Debljina peripapilarnih retinalnih nervnih vlakana kod različitih stepena glaukoma merena optičkom koherentnom tomografijom
Sažetak
Uvod/Cilj. Jedna od najpouzdanijih metoda za merenje strukturnih promena kod glaukoma je spektralna optička koherentna tomografija – spectral domain optical coherence tomography (SD-OCT). Cilj rada bio je da se izmeri debljina peripapilarnih retinalnih nervnih vlakana (RNFL) uz pomoć SD-OCT, kao i da se utvrdi koji je sektor u pomenutom prostoru najosetljiviji na glaukomatozno oštećenje. Metode. U studiju je bilo uključeno ukupno 153 očiju 93 bolesnika sa potvrđenim primarnim glaukomom otvorenog ugla (POAG). Svim bolesnicima urađen je kompletan oftalmološki pregled, uključujući dodatno kompjuterizovano vidno polje i merenje peripapilarnih RNFL pomoću SD- OCT. Bolesnici su bili podeljeni u tri podgrupe: rani, srednji i odmakli stepen glaukoma (prema vrednostima MD na vidnom polju). Rezultati. Rezultati su predstavljeni kao srednje vrednosti ukupne debljine RNFL za celu grupu i podgrupe, kao i preko 4 cirkularna i 12 linearnih sektora. Srednja vrednost RNFL iznosila je 74,95 ± 14,51 µm. Najdeblji je bio donji kvadrant (92,78 ± 25,84 µm), potom gornji (88,82 ± 22,04 µm), nazalni (64,31 ± 11,67 µm) i temporalni (54,02 ± 12,76 µm) što je značajna razlika (χ2 = 273,36, DF = 3, p < 0,001). Poređenjem debljine RNFL kod ranog glaukoma u odnosu na srednji i odmakli stadijum, najsenzitivniji su bili gornji i donji kvadrant kao i sektor od 5 do 7 sati. Najtanja je bila pozicija na 9 sati (46,99 ± 13,28 µm), a najdeblja na 6 sati (102,63 ± 34,12 µm). Zaključak. Debljina peripapilarnih RNFL i stepen glaukoma su obrnuto proporcionalni: veći stepen oštećenja podrazumeva tanja peripapilarna RNFL.
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