Imaging Glaucomatous Damage Across the Temporal Raphe

摘要： PURPOSE. To image and analyze anatomical differences at the temporal raphe between normal and glaucomatous eyes using adaptive optics scanning laser ophthalmoscopy (AOSLO) and optical coherence tomography (OCT), and to relate these differences to visual ?eld measurements. METHODS. Nine glaucomatous eyes of 9 patients (age 54–78 years, mean deviation of visual ?eld [MD] (cid:2)5.03 to (cid:2)0.20 dB) and 10 normal eyes of 10 controls (age 54–81, MD (cid:2)1.13 to t1.39 dB) were enrolled. All the participants were imaged in a region that was centered approximately 98 temporal to the fovea. The size of imaging region was at least 108 vertically by 48 horizontally. The raphe gap, de?ned as the distance between the superior and inferior retinal nerve ?ber layer (RNFL) bundles, was measured. A bundle index was computed to quantify the relative re?ectivity and density of the nerve ?ber bundles. We also measured thickness of the ganglion cell complex (GCC) and RNFL. RESULTS. The raphe gap was larger in glaucomatous eyes than control eyes. Speci?cally, eight glaucomatous eyes with local averaged ?eld loss no worse than (cid:2)3.5 dB had larger raphe gaps than all control eyes. The bundle index, GCC thickness, and RNFL thickness were on average reduced in glaucomatous eyes, with the ?rst two showing statistically signi?cant differences between the two groups. CONCLUSIONS. Structural changes in the temporal raphe were observed and quanti?ed even when local functional loss was mild. These techniques open the possibility of using the raphe as a site for glaucoma research and clinical assessment.