The changes in optic disc parameter and the thickness of circumpapillary retinal nerve fiber layer and macular retina after acute primary angle closure_Chinese Journal of Ocular Fundus Diseases

Authors：

PangYanhua , LyuQiurong , ZhouZhou , XueYingying ,  ZhaoGuilling

Department of Ophthalmology, Affiliated Hospital of Guangdong Medical College, Zhanjiang 524023, China;

Corresponding author：

ZhaoGuilling, Email: zhaoguiling@qq.com

Keywords：

Glaucoma, angle-closure/diagnosis; Optic disk/physiopathology; Nerve fibers/pathology; Retina/physiopathology; Tomography, optical coherence

DOI：

10.3760/cma.j.issn.1005-1015.2016.03.012

Video：

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Objective To determine the long-term changes in optic disc parameter and the thickness of circumpapillary retinal nerve fiber layer (CP-RNFL) and macular retina after acute primary angle closure. Methods Prospective clinical case-control study. A total of 26 patients (30 eyes) with acute primary angle-closure glaucoma (APACG) were in the APACG group, whose intraocular pressure were control after a single episode acute primary angle closure; 30 age-and sex-matched healthy subjects (30 eyes) in the control group. All subjects underwent three dimensional optical coherence tomography (3D-OCT) examination with 3D optic disk scanning or circle optic disk scanning and 6 mm×6 mm macular scanning. The parameters included average thickness of entire CP-RNFL, thickness of nasal, superior, temporal and inferior quadrant of CP-RNFL, disc area, disc cup area, rim area, cup/disc (C/D) area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio. The foveal retinal thickness, center retinal thickness (≤1 mm from the fovea), 4 quadrants of macular inner-ring ( > 1 mm but≤3 mm from the fovea) retinal thickness, 4 quadrants of macular outer-ring ( > 3 mm but≤6 mm from the fovea) retinal thickness, average thickness of macular retinal thickness and macular volume were measured and analyzed. Results The disc area, disc cup area, C/D area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio in APACG group were significantly bigger than the control group (t=3.22, 4.12, 3.90, 3.00, 3.23; P < 0.05), rim area was smaller than the control group (t=-2.63, P < 0.05). The average thickness (t=-6.68) and the thickness of superior (t=-5.90), temporal (t=-11.64) and inferior (t=-5.06) quadrants of CP-RNFL, center retinal thickness (t=-2.50), 4 quadrants of macular inner-ring retinal thickness (t=-4.91, -4.88, -2.83, -3.59), nasal (t=-2.13) and superior (t=-2.49) quadrants of macular outer-ring retinal thickness as well as average thickness of macular retinal thickness (t=-2.65) were significantly thinner than the control group (P < 0.05), and the macular volume (t=-2.69) was significantly smaller than the control group (P < 0.05). There was no statistically difference at nasal CP-RNFL (t=-0.11), foveal retinal thickness (t=-0.59), temporal (t=-0.67) and inferior (t=-1.02) quadrants of macular outer-ring retinal thickness between two groups (P > 0.05). Conclusions In comparison with the healthy subjects, the disc area, disc cup area, C/D area ratio, C/D horizontal diameter ratio, C/D vertical diameter ratio in APACG eyes were bigger, while rim area was smaller; the CP-RNFL and macular retinal thickness were thinner except nasal CP-RNFL, fovea, temporal and inferior quadrants of macular outer-ring retinal.

Citation： PangYanhua, LyuQiurong, ZhouZhou, XueYingying, ZhaoGuilling. The changes in optic disc parameter and the thickness of circumpapillary retinal nerve fiber layer and macular retina after acute primary angle closure. Chinese Journal of Ocular Fundus Diseases, 2016, 32(3): 278-282. doi: 10.3760/cma.j.issn.1005-1015.2016.03.012 Copy

1.	中华医学会眼科分会青光眼学组.我国原发性青光眼诊断和治疗专家共识[J].中华眼科杂志, 2014, 50(5):382-383. DOI:10.3760/cma.j.issn.0412-4081.2014.05.022.Glaucome Group, Chinese Ophthalmological Society, Chinese Medical Association. Expert consensus in diagnosis and treatment for primary glaucoma in China[J].Chin J Ophthalmol, 2014, 50(5):382-383. DOI:10.3760/cma.j.issn.0412-4081.2014.05.022.
2.	Fang AW, Qu J, Li LP, et al. Measurement of retinal nerve fiber layer in primary acute angle closure glaucoma by optical coherence tomography[J].J Glaucoma, 2007, 16(2):178-184.
3.	庞燕华, 赵桂玲, 谭志, 等. 3D-OCT检测急性闭角型青光眼发作眼黄斑区视网膜厚度研究[J].中国实用眼科杂志, 2014, 32(6):701-704. DOI:10.3760/cma.j.issn.1006-4443.2014.06.008.Pang YH, Zhao GL, Tan Z, et al. Study of macular retinal thickness measured by three dimensional optical coherence tomography (3D-OCT) for acute primary angle-closure glaucoma[J]. Chin J Pract Ophthalmol, 2014, 32(6):701-704. DOI:10.3760/cma.j.issn.1006-4443.2014.6.008.
4.	Celebi AR, Mirza GE.Age-related change in retinal nerve fiber layer thickness measured with spectral domain optical coherence tomography[J].Invest Ophthalmol Vis Sci, 2013, 54(13):8095-8103. DOI:10.1167/iovs.13-12634.
5.	Gupta P, Sidhartha E, Tham YC, et al. Determinants of macular thickness using spectral domain optical coherence tomography in healthy eyes:the Singapore Chinese eyes study[J]. Invest Ophthalmol Vis Sci, 2013, 54(13):7968-7976.DOI:10.1167/iovs.13-12436.
6.	赵桂玲, 陈剑, 庞燕华, 等. 3DOCT研究近视眼RNFL厚度及视盘参数[J].中国实用眼科杂志, 2014, 32(3):282-285.DOI:10.3760/cma.j.issn.1006-4443.2014.03.007.Zhao GL, Chen J, Pang YH, et al. Analysis on thickness of retinal nerve fiber layer and optic nerve head parameters in myopia by using optical coherence tomography[J].Chin J Pract Ophthalmol, 2014, 32(3):282-285.DOI:10.3760/cma.j.issn.1006-4443.2014.03.007.
7.	李媚, 刘杏, 黄晶晶, 等.原发性急性闭角型青光眼视网膜神经纤维层厚度变化研究[J].中国实用眼科杂志, 2008, 26(6):562-565. DOI:10.3760/cma.j.issn.1006-4443.2008.06.010.Li M, Liu X, Huang JJ, et al. Changes in retinal nerve fiber layer thickness afteracute primary angle closure glaucoma attack[J]. Chin J Pract Ophthalmol, 2008, 26(6):562-565. DOI:10.3760/cma.j.issn.1006-4443.2008.06.010.
8.	Quigley HA, Addicks EM. Chronic experimental glaucoma in primatesⅡ:effect of extended intraocular pressure elevation on optic nerve head and axonal transport[J].Invest Ophthalmol Vis Sci, 1980, 19(2):137-152.
9.	Sng CC, See JS, Ngo CS, et al. Changes in retinal nerve fibre layer, optic nerve head morphology, and visual field after acute primary angle closure[J]. Eye (Lond), 2011, 25(5):619-625.
10.	Jiang R, Xu L, Liu X, et al. Optic nerve head changes after short-term intraocular pressure elevation in acute primary angle-closure suspects[J]. Ophthalmology, 2015, 122(4):730-737. DOI:10.1016/j.ophtha.2014.11.008.
11.	赵军, 胡莲娜, 赵宏伟, 等.频域-OCT观测原发性闭角型青光眼患者视盘形态、视网膜神经纤维层及神经节细胞复合体的临床意义[J].眼科新进展, 2014, 34(10):968-971. DOI:10.13389/j.cnki.rao.2014.0268.Zhao J, Hu LN, Zhao HW, et al. Clinical significance of SD-OCT detecting visual disc morphous, retinal nerve fibre layer and ganglion cell complex of PACG[J]. Rec Adv Ophthalmol, 2014, 34(10):968-971. DOI:10.13389/j.cnki.rao.2014.0268.
12.	Liu X, Li M, Zhong Y, et al. The damage patterns of retinal nerve fiber layer in acute and chronic intraocular pressure elevation in primaryangle closure glaucoma[J].Eye Sci, 2011, 26(3):154-160. DOI:10.3969/j.issn.1000-4432.2011.03.006.
13.	Lee JW, Woo TT, Yau GS, et al. Cross-sectional study of the retinal nerve fiber layer thickness at 7 years after an acute episode of unilateral primary acute angle closure[J]. Medicine (Baltimore), 2015, 94(2):391. DOI:10.1097/MD.0000000000000391.
14.	Yoles E, Schwartz M. Potential neuroprotective therapy for laucomatous optic neuropathy[J].Surv Ophthalmol, 1998, 42(4):367-372.
15.	欧文, 王泽飞, 方爱武, 等. FD-OCT对原发性急性闭角型青光眼视网膜厚度和体积的测量[J].中华实验眼科杂志, 2014, 32(2):154-157. DOI:10.3760/cma.j.issn.2095-0160.2014.02.012.Ou W, Wang ZF, Fang AW, et al. Measurement of retinal thickness and volume after onset of primary acute angle-closure glaucoma[J]. Chin J Exp Ophthalmol, 2014, 32(2):154-157. DOI:10.3760/cma.j.issn.2095-0160.2014.02.012.

1. 中华医学会眼科分会青光眼学组.我国原发性青光眼诊断和治疗专家共识[J].中华眼科杂志, 2014, 50(5):382-383. DOI:10.3760/cma.j.issn.0412-4081.2014.05.022.Glaucome Group, Chinese Ophthalmological Society, Chinese Medical Association. Expert consensus in diagnosis and treatment for primary glaucoma in China[J].Chin J Ophthalmol, 2014, 50(5):382-383. DOI:10.3760/cma.j.issn.0412-4081.2014.05.022.
2. Fang AW, Qu J, Li LP, et al. Measurement of retinal nerve fiber layer in primary acute angle closure glaucoma by optical coherence tomography[J].J Glaucoma, 2007, 16(2):178-184.
3. 庞燕华, 赵桂玲, 谭志, 等. 3D-OCT检测急性闭角型青光眼发作眼黄斑区视网膜厚度研究[J].中国实用眼科杂志, 2014, 32(6):701-704. DOI:10.3760/cma.j.issn.1006-4443.2014.06.008.Pang YH, Zhao GL, Tan Z, et al. Study of macular retinal thickness measured by three dimensional optical coherence tomography (3D-OCT) for acute primary angle-closure glaucoma[J]. Chin J Pract Ophthalmol, 2014, 32(6):701-704. DOI:10.3760/cma.j.issn.1006-4443.2014.6.008.
4. Celebi AR, Mirza GE.Age-related change in retinal nerve fiber layer thickness measured with spectral domain optical coherence tomography[J].Invest Ophthalmol Vis Sci, 2013, 54(13):8095-8103. DOI:10.1167/iovs.13-12634.
5. Gupta P, Sidhartha E, Tham YC, et al. Determinants of macular thickness using spectral domain optical coherence tomography in healthy eyes:the Singapore Chinese eyes study[J]. Invest Ophthalmol Vis Sci, 2013, 54(13):7968-7976.DOI:10.1167/iovs.13-12436.
6. 赵桂玲, 陈剑, 庞燕华, 等. 3DOCT研究近视眼RNFL厚度及视盘参数[J].中国实用眼科杂志, 2014, 32(3):282-285.DOI:10.3760/cma.j.issn.1006-4443.2014.03.007.Zhao GL, Chen J, Pang YH, et al. Analysis on thickness of retinal nerve fiber layer and optic nerve head parameters in myopia by using optical coherence tomography[J].Chin J Pract Ophthalmol, 2014, 32(3):282-285.DOI:10.3760/cma.j.issn.1006-4443.2014.03.007.
7. 李媚, 刘杏, 黄晶晶, 等.原发性急性闭角型青光眼视网膜神经纤维层厚度变化研究[J].中国实用眼科杂志, 2008, 26(6):562-565. DOI:10.3760/cma.j.issn.1006-4443.2008.06.010.Li M, Liu X, Huang JJ, et al. Changes in retinal nerve fiber layer thickness afteracute primary angle closure glaucoma attack[J]. Chin J Pract Ophthalmol, 2008, 26(6):562-565. DOI:10.3760/cma.j.issn.1006-4443.2008.06.010.
8. Quigley HA, Addicks EM. Chronic experimental glaucoma in primatesⅡ:effect of extended intraocular pressure elevation on optic nerve head and axonal transport[J].Invest Ophthalmol Vis Sci, 1980, 19(2):137-152.
9. Sng CC, See JS, Ngo CS, et al. Changes in retinal nerve fibre layer, optic nerve head morphology, and visual field after acute primary angle closure[J]. Eye (Lond), 2011, 25(5):619-625.
10. Jiang R, Xu L, Liu X, et al. Optic nerve head changes after short-term intraocular pressure elevation in acute primary angle-closure suspects[J]. Ophthalmology, 2015, 122(4):730-737. DOI:10.1016/j.ophtha.2014.11.008.
11. 赵军, 胡莲娜, 赵宏伟, 等.频域-OCT观测原发性闭角型青光眼患者视盘形态、视网膜神经纤维层及神经节细胞复合体的临床意义[J].眼科新进展, 2014, 34(10):968-971. DOI:10.13389/j.cnki.rao.2014.0268.Zhao J, Hu LN, Zhao HW, et al. Clinical significance of SD-OCT detecting visual disc morphous, retinal nerve fibre layer and ganglion cell complex of PACG[J]. Rec Adv Ophthalmol, 2014, 34(10):968-971. DOI:10.13389/j.cnki.rao.2014.0268.
12. Liu X, Li M, Zhong Y, et al. The damage patterns of retinal nerve fiber layer in acute and chronic intraocular pressure elevation in primaryangle closure glaucoma[J].Eye Sci, 2011, 26(3):154-160. DOI:10.3969/j.issn.1000-4432.2011.03.006.
13. Lee JW, Woo TT, Yau GS, et al. Cross-sectional study of the retinal nerve fiber layer thickness at 7 years after an acute episode of unilateral primary acute angle closure[J]. Medicine (Baltimore), 2015, 94(2):391. DOI:10.1097/MD.0000000000000391.
14. Yoles E, Schwartz M. Potential neuroprotective therapy for laucomatous optic neuropathy[J].Surv Ophthalmol, 1998, 42(4):367-372.
15. 欧文, 王泽飞, 方爱武, 等. FD-OCT对原发性急性闭角型青光眼视网膜厚度和体积的测量[J].中华实验眼科杂志, 2014, 32(2):154-157. DOI:10.3760/cma.j.issn.2095-0160.2014.02.012.Ou W, Wang ZF, Fang AW, et al. Measurement of retinal thickness and volume after onset of primary acute angle-closure glaucoma[J]. Chin J Exp Ophthalmol, 2014, 32(2):154-157. DOI:10.3760/cma.j.issn.2095-0160.2014.02.012.

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The changes in optic disc parameter and the thickness of circumpapillary retinal nerve fiber layer and macular retina after acute primary angle closure

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