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Analyse glaukombedingter Makulaver?nderungen mittels optischer Koh?renztomografie

DOI:10.1055/a-0808-4807 期刊:Klinische Monatsbl?tter für Augenheilkunde 出版年份:2019 更新时间:2025-09-19 17:15:36
摘要: Background In glaucoma, progressive retinal nerve fibre loss can be measured in the peripapillary and macular regions using optical coherence tomography (OCT). The goal of this study was to evaluate the impact of glaucoma on all measurable retinal layers using the spectral domain OCT (SD-OCT). Materials and Methods SD-OCT scans using automated retinal layer segmentation were performed in both eyes of primary open-angle glaucoma patients with strictly monocular absolute visual field scotoma in the central 10° of their visual field. The same measurements were performed in one eye per person in a healthy age-matched control group. The mean thickness of all retinal layers in the central 24 × 24° of the macular region was compared between groups. Results SD-OCT scans were performed in 24 eyes of 12 glaucoma patients (10 female, 2 male) with a mean age of 72.3 ± 8.1 years and in 12 eyes of 12 healthy controls (9 female, 3 male) with a mean age of 66.0 ± 7.6 years. Statistically significant thickness differences between the glaucomatous and the healthy eyes could be demonstrated for the retinal nerve fibre layer, the ganglion cell layer, the inner plexiform layer and the complete retinal thickness, with lower mean thicknesses in the glaucoma group. Conclusion Using SD-OCT, single retinal layers of the macular region can be scanned and measured automatically. In glaucoma, a decrease in thickness of the inner retinal layers containing ganglion cells and their axons or dendrites could be demonstrated compared to healthy eyes. No corresponding difference in thickness could be found for the outer retinal layers using SD-OCT measurements.
作者: Jan Darius Unterlauft,Theresa Theilig,Somar Hasan,Michael R. B?hm,Franziska Rauscher
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To evaluate the impact of glaucoma on all measurable retinal layers using spectral domain optical coherence tomography (SD-OCT).

SD-OCT effectively measures thinning of inner retinal layers (RNFL, GCL, IPL) in glaucoma, indicating neurodegenerative changes. No significant differences were found in outer retinal layers. The study supports the use of macular SD-OCT for glaucoma detection and monitoring, but larger, longitudinal studies are needed for normative data and to assess disease progression.

The study is cross-sectional, limiting longitudinal insights. Sample size is small (12 patients and 12 controls), and findings are specific to advanced glaucoma with central scotomas. SD-OCT may not detect subtle changes in outer retinal layers, and the method is currently applicable only to central macular regions, not peripheral areas.

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