非动脉炎性前部缺血性视神经病变黄斑视敏度与神经节细胞内丛状层的相关性  

Correlation between macular mean sensitivity and ganglionic plexiform layer in non-arteriotic anterior ischemicoptic neuropathy

作　　者：张冉[1] 李秋明[1] Zhang Ran;Li Qiuming(Department of Ophthalmology,The First Affiliated Hospital of Zhengzhou University,Henan Provincial Ophthalmic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院眼科、河南省眼科医院,郑州450052

出　　处：《中华眼底病杂志》2023年第11期887-892,共6页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的观察并分析非动脉炎性前部缺血性视神经病变(NAION)患眼黄斑视敏度(MS)和黄斑区神经节细胞内丛状层(GCIPL)厚度的变化和相关性。方法横断面临床研究。2023年3~ 8月于郑州大学第一附属医院眼科检查确诊的NAION患者37例38只眼(NAION组)纳入研究。NAION组患者29只对侧健康眼作为对侧健眼组。选取同期性别、年龄匹配的健康体检者16名31只眼作为正常对照组。NAION组按病程再分为急性期组(病程≤3周)、亚急性期组(病程4~ 12周)、慢性期组(病程>12周), 分别为16、10、12只眼。所有受检眼均行最佳矫正视力(BCVA)、光相干断层扫描(OCT)、视野、微视野检查。BCVA统计时换算为最小分辨角对数(logMAR)视力。采用Cirrus HD-OCT仪黄斑容积512×128扫描程序对黄斑区进行扫描, 测量受检眼平均(GCIPLav)、最小(GCIPLmin)以及鼻上、上方、鼻下、颞上、下方、颞下GCIPL厚度。采用Humphrey 24-2自动视野仪测量受检眼视野平均缺损(MD);采用MP-3微视野计测量受检眼黄斑区10°范围内MS(总MS)以及鼻上、上方、鼻下、颞上、下方、颞下象限MS. MS> 21 dB定义为正常值。组间比较采用单因素方差分析;MS≤21 dB、>21 dB区域GCIPL厚度比较采用t检验。GCIPL厚度与相应区域MS的相关性采用Spearman性相关分析。结果 NAION组、对侧健眼组、正常对照组受检眼logMAR BCVA、总MS比较, 差异均有统计学意义(F=13.595、83.741, P<0.05)。NAION组受检眼中MS≤21 dB区域GCIPL厚度显著低于>21 dB区域, 差异有统计学意义(t=2.634, P=0.009)。NAION组与对侧健眼组、正常对照组比较, 下方象限GCIPL厚度降低, 但差异无统计学意义(P=0.092、0.192 );其他象限GCIPL、GCIPLav、GCIPLmin厚度差异均有统计学意义(P<0.05)。与对侧健眼组、正常对照组比较, 急性期组GCIPLmin、上方、颞上象限GCIPL厚度显著降低, 差异均有统计学意义(P<0.05 );亚急性期组GCIPLav、GCIPLmin、鼻Objective To observe and analyze the changes and correlation of macular mean sensitivity(MS)and the thickness of ganglionic plexiform layer(GCIPL)in patients with non-arteriotic anterior ischemic optic neuropathy(NAION).Methods A cross-sectional clinical study.From March to August 2023,37 patients with 38 eyes of NAION(NAION group)diagnosed by ophthalmic examination in the First Affiliated Hospital of Zhengzhou University were included in the study.In the NAION group,29 patients with contralateral healthy eyes were selected as the contralateral healthy eye group.A total of 31 eyes of 16 healthy subjects matching gender and age were selected as the normal control group.NAION group was divided into acute stage group(disease course≤3 weeks),subacute stage group(disease course 4-12 weeks)and chronic stage group(disease course>12 weeks),with 16,10 and 12 eyes,respectively.Best corrected visual acuity(BCVA),optical coherence tomography(OCT),perimetry,and microperimetry were performed.BCVA statistics are converted to logarithm of the minimum angle of resolution(logMAR).The macular region was scanned by Cirrus HD-OCT macular volume 512 X 128 scanning program.The mean(GCIPLav),minimum(GCIPLmin),and the GCIPL thickness at supranasal,superior,subnasal,supratemporal,inferior,and inferotemporal quadrants were detected.The Humphrey 24-2 automated visual field test was utilized to measure the mean defect(MD)of the visual field.MP-3 microperimetry was used to measure MS(total MS)in the 10°macular region and MS in the supranasal,superior,subnasal,supratemporal,inferior,and inferotemporal quadrants.MS>21 dB was defined as normal.One-way analysis of variance was used to compare among groups.t test was used to compare GCIPL thickness between MS≤21 dB and>21 dB regions.Spearman correlation analysis was used to analyze the correlation between GCIPL thickness and MS in corresponding areas.ResultsThere were statistically significant differences in logMAR BCVA and MS in the NAION group,contralateral healthy eye group,and normal cont

关 键 词：缺血性视神经病变 微视野 神经节细胞内丛状层厚度 体层摄影术 光学相干 

分 类 号：R774.6[医药卫生—眼科]