束的病理变化。设计：前瞻性横断面研究。方法：对28例开角型青光眼患者的28只眼和21名志愿者的21只正常眼进行全面眼科检查，使用Humphrey field Analyzer进行视野测试，眼底摄影，无红色SLO成像，光谱域光学相干断层扫描，并使用原始原型AO SLO系统进行成像。结果：AO - SLO图像显示许多高反射束提示神经纤维束。青光眼神经纤维束较正常眼窄，AO SLO上神经纤维层厚度与神经纤维束宽度相关（P < 0.001）。眼底摄影神经纤维层缺损区，AO - SLO上的神经纤维束较正常眼窄（P < 0.001）。青光眼视盘颞下侧60度处，即使在无神经纤维层缺损的区域，神经纤维束宽度也明显低于正常眼（P = 0.026）。视野测试各簇的平均偏差与相应的神经纤维束宽度相关（P = 0.017）。结论：AO SLO图像显示青光眼临床正常区和异常区神经纤维束宽度均减小，且这些异常与视野缺损有关，提示AO SLO可用于早期发现与视觉功能丧失相关的神经纤维束异常。[J]中华眼科杂志，2013;32(5):879 -881。(C)爱思唯尔公司2013年版权所有。)
PURPOSE: To detect pathologic changes in retinal nerve fiber bundles in glaucomatous eyes seen on images obtained by adaptive optics (AO) scanning laser ophthalmoscopy (AO SLO).DESIGN: Prospective cross-sectional study.METHODS: Twenty-eight eyes of 28 patients with open-angle glaucoma and 21 normal eyes of 21 volunteer subjects underwent a full ophthalmologic examination, visual field testing using a Humphrey Field Analyzer, fundus photography, red-free SLO imaging, spectral-domain optical coherence tomography, and imaging with an original prototype AO SLO system.RESULTS: The AO SLO images showed many hyperreflective bundles suggesting nerve fiber bundles. In glaucomatous eyes, the nerve fiber bundles were narrower than in normal eyes, and the nerve fiber layer thickness was correlated with the nerve fiber bundle widths on AO SLO (P < .001). In the nerve fiber layer defect area on fundus photography, the nerve fiber bundles on AO SLO were narrower compared with those in normal eyes (P < .001). At 60 degrees on the inferior temporal side of the optic disc, the nerve fiber bundle width was significantly lower, even in areas without nerve fiber layer defect, in eyes with glaucomatous eyes compared with normal eyes (P = .026). The mean deviations of each cluster in visual field testing were correlated with the corresponding nerve fiber bundle widths (P = .017).CONCLUSIONS: AO SLO images showed reduced nerve fiber bundle widths both in clinically normal and abnormal areas of glaucomatous eyes, and these abnormalities were associated with visual field defects, suggesting that AO SLO may be useful for detecting early nerve fiber bundle abnormalities associated with loss of visual function. (Am J Ophthalmol 2013;155: 870-881. (C) 2013 by Elsevier Inc. All rights reserved.)