AIM:To compare the retinal nerve fiber layer(RNFL)thickness in the morning and evening in Thai patients with varying degrees of obstructive sleep apnea/hypopnea syndrome(OSAHS).METHODS:In this cross-sectional study,po...AIM:To compare the retinal nerve fiber layer(RNFL)thickness in the morning and evening in Thai patients with varying degrees of obstructive sleep apnea/hypopnea syndrome(OSAHS).METHODS:In this cross-sectional study,potential OSAHS patients at Siriraj Hospital underwent polysomnography to determine the severity of OSAHS and an eye examination(including best corrected visual acuity,slit-lamp examination,and Goldmann applanation tonometry).RNFL thickness was recorded once in the morning and once in the evening,using spectral domain optical coherence tomography.Thickness was expressed as an average and given for each quadrant.Patients with ocular or systemic diseases that might affect RNFL thickness were excluded.RESULTS:Forty-one eyes of 41 patients were classified into 4 OSAHS groups.The average and mean RNFL thickness in most of the four quadrants of the severe OSAHS group trended toward being less than those in the comparable quadrants of the other groups in both the morning and evening.In the moderate OSAHS group,the average RNFL thickness and temporal and superior quadrant thickness in the morning were significantly higher than in the evening(P=0.01,P=0.01,and P=0.03,respectively).In the severe OSAHS group,the inferior quadrant thickness in the morning was significantly higher than in the evening(P=0.03).CONCLUSION:The RNFL thickness in the morning was higher than in the evening in moderate OSAHS.展开更多
AIM:To assess the differences in average and sectoral peripapillary retinal nerve fiber layer(p RNFL)thickness using spectral domain optical coherence tomography(SD-OCT)in patients with non-arteritic anterior ischemic...AIM:To assess the differences in average and sectoral peripapillary retinal nerve fiber layer(p RNFL)thickness using spectral domain optical coherence tomography(SD-OCT)in patients with non-arteritic anterior ischemic neuropathy(NAION)compared with those with primary open angle glaucoma(POAG).METHODS:A comprehensive literature search of the Pub Med,Cochrane Library,and Embase databases were performed prior to October,2021.Studies that compared the p RNFL thickness in NAION eyes with that in POAG eyes with matched mean deviation of the visual fields were included.The weighted mean difference(WMD)with 95%confidence interval(CI)was used to pool continuous outcomes.RESULTS:Ten cross-sectional studies(11 datasets)comprising a total of 625 eyes(278 NAION eyes,347 POAG eyes)were included in the qualitative and quantitative analyses.The pooled results demonstrated that the superior p RNFL was significantly thinner in NAION eyes than in POAG eyes(WMD=-6.40,95%CI:-12.22 to-0.58,P=0.031),whereas the inferior p RNFL was significant thinner in POAG eyes than in NAION eyes(WMD=11.10,95%CI:7.06 to 15.14,P≤0.001).No difference was noted concerning the average,nasal,and temporal p RNFL thickness(average:WMD=1.45,95%CI:-0.75 to 3.66,P=0.196;nasal:WMD=-2.12,95%CI:-4.43 to 0.19,P=0.072;temporal:WMD=-1.24,95%CI:-3.96 to 1.47,P=0.370).CONCLUSION:SD-OCT based evaluation of inferior and superior p RNFL thickness can be potentially utilized to differentiate NAION from POAG,and help to understand the different pathophysiological mechanisms between these two diseases.Further longitudinal studies and studies using eight-quadrant or clock-hour classification method are required to validate the obtained findings.展开更多
AIM:To evaluate retinal nerve fiber layer thickness and retinal vascular caliber alterations in coal mine workers.METHODS:The community-based observational crosssectional study included 4004 participants of a subpopul...AIM:To evaluate retinal nerve fiber layer thickness and retinal vascular caliber alterations in coal mine workers.METHODS:The community-based observational crosssectional study included 4004 participants of a subpopulation of the Kailuan Study.All the study participants underwent structured interviews with a standardized questionnaire,fundus photography and spectral-domain optical coherence tomography(OCT)examinations performed by trained doctors.RESULTS:The retinal nerve fiber layer thickness was significantly higher(P=0.006)and the central macular thickness was lower in coal miners(n=659,51.0±7.8 y)as compared to the control(working above the ground;n=477,51.8±7.5 y;P=0.032).Additionally,the downhole workers showed a significantly thicker retinal artery(P=0.012)and vein diameters(P<0.001).In multivariable regression,a thicker retinal nerve fiber layer was associated with a higher cumulative silica dust exposure(P=0.005)after adjusting for younger age and larger spherical equivalent.In a reverse pattern,a higher cumulative silica dust exposure(P=0.004)was significantly associated with a thicker retinal nerve fiber layer after adjusting for age,high-density lipoproteins and uric acid.Wider retinal vein diameters were associated with higher cumulative silica dust exposure(P=0.036)after adjusting for younger age and larger spherical equivalent.CONCLUSION:The retinal vessels diameters and retinal nerve fiber layer thickness are significantly thicker in long term of coal mining.The results of our study indicate that underground working environment may lead to retinal vessel dilation and inflammation.Thus,ocular examination might be needed within coal miners in order to monitor the occupational eye health as well as the incidence and progression of eye diseases.展开更多
Objective:To observe the changes of peripapillary vascular density(VD)and its correlation with retinal nerve fiber layer(RNFL)thickness in patients with unilateral retinal vein occlusion(RVO)by optical coherence tomog...Objective:To observe the changes of peripapillary vascular density(VD)and its correlation with retinal nerve fiber layer(RNFL)thickness in patients with unilateral retinal vein occlusion(RVO)by optical coherence tomography angiography(OCTA).Methods:Prospective case-control study.Thirty-two patients(32 eyes)with RVO diagnosed at the Eye Hospital of China Academy of Chinese Medical Sciences from September 2020 to June 2021 were selected.Another 32 outpatients(32 eyes)with normal ocular examination were selected as the normal control group.Optic disc blood flow imaging was performed in all subjects using the OCTA to measure peripapillary RNFL thickness,peripapillary vessel density,optic disc area,and disc rim area.The correlation between peripapillary vascular density and RNFL,optic disc area and disc rim area in eyes with unilateral RVO was analyzed.Results:Compared with the normal control group,the prevalence of hypertension was higher in the unilateral RVO group,and the difference was statistically significant(P<0.05).Compared with the normal control group,the overall,inferior and temporal RNFL thickness around the optic disc was thinner in patients with unilateral RVO,and the difference was statistically significant(P<005).Compared with the normal control group,the overall VD,internal ring,external ring and inferior VD around the optic disc were slightly decreased in patients with unilateral RVO,and the differences were statistically significant(P<0.05).The results of Pearson correlation analysis indicated that RNFL thickness was positively correlated with peripapillary global VD(r=0.648,P<0.001),RNFL thickness was positively correlated with intrapapillary ring VD(r=0.427,P=0.015),and RNFL thickness was positively correlated with peripapillary VD(r=0.666,P<0.001).Conclusion:The results showed that the RNFL thickness around the optic disc was thinner in patients with unilateral RVO,especially in the inferior and temporal area,and the full area VD around the optic disc was decreased,especially in the internal ring,external ring and inferior area.In patients with unilateral RVO,peripapillary RNFL was positively correlated with peripapillary global,internal ring and external ring VD.展开更多
Background:In this paper we determined the benefits of image registration on estimating longitudinal retinal nerve fiber layer thickness(RNFLT)changes.Methods:RNFLT maps around the optic nerve head(ONH)of healthy prim...Background:In this paper we determined the benefits of image registration on estimating longitudinal retinal nerve fiber layer thickness(RNFLT)changes.Methods:RNFLT maps around the optic nerve head(ONH)of healthy primate eyes were measured using Optical Coherence Tomography(OCT)weekly for 30 weeks.One automatic algorithm based on mutual information(MI)and the other semi-automatic algorithm based on log-polar transform cross-correlation using manually segmented blood vessels(LPCC_MSBV),were used to register retinal maps longitudinally.We compared the precision and recall between manually segmented image pairs for the two algorithms using a linear mixed effects model.Results:We found that the precision calculated between manually segmented image pairs following registration by LPCC_MSBV algorithm is significantly better than the one following registration by MI algorithm(p<<0.0001).Trend of the all-rings and temporal,superior,nasal and inferior(TSNI)quadrants average of RNFLT over time in healthy primate eyes are not affected by registration.RNFLT of clock hours 1,2,and 10 showed significant change over 30 weeks(p=0.0058,0.0054,and 0.0298 for clock hours 1,2 and 10 respectively)without registration,but stayed constant over time with registration.Conclusions:The LPCC_MSBV provides better registration of RNFLT maps recorded on different dates than the automatic MI algorithm.Registration of RNFLT maps can improve clinical analysis of glaucoma progression.展开更多
The integrity of retinal ganglion cells is tightly associated with diabetic macular degeneration that leads to damage and death of retinal ganglion cells,affecting vision.The major clinical treatments for diabetic mac...The integrity of retinal ganglion cells is tightly associated with diabetic macular degeneration that leads to damage and death of retinal ganglion cells,affecting vision.The major clinical treatments for diabetic macular edema are anti-vascular endothelial growth factor drugs and laser photocoagulation.However,although the macular thickness can be normalized with each of these two therapies used alone,the vision does not improve in many patients.This might result from the incomplete recovery of retinal ganglion cell injury.Therefore,a prospective,non-randomized,controlled clinical trial was designed to investigate the effect of anti-vascular endothelial growth factor drugs combined with laser photocoagulation on the integrity of retinal ganglion cells in patients with diabetic macular edema and its relationship with vision recovery.In this trial,150 patients with diabetic macular edema will be equally divided into three groups according to therapeutic methods,followed by treatment with anti-vascular endothelial growth factor drugs,laser photocoagulation therapy,and their combination.All patients will be followed up for 12 months.The primary outcome measure is retinal ganglion cell-inner plexiform layer thickness at 12 months after treatment.The secondary outcome measures include retinal ganglion cell-inner plexiform layer thickness before and 1,3,6,and 9 months after treatment,retinal nerve fiber layer thickness,best-corrected visual acuity,macular area thickness,and choroidal thickness before and 1,3,6,9,and 12 months after treatment.Safety measure is the incidence of adverse events at 1,3,6,9,and 12 months after treatment.The study protocol hopes to validate the better efficacy and safety of the combined treatment in patients with diabetic macula compared with the other two monotherapies alone during the 12-month follow-up period.The trial is designed to focus on clarifying the time-effect relationship between imaging measures related to the integrity of retinal ganglion cells and best-corrected visual acuity.The trial protocol was approved by the Medical Ethics Committee of the Affiliated Hospital of Beihua University with approval No.(2023)(26)on April 25,2023,and was registered with the Chinese Clinical Trial Registry(registration number:ChiCTR2300072478,June 14,2023,protocol version:2.0).展开更多
AIM:To assess the performance of macular ganglion cell-inner plexiform layer thickness(mGCIPLT)and 10-2 visual field(VF)parameters in detecting early glaucoma and evaluating the severity of advanced glaucoma.METHODS:T...AIM:To assess the performance of macular ganglion cell-inner plexiform layer thickness(mGCIPLT)and 10-2 visual field(VF)parameters in detecting early glaucoma and evaluating the severity of advanced glaucoma.METHODS:Totally 127 eyes from 89 participants(36 eyes of 19 healthy participants,45 eyes of 31 early glaucoma patients and 46 eyes of 39 advanced glaucoma patients)were included.The relationships between the optical coherence tomography(OCT)-derived parameters and VF sensitivity were determined.Patients with early glaucoma were divided into eyes with or without central 10°of the VF damages(CVFDs),and the diagnostic performances of OCT-derived parameters were assessed.RESULTS:In early glaucoma,the mGCIPLT was significantly correlated with 10-2 VF pattern standard deviation(PSD;with average mGCIPLT:β=-0.046,95%CI,-0.067 to-0.024,P<0.001).In advanced glaucoma,the mGCIPLT was related to the 24-2 VF mean deviation(MD;with average mGCIPLT:β=0.397,95%CI,0.199 to 0.595,P<0.001),10-2 VF MD(with average mGCIPLT:β=0.762,95%CI,0.485 to 1.038,P<0.001)and 24-2 VF PSD(with average mGCIPLT:β=0.244,95%CI,0.124 to 0.364,P<0.001).Except for the minimum and superotemporal mGCIPLT,the decrease of mGCIPLT in early glaucomatous eyes with CVFDs was more severe than that of early glaucomatous eyes without CVFDs.The area under the curve(AUC)of the average mGCIPLT(AUC=0.949,95%CI,0.868 to 0.982)was greater than that of the average circumpapillary retinal nerve fiber layer thickness(cpRNFLT;AUC=0.827,95%CI,0.674 to 0.918)and rim area(AUC=0.799,95%CI,0.610 to 0.907)in early glaucomatous eyes with CVFDs versus normal eyes.CONCLUSION:The 10-2 VF and mGCIPLT parameters are complementary to 24-2 VF,cpRNFLT and ONH parameters,especially in detecting early glaucoma with CVFDs and evaluating the severity of advanced glaucoma in group level.展开更多
BACKGROUND The basic method of glaucoma diagnosis is visual field examination,however,in patients with high myopia,the diagnosis of glaucoma is difficult.AIM To explore the value of optical coherence tomography(OCT)fo...BACKGROUND The basic method of glaucoma diagnosis is visual field examination,however,in patients with high myopia,the diagnosis of glaucoma is difficult.AIM To explore the value of optical coherence tomography(OCT)for measuring optic disc parameters and macular thickness as a screening tool for glaucoma in patients with high myopia.METHODS Visual values(contrast sensitivity,color vision,and best-corrected visual acuity)in three groups,patients with high myopia in Group A,patients with high myopia and glaucoma in Group B,and patients with high myopia suspicious for glaucoma in Group C,were compared.Optic disc parameters,retinal nerve fiber layer(RNFL)thickness,and ganglion cell layer(GCC)thickness were measured using OCT technology and used to compare the peri-optic disc vascular density of the patients and generate receiver operator characteristic(ROC)test performance curves of the RNFL and GCC for high myopia and glaucoma.RESULTS Of a total of 98 patients admitted to our hospital from May 2018 to March 2022,totaling 196 eyes in the study,30 patients with 60 eyes were included in Group A,33 patients with 66 eyes were included in Group B,and 35 patients with 70 eyes were included in Group C.Data were processed for Groups A and B to analyze the efficacy of RNFL and GCC measures in distinguishing high myopia from high myopia with glaucoma.The area under the ROC curve was greater than 0.7,indicating an acceptable diagnostic value.CONCLUSION The value of OCT measurement of RNFL and GCC thickness in diagnosing glaucoma in patients with high myopia and suspected glaucoma is worthy of development for clinical use.展开更多
AIM:To assess the retinal vasculature alterations in indirect traumatic optic neuropathy(ITON)patients following craniofacial trauma by optic coherence tomography angiography(OCTA).METHODS:Patients diagnosed of monocu...AIM:To assess the retinal vasculature alterations in indirect traumatic optic neuropathy(ITON)patients following craniofacial trauma by optic coherence tomography angiography(OCTA).METHODS:Patients diagnosed of monocular ITON were recruited from August 2016 to May 2020.OCTA was performed using the Angio Vue OCT-A system for two cube scans centered at the optic nerve head and fovea.OCTA data included thicknesses of peripapillary retinal nerve fiber layer(RNFL)and macular ganglion cell complex(GCC),as well as proportion of capillary perfusion and data were analyzed for correlation with post-injury timepoints:within 7,8-30,31-90,and 91-365d.RESULTS:A total of 73 ITON patients were studied.Significant thinning of RNFL and GCC layers and attenuation of microvascular perfusion were observed in ITON eyes as compared to contralateral unaffected eyes(for most of the analyzed sectors and quadrants,P<0.05).Without respect to surgical intervention and vision recovery,the decrease in retinal layer thicknesses and microvascular perfusion was time-dependent,and most significant within three months(P<0.001).CONCLUSION:ITON presents with time-dependent thinning of retinal layers and attenuation of microvasculature,indicating possible degeneration of retinal ganglion cells due to reduced retinal blood supply.展开更多
基金Supported partially by the Siriraj Hospital Research Fund,which helped to develop ophthalmology research.The funding organization had no role in the design or conduct of the research
文摘AIM:To compare the retinal nerve fiber layer(RNFL)thickness in the morning and evening in Thai patients with varying degrees of obstructive sleep apnea/hypopnea syndrome(OSAHS).METHODS:In this cross-sectional study,potential OSAHS patients at Siriraj Hospital underwent polysomnography to determine the severity of OSAHS and an eye examination(including best corrected visual acuity,slit-lamp examination,and Goldmann applanation tonometry).RNFL thickness was recorded once in the morning and once in the evening,using spectral domain optical coherence tomography.Thickness was expressed as an average and given for each quadrant.Patients with ocular or systemic diseases that might affect RNFL thickness were excluded.RESULTS:Forty-one eyes of 41 patients were classified into 4 OSAHS groups.The average and mean RNFL thickness in most of the four quadrants of the severe OSAHS group trended toward being less than those in the comparable quadrants of the other groups in both the morning and evening.In the moderate OSAHS group,the average RNFL thickness and temporal and superior quadrant thickness in the morning were significantly higher than in the evening(P=0.01,P=0.01,and P=0.03,respectively).In the severe OSAHS group,the inferior quadrant thickness in the morning was significantly higher than in the evening(P=0.03).CONCLUSION:The RNFL thickness in the morning was higher than in the evening in moderate OSAHS.
基金Supported by National Natural Science Foundation of China(No.82070967No.81770930)+1 种基金National Natural Science Foundation of Hunan Province Grant(No.2020jj4788)China Hunan Provincial Science and Technology Department(No.2020SK2086)。
文摘AIM:To assess the differences in average and sectoral peripapillary retinal nerve fiber layer(p RNFL)thickness using spectral domain optical coherence tomography(SD-OCT)in patients with non-arteritic anterior ischemic neuropathy(NAION)compared with those with primary open angle glaucoma(POAG).METHODS:A comprehensive literature search of the Pub Med,Cochrane Library,and Embase databases were performed prior to October,2021.Studies that compared the p RNFL thickness in NAION eyes with that in POAG eyes with matched mean deviation of the visual fields were included.The weighted mean difference(WMD)with 95%confidence interval(CI)was used to pool continuous outcomes.RESULTS:Ten cross-sectional studies(11 datasets)comprising a total of 625 eyes(278 NAION eyes,347 POAG eyes)were included in the qualitative and quantitative analyses.The pooled results demonstrated that the superior p RNFL was significantly thinner in NAION eyes than in POAG eyes(WMD=-6.40,95%CI:-12.22 to-0.58,P=0.031),whereas the inferior p RNFL was significant thinner in POAG eyes than in NAION eyes(WMD=11.10,95%CI:7.06 to 15.14,P≤0.001).No difference was noted concerning the average,nasal,and temporal p RNFL thickness(average:WMD=1.45,95%CI:-0.75 to 3.66,P=0.196;nasal:WMD=-2.12,95%CI:-4.43 to 0.19,P=0.072;temporal:WMD=-1.24,95%CI:-3.96 to 1.47,P=0.370).CONCLUSION:SD-OCT based evaluation of inferior and superior p RNFL thickness can be potentially utilized to differentiate NAION from POAG,and help to understand the different pathophysiological mechanisms between these two diseases.Further longitudinal studies and studies using eight-quadrant or clock-hour classification method are required to validate the obtained findings.
基金Supported by Science and Technology Project of Beijing Municipal Science and Technology Commission(No.Z181100001818003)The Capital Health Research and Development of Special(No.2020-1-2052)。
文摘AIM:To evaluate retinal nerve fiber layer thickness and retinal vascular caliber alterations in coal mine workers.METHODS:The community-based observational crosssectional study included 4004 participants of a subpopulation of the Kailuan Study.All the study participants underwent structured interviews with a standardized questionnaire,fundus photography and spectral-domain optical coherence tomography(OCT)examinations performed by trained doctors.RESULTS:The retinal nerve fiber layer thickness was significantly higher(P=0.006)and the central macular thickness was lower in coal miners(n=659,51.0±7.8 y)as compared to the control(working above the ground;n=477,51.8±7.5 y;P=0.032).Additionally,the downhole workers showed a significantly thicker retinal artery(P=0.012)and vein diameters(P<0.001).In multivariable regression,a thicker retinal nerve fiber layer was associated with a higher cumulative silica dust exposure(P=0.005)after adjusting for younger age and larger spherical equivalent.In a reverse pattern,a higher cumulative silica dust exposure(P=0.004)was significantly associated with a thicker retinal nerve fiber layer after adjusting for age,high-density lipoproteins and uric acid.Wider retinal vein diameters were associated with higher cumulative silica dust exposure(P=0.036)after adjusting for younger age and larger spherical equivalent.CONCLUSION:The retinal vessels diameters and retinal nerve fiber layer thickness are significantly thicker in long term of coal mining.The results of our study indicate that underground working environment may lead to retinal vessel dilation and inflammation.Thus,ocular examination might be needed within coal miners in order to monitor the occupational eye health as well as the incidence and progression of eye diseases.
文摘Objective:To observe the changes of peripapillary vascular density(VD)and its correlation with retinal nerve fiber layer(RNFL)thickness in patients with unilateral retinal vein occlusion(RVO)by optical coherence tomography angiography(OCTA).Methods:Prospective case-control study.Thirty-two patients(32 eyes)with RVO diagnosed at the Eye Hospital of China Academy of Chinese Medical Sciences from September 2020 to June 2021 were selected.Another 32 outpatients(32 eyes)with normal ocular examination were selected as the normal control group.Optic disc blood flow imaging was performed in all subjects using the OCTA to measure peripapillary RNFL thickness,peripapillary vessel density,optic disc area,and disc rim area.The correlation between peripapillary vascular density and RNFL,optic disc area and disc rim area in eyes with unilateral RVO was analyzed.Results:Compared with the normal control group,the prevalence of hypertension was higher in the unilateral RVO group,and the difference was statistically significant(P<0.05).Compared with the normal control group,the overall,inferior and temporal RNFL thickness around the optic disc was thinner in patients with unilateral RVO,and the difference was statistically significant(P<005).Compared with the normal control group,the overall VD,internal ring,external ring and inferior VD around the optic disc were slightly decreased in patients with unilateral RVO,and the differences were statistically significant(P<0.05).The results of Pearson correlation analysis indicated that RNFL thickness was positively correlated with peripapillary global VD(r=0.648,P<0.001),RNFL thickness was positively correlated with intrapapillary ring VD(r=0.427,P=0.015),and RNFL thickness was positively correlated with peripapillary VD(r=0.666,P<0.001).Conclusion:The results showed that the RNFL thickness around the optic disc was thinner in patients with unilateral RVO,especially in the inferior and temporal area,and the full area VD around the optic disc was decreased,especially in the internal ring,external ring and inferior area.In patients with unilateral RVO,peripapillary RNFL was positively correlated with peripapillary global,internal ring and external ring VD.
基金This study is supported by National Eye Institute at the National Institutes of Health(Grant R01EY016462).
文摘Background:In this paper we determined the benefits of image registration on estimating longitudinal retinal nerve fiber layer thickness(RNFLT)changes.Methods:RNFLT maps around the optic nerve head(ONH)of healthy primate eyes were measured using Optical Coherence Tomography(OCT)weekly for 30 weeks.One automatic algorithm based on mutual information(MI)and the other semi-automatic algorithm based on log-polar transform cross-correlation using manually segmented blood vessels(LPCC_MSBV),were used to register retinal maps longitudinally.We compared the precision and recall between manually segmented image pairs for the two algorithms using a linear mixed effects model.Results:We found that the precision calculated between manually segmented image pairs following registration by LPCC_MSBV algorithm is significantly better than the one following registration by MI algorithm(p<<0.0001).Trend of the all-rings and temporal,superior,nasal and inferior(TSNI)quadrants average of RNFLT over time in healthy primate eyes are not affected by registration.RNFLT of clock hours 1,2,and 10 showed significant change over 30 weeks(p=0.0058,0.0054,and 0.0298 for clock hours 1,2 and 10 respectively)without registration,but stayed constant over time with registration.Conclusions:The LPCC_MSBV provides better registration of RNFLT maps recorded on different dates than the automatic MI algorithm.Registration of RNFLT maps can improve clinical analysis of glaucoma progression.
基金supported by Science and Technology Research Project of Jilin Provincial Department of Education,No.JJKH20220072KJ(to XL)Science and Technology Development Program of Jilin Province,No.20200201495JC(to YL)。
文摘The integrity of retinal ganglion cells is tightly associated with diabetic macular degeneration that leads to damage and death of retinal ganglion cells,affecting vision.The major clinical treatments for diabetic macular edema are anti-vascular endothelial growth factor drugs and laser photocoagulation.However,although the macular thickness can be normalized with each of these two therapies used alone,the vision does not improve in many patients.This might result from the incomplete recovery of retinal ganglion cell injury.Therefore,a prospective,non-randomized,controlled clinical trial was designed to investigate the effect of anti-vascular endothelial growth factor drugs combined with laser photocoagulation on the integrity of retinal ganglion cells in patients with diabetic macular edema and its relationship with vision recovery.In this trial,150 patients with diabetic macular edema will be equally divided into three groups according to therapeutic methods,followed by treatment with anti-vascular endothelial growth factor drugs,laser photocoagulation therapy,and their combination.All patients will be followed up for 12 months.The primary outcome measure is retinal ganglion cell-inner plexiform layer thickness at 12 months after treatment.The secondary outcome measures include retinal ganglion cell-inner plexiform layer thickness before and 1,3,6,and 9 months after treatment,retinal nerve fiber layer thickness,best-corrected visual acuity,macular area thickness,and choroidal thickness before and 1,3,6,9,and 12 months after treatment.Safety measure is the incidence of adverse events at 1,3,6,9,and 12 months after treatment.The study protocol hopes to validate the better efficacy and safety of the combined treatment in patients with diabetic macula compared with the other two monotherapies alone during the 12-month follow-up period.The trial is designed to focus on clarifying the time-effect relationship between imaging measures related to the integrity of retinal ganglion cells and best-corrected visual acuity.The trial protocol was approved by the Medical Ethics Committee of the Affiliated Hospital of Beihua University with approval No.(2023)(26)on April 25,2023,and was registered with the Chinese Clinical Trial Registry(registration number:ChiCTR2300072478,June 14,2023,protocol version:2.0).
基金National Natural Science Foundation of China(No.81860170).
文摘AIM:To assess the performance of macular ganglion cell-inner plexiform layer thickness(mGCIPLT)and 10-2 visual field(VF)parameters in detecting early glaucoma and evaluating the severity of advanced glaucoma.METHODS:Totally 127 eyes from 89 participants(36 eyes of 19 healthy participants,45 eyes of 31 early glaucoma patients and 46 eyes of 39 advanced glaucoma patients)were included.The relationships between the optical coherence tomography(OCT)-derived parameters and VF sensitivity were determined.Patients with early glaucoma were divided into eyes with or without central 10°of the VF damages(CVFDs),and the diagnostic performances of OCT-derived parameters were assessed.RESULTS:In early glaucoma,the mGCIPLT was significantly correlated with 10-2 VF pattern standard deviation(PSD;with average mGCIPLT:β=-0.046,95%CI,-0.067 to-0.024,P<0.001).In advanced glaucoma,the mGCIPLT was related to the 24-2 VF mean deviation(MD;with average mGCIPLT:β=0.397,95%CI,0.199 to 0.595,P<0.001),10-2 VF MD(with average mGCIPLT:β=0.762,95%CI,0.485 to 1.038,P<0.001)and 24-2 VF PSD(with average mGCIPLT:β=0.244,95%CI,0.124 to 0.364,P<0.001).Except for the minimum and superotemporal mGCIPLT,the decrease of mGCIPLT in early glaucomatous eyes with CVFDs was more severe than that of early glaucomatous eyes without CVFDs.The area under the curve(AUC)of the average mGCIPLT(AUC=0.949,95%CI,0.868 to 0.982)was greater than that of the average circumpapillary retinal nerve fiber layer thickness(cpRNFLT;AUC=0.827,95%CI,0.674 to 0.918)and rim area(AUC=0.799,95%CI,0.610 to 0.907)in early glaucomatous eyes with CVFDs versus normal eyes.CONCLUSION:The 10-2 VF and mGCIPLT parameters are complementary to 24-2 VF,cpRNFLT and ONH parameters,especially in detecting early glaucoma with CVFDs and evaluating the severity of advanced glaucoma in group level.
文摘BACKGROUND The basic method of glaucoma diagnosis is visual field examination,however,in patients with high myopia,the diagnosis of glaucoma is difficult.AIM To explore the value of optical coherence tomography(OCT)for measuring optic disc parameters and macular thickness as a screening tool for glaucoma in patients with high myopia.METHODS Visual values(contrast sensitivity,color vision,and best-corrected visual acuity)in three groups,patients with high myopia in Group A,patients with high myopia and glaucoma in Group B,and patients with high myopia suspicious for glaucoma in Group C,were compared.Optic disc parameters,retinal nerve fiber layer(RNFL)thickness,and ganglion cell layer(GCC)thickness were measured using OCT technology and used to compare the peri-optic disc vascular density of the patients and generate receiver operator characteristic(ROC)test performance curves of the RNFL and GCC for high myopia and glaucoma.RESULTS Of a total of 98 patients admitted to our hospital from May 2018 to March 2022,totaling 196 eyes in the study,30 patients with 60 eyes were included in Group A,33 patients with 66 eyes were included in Group B,and 35 patients with 70 eyes were included in Group C.Data were processed for Groups A and B to analyze the efficacy of RNFL and GCC measures in distinguishing high myopia from high myopia with glaucoma.The area under the ROC curve was greater than 0.7,indicating an acceptable diagnostic value.CONCLUSION The value of OCT measurement of RNFL and GCC thickness in diagnosing glaucoma in patients with high myopia and suspected glaucoma is worthy of development for clinical use.
基金Supported by the High-level Hospital Construction Project(No.303010406)Natural Science Foundation of Guangdong Province,China(No.2019A1515010361)。
文摘AIM:To assess the retinal vasculature alterations in indirect traumatic optic neuropathy(ITON)patients following craniofacial trauma by optic coherence tomography angiography(OCTA).METHODS:Patients diagnosed of monocular ITON were recruited from August 2016 to May 2020.OCTA was performed using the Angio Vue OCT-A system for two cube scans centered at the optic nerve head and fovea.OCTA data included thicknesses of peripapillary retinal nerve fiber layer(RNFL)and macular ganglion cell complex(GCC),as well as proportion of capillary perfusion and data were analyzed for correlation with post-injury timepoints:within 7,8-30,31-90,and 91-365d.RESULTS:A total of 73 ITON patients were studied.Significant thinning of RNFL and GCC layers and attenuation of microvascular perfusion were observed in ITON eyes as compared to contralateral unaffected eyes(for most of the analyzed sectors and quadrants,P<0.05).Without respect to surgical intervention and vision recovery,the decrease in retinal layer thicknesses and microvascular perfusion was time-dependent,and most significant within three months(P<0.001).CONCLUSION:ITON presents with time-dependent thinning of retinal layers and attenuation of microvasculature,indicating possible degeneration of retinal ganglion cells due to reduced retinal blood supply.
