中国神经再生研究(英文版) ›› 2016, Vol. 11 ›› Issue (3): 469-475.doi: 10.4103/1673-5374.179061

• 原著:视神经损伤修复保护与再生 • 上一篇    下一篇

黄斑厚度能预测乙胺丁醇中毒性视神经病变?

  

  • 收稿日期:2015-12-22 出版日期:2016-03-15 发布日期:2016-03-15
  • 基金资助:

    基金资助:863项目(2015AA020511)

Macular thickness as a predictor of loss of visual sensitivity in ethambutol-induced optic neuropathy

Chun-xia Peng, Ai-di Zhang, Bing Chen, Bing-jian Yang, Qiu-hong Wang, Mo Yang, Shi-hui Wei   

  1. Department of Ophthalmology, Chinese PLA General Hospital, Beijing, China
  • Received:2015-12-22 Online:2016-03-15 Published:2016-03-15
  • Contact: Shi-hui Wei,weishihui706@hotmail.com.
  • Supported by:

    This research was supported by the National High Technology Research and Development Program of China (863 Program), No. 2015AA020511.

摘要:

乙胺丁醇可导致中毒性视神经病变,如早期发现及时停药,可能是防止其视力损伤的有效方法。以往相关研究结果显示,视神经形态结构损伤早于视功能损伤,因此,需探寻一个早期发现乙胺丁醇中毒性视神经病变视野损伤的敏感指标。鉴于此,我们采用光学相干断层成像技术对11例乙胺丁醇中毒性视神经病变患者22眼的视盘周围视网膜神经纤维层厚度、黄斑厚度及视敏度丢失的情况进行观察,并与24例年龄-性别匹配的正常人48眼作为对照。发现乙胺丁醇中毒性视神经病变患者颞侧视盘周围神经纤维层厚度、平均黄斑厚度明显比正常人薄。乙胺丁醇中毒性视神经病变患者的平均黄斑厚度与中央平均视野敏感度的丢失呈明显的正相关性(r2 =0.878, P=0.000)。从而表明光学相干断层成像技术是筛查乙胺丁醇中毒性视神经病变的有效检查方法,视网膜黄斑厚度变薄可能是早期发现乙胺丁醇中毒性视神经病变的敏感指标。

关键词: 神经再生, 视神经损伤, 乙胺丁醇, 结核, 视神经病变, 光学相干断层扫描, 视网膜神经纤维, 黄斑厚度, 视敏度, 神经纤维, 863项目

Abstract:

Ethambutol is a common cause of drug-related optic neuropathy. Prediction of the onset of ethambutol-induced optic neuropathy and consequent drug withdrawal may be an effective method to stop visual loss. Previous studies have shown that structural injury to the optic nerve occurred earlier than the damage to visual function. Therefore, we decided to detect structural biomarkers marking visual field loss in early stage ethambutol-induced optic neuropathy. The thickness of peripapillary retinal nerve fiber layer, macular thickness and visual sensitivity loss would be observed in 11 ethambutol-induced optic neuropathy patients (22 eyes) using optical coherence tomography. Twenty-four healthy age- and sex-matched participants (48 eyes) were used as controls. Results demonstrated that the temporal peripapillary retinal nerve fiber layer thickness and average macular thickness were thinner in patients with ethambutol-induced optic neuropathy compared with healthy controls. The average macular thickness was strongly positively correlated with central visual sensitivity loss (r2=0.878, P=0.000). These findings suggest that optical coherence tomography can be used to efficiently screen patients. Macular thickness loss could be a potential factor for predicting the onset of ethambutol-induced optic neuropathy.

Key words: nerve regeneration, ethambutol-induced optic neuropathy, optical coherence tomography, peripapillary retinal nerve fiber layer, ethambutol, macular thickness, visual sensitivity, neural regeneration