单侧正常张力青光眼患者未受影响对侧眼视网膜神经纤维层快速变薄：一项回顾性观察研究

IF 2.8 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma Pub Date : 2024-09-01 DOI:10.1016/j.ogla.2024.04.009

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Factors associated with the rate of thinning of the unaffected eyes of unilateral patients with NTG were identified using regression analysis.</div></div><div><h3>Main Outcome Measures</h3><div>The rate of progressive RNFL thinning and the associated factors.</div></div><div><h3>Results</h3><div>Retinal nerve fiber layer thickness decreased significantly in both the unaffected eyes of unilateral patients with NTG and the healthy eyes (both <em>P</em> < 0.001). The RNFL thinning was significantly faster in the unaffected eyes of unilateral patients with NTG than in the healthy eyes (<em>P</em> < 0.001), specifically in the temporal-inferior (TI) sector (<em>P</em> = 0.003). Factors associated with faster RNFL thinning in the unaffected eyes of unilateral patients with NTG were thicker baseline RNFL of the unaffected eyes (<em>P</em> = 0.002) and a worse visual field (VF) mean deviation (MD) in the NTG eyes (<em>P</em><span> = 0.040). 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引用次数: 0

摘要

目的：观察单侧正常张力青光眼（NTG）患者未受影响眼视网膜神经纤维层（RNFL）逐渐变薄的速度，并与健康受试者进行比较，同时确定与RNFL逐渐变薄相关的因素：设计：回顾性纵向观察研究：方法：本研究纳入了随访时间超过 4 年的单侧 NTG 患者和健康对照组受试者，这些受试者至少接受过 5 次可靠的 RNFL 厚度（RNFLT）光学相干断层扫描测量。通过回归分析确定了与单侧 NTG 患者未受影响眼球变薄率相关的因素：主要结果测量：RNFL逐渐变薄的速度和相关因素：结果：单侧NTG患者未受影响眼球和健康眼球的RNFLT均明显下降（均为PC结论：单侧NTG患者未受影响眼球和健康眼球的RNFLT均明显下降（均为PC结论）：与健康对照眼相比，单侧NTG患者未受影响眼的RNFL变薄速度更快，在颞下区更为明显，当其基线RNFL较厚时，以及当NTG眼的VF MD较差时，其进展速度可能更快。在单侧 NTG 患者中，当未受影响的眼睛有患青光眼的风险时，可考虑对其进行预防性治疗。

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Rapid Retinal Nerve Fiber Layer Thinning in the Unaffected Contralateral Eyes of Patients with Unilateral Normal-Tension Glaucoma

Purpose

To observe the rate of progressive retinal nerve fiber layer (RNFL) thinning in the unaffected eyes of patients with unilateral normal-tension glaucoma (NTG), in comparison with that of healthy subjects, and to identify the factors associated with progressive RNFL thinning.

Design

Retrospective, longitudinal, observational study.

Participants

Ninety-five patients with unilateral NTG and 61 healthy controls.

Methods

This study included unilateral NTG and healthy control subjects who were followed up for longer than 4 years and in whom at least 5 reliable retinal nerve fiber layer thickness (RNFLT) measurements were performed using OCT. Factors associated with the rate of thinning of the unaffected eyes of unilateral patients with NTG were identified using regression analysis.

Main Outcome Measures

The rate of progressive RNFL thinning and the associated factors.

Results

Retinal nerve fiber layer thickness decreased significantly in both the unaffected eyes of unilateral patients with NTG and the healthy eyes (both P < 0.001). The RNFL thinning was significantly faster in the unaffected eyes of unilateral patients with NTG than in the healthy eyes (P < 0.001), specifically in the temporal-inferior (TI) sector (P = 0.003). Factors associated with faster RNFL thinning in the unaffected eyes of unilateral patients with NTG were thicker baseline RNFL of the unaffected eyes (P = 0.002) and a worse visual field (VF) mean deviation (MD) in the NTG eyes (P = 0.040). In the healthy controls, the rate of RNFL thinning in the contralateral eyes was the only factor associated with faster thinning (P = 0.007).

Conclusions

The unaffected eyes of unilateral patients with NTG showed faster RNFL thinning than healthy control eyes, more obviously in the TI sector, and were likely to progress faster when they had a thicker baseline RNFL, and when the NTG eyes had a worse VF MD. In unilateral patients with NTG, initiation of prophylactic treatment could be considered for the unaffected eyes when they are accompanied by a risk of developing glaucoma.