应用Cirrus-HD OCT分析乙胺丁醇对视网膜 神经节细胞的损害

doi:10.3760/cma.j.cn115909-20190614-00172

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Abstract Objective: To investigate the structural injury patterns in retinal ganglion cell injury from ethambutol (EMB) treatment, and the value of Cirrus-HD OCT examination in the early diagnosis of toxic optic neuropathy. Methods: This was a retrospective case-control study. Sixty tuberculosis (TB) patients who took anti-TB drugs containing EMB from January 2018 to March 2019 were recruited. Among them, 6 patients (12 eyes) who were diagnosed with ethambutal-induced optic neuropathy (EON) were included in the EON group, another 43 patients (85 eyes) who had normal visual function after taking the medicine were included in the drug group. Forty-one patients (82 eyes) who matched the age and gender of the drug group were included in control group 1, and 13 patients (26 eyes) who matched the age and gender of the EON group were included in control group 2. The thickness of the retinal nerve fiber layer (RNFL) and the ganglion cell-inner plexiform layer (GCIPL) on Cirrus-HD OCT images were compared with those of healthy controls. Results: No significant changes in RNFL thickness were found in the drug group compared with control group 1. Meanwhile, the ganglion cell layer visibly decreased in the nasal-superior, nasal-inferior, inferior, temporal-superior and the superior sectors compared with control group 1 (t=-3.149, -2.880, -3.816, -3.697, -2.646, -2.231, -2.323, all P<0.05), except for the temporal inferior sector. The p-RNFL thickness of the EON group increased in the nasal and inferior sectors (t=2.452, 2.314, both P<0.05), while the ganglion cell layer thickness decreased in the nasal-superior, nasal-inferior, inferior, temporal-inferior, temporal-superior and the superior sectors compared with the healthy controls in group 2. The differences were significant (t=-2.809, -2.622, -2.806, -2.461, -2.887, -3.478, all P<0.05). Conclusions: CirrusHD OCT can accurately measure the thickness of the GCL layer, and enables more direct observance of damage to retinal ganglion cells. Combined with the measurement of p-RNFL and GCL thickness, it can assist in the early diagnosis of EON.

Key words： Cirrus-HD optical coherence tomography peripapillary retinal nerve fiber layer ganglia cell inner-plexiform layer ethambutol toxic optic neuropathy

Fund:Science and Technology Development Project of Hangzhou (20170533B70, 20191203B129); Medical and Health Science and Technology Program of Hangzhou (0020190136); Natural Science Foundation of Zhejiang Province (LY17H120009)

Corresponding Authors: Wei Ge, Department of Ophthalmology, Zhe Jiang Chinese Medicine and Western Medicine Intergrated Hospital, Hangzhou 310003, China (Email: v.v.anna@163.com)

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https://www.cjoovs.com/EN/10.3760/cma.j.cn115909-20190614-00172 OR https://www.cjoovs.com/EN/Y2020/V22/I4/299

[1]	Chen SC, Lin MC, Sheu SJ. Incidence and prognostic factor of ethambutol-related optic neuropathy: 10-year experience in southern Taiwan. Kaohsiung J Med Sci, 2015, 31(7): 358-362. DOI: 10.1016/j.kjms.2015.05.004.
[2]	Lee EJ, Kim SJ, Choung HK, et al. Incidence and clinical features of ethambutol-induced optic neuropathy in Korea. J Neuroophthalmol, 2008, 28(4): 269-277. DOI: 10.1097/ WNO.0b013e31818e3c6b.
[3]	Chamberlain PD, Sadaka A, Berry S, et al. Ethambutol optic neuropathy. Curr Opin Ophthalmol, 2017, 28(6): 545-551. DOI: 10.1097/ICU.0000000000000416.
[4]	G r z y b o w s k i A , Z ü l s d o r f f M , Wi l h e l m H , e t a l . Toxic optic neuropathies: An updated review. Acta Ophthalmol, 2015, 93(5): 402-410. DOI: 10.1111/aos.12515.
[5]	Menon V, Jain D, Saxena R, et al. Prospective evaluation of visual function for early detection of ethambutol toxicity. Br J Ophthalmol, 2009, 93(9): 1251-1254. DOI: 10.1136/ bjo.2008.148502.
[6]	Chai SJ, Foroozan R. Decreased retinal nerve fibre layer thickness detected by optical coherence tomography in patients with ethambutol-induced optic neuropathy. Br J Ophthalmol, 2007, 91(7): 895-897. DOI: 10.1136/bjo.2006.113118.
[7]	Zoumalan CI, Sadun AA. Optical coherence tomography can monitor reversible nerve-fibre layer changes in a patient with ethambutol-induced optic neuropathy. Br J Ophthalmol, 2007, 91(6): 839-840. DOI: 10.1136/bjo.2006.107326.
[8]	邹文军, 田国红, 李梦玮, 等. Leber遗传性视神经病变视神经纤维层厚度及黄斑区神经节细胞复合体相关参数分析. 中华眼视光学与视觉科学杂志, 2016, 18(8): 473-477. DOI: 10.3760/cma.j.issn.1674-845X.2016.08.006.
[9]	李刚, 张方华, 颜少明, 等. 标准化logMAR视力表的研制与临床应用. 第二军医大学学报, 2005, 26(12): 1371-1373. DOI: 10.3321/j.issn: 0258-879X.2005.12.012.
[10]	Holladay JT. Visual acuity measurements. J Cataract Refract Surg, 2004, 30(2): 287-290. DOI: j.jcrs.2004.01.014.
[11]	Kim KL, Park SP. Visual function test for early detection of ethambutol induced ocular toxicity at the subclinical level. Cutan Ocul Toxicol, 2016, 35(3): 228-232. DOI: 10.3109/15569527. 2015.1079784.
[12]	Kim U, Hwang JM. Early stage ethambutol optic neuropathy: Retinal nerve fiber layer and optical coherence tomography. Eur J Ophthalmol, 2009, 19(3): 466-469. DOI: 10.1177/ 112067210901900323.
[13]	Kim YK, Hwang JM. Serial retinal nerve fiber layer changes in patients with toxic optic neuropathy associated with antituberculosis pharmacotherapy. J Ocul Pharmacol Ther, 2009, 25(6): 531-535. DOI: 10.1089/jop.2009.0064.
[14]	Sadun AA. Mitochondrial optic neuropathies. J Neurol Neurosurg Psychiatry, 2002, 72(4): 423-425. DOI: 10.1136/ jnnp.72.4.423.
[15]	Peng CX, Zhang AD, Chen B, et al. Macular thickness as a predictor of loss of visual sensitivity in ethambutol-induced optic neuropathy. Neural Regen Res, 2016, 11(3): 469-475. DOI: 10.4103/1673-5374.179061.
[16]	Lee JY, Choi JH, Park KA, et al. Ganglion cell layer and inner plexiform layer as predictors of vision recovery in ethambutolinduced optic neuropathy: A longitudinal OCT analysis. Invest Ophthalmol Vis Sci, 2018, 59(5): 2104-2109. DOI: 10.1167/ iovs.17-22988.
[17]	Han J, Byun MK, Lee J, et al. Longitudinal analysis of retinal nerve fiber layer and ganglion cell-inner plexiform layer thickness in ethambutol-induced optic neuropathy. Graefes Arch Clin Exp Ophthalmol, 2015, 253(12): 2293-2299. DOI: 10.1007/ s00417-015-3150-8.
[18]	Vieira LM, Silva NF, Dias dos Santos AM, et al. Retinal ganglion cell Layer analysis by optical coherence tomography in toxic and nutritional optic neuropathy. J Neuroophthalmol, 2015, 35(3): 242-245. DOI: 10.1097/WNO.0000000000000229.
[19]	Teng D, Peng CX, Qian HY, et al. Structural impairment patterns in peripapillary retinal fiber layer and retinal ganglion cell layer in mitochondrial optic neuropathies. Int J Ophthalmol, 2018, 11(10): 1643-1648. DOI: 10.18240/ijo.2018.10.11.