Analysis Of The Thickness And Volume Of Macular Inner And Outer Retina In Patients With Chronic Primary Angle-closure Glaucoma

Primary chronic angle-closure glaucoma(CPACG)is different from primary acute angle-closure glaucoma.Patients with primary chronic angle-closure glaucoma have no obvious symptoms.When glaucoma was found,the visual acuity of the patient was irreversibly lost.Nowadays,the diagnosis of primary chronic angle-closure glaucoma is based on the increase of intraocular pressure,visual field defect,anterior chamber angle closure,fundus changes,and the thinning of circumpapillary retinal never fiber layer(cpRNFL)thickness.The monitoring of retinal ganglion cells(RGC)before the defect of visual defect plays an important role in early diagnosis,treatment and prognosis of glaucoma.The structure of macular area is low variation,without large blood vessels.The retina contains an average of 1.07 million RGC,of which nearly 50% RGC is within the 4.5mm range around the macula.Therefore,the change of retinal thickness in macular area has become a hot topic in scientific research.Optical coherence tomography(OCT)is a new optical diagnostic technique which has the advantages of non-contact,non-invasive and high resolution.It can quantitatively measure the thickness of the retinal nerve fiber layer.Compared with the time domain OCT,the frequency domain OCT has the characteristics of fast speed and high resolution.The structure and information of retina in macular area can be collected and analyzed.The retinal thickness of macular area can be measured quantitatively.Objective:Using OCT to compare the differences between the CPACG and the normal in the macular inner layer and outer retinal thickness and volume,analyze its change rule.Methods:58 patients with CPACG(58 eyes)were selected.Fourteen patients(14 eyes)with early CPACG,23 patients(23 eyes)with moderate CPACG and 21 patients(21 eyes)with late CPACG were recruited as early CPACG group,moderate CPACG and late CPACG group,23 healthy(23 eyes)volunteer were chosen as control.To measure and note the thickness and volume of macular inner and outer retina at all parts by RTVue-100 OCT.Results:1.In fovea,the macular thickness values of the control group and the late CPACG group were respectively(78.33±8.70)and(62.33±12.10)μm.In the control group,early stage,advanced stage and late CPACG group,the inner retinal thickness of the fovea was(135.62±2.96),(124.21±6.47),(119.74±10.67),(94.95±11.24)μm.In perifovea,the macular thickness values of the control group and the late CPACG group were respectively(78.33±8.70)and(62.33±12.10)μm.Compared with the control group,the macular fovea thickness of the late CPACG group was significantly thinner,and the difference was statistically significant(P<0.05).The macular parafovea thickness of the ealry CPACG group,advanced CPACG group and late group were significantly thinner than those in the control group,and the difference was statistically significant(P<0.05).The macular perifovea thickness of the late CPACG group was significantly thinner than that in the normal group,and the difference was statistically significant(P<0.05).There was no statistically significant difference between the other parameters(P>0.05).2.In the control group,the macular fovea,parafovea and perifovea thickness values of the outer retinal were(180.62±8.87)、(192.19±4.69)、(176.19±2.87)μm.In the late CPACG group,the macular fovea,parafovea and perifovea thickness of the outer retinal were respectively(166.38±14.22)、(174.19±9.79)、(163.43±8.10)μm.Compared with the control group,the thickness of the late CPACG group was significantly thinner,and the difference was statistically significant(P<0.05).There was no statistically significant difference between the other parameters(P>0.05).3.Compared with the control group,there was a significant decrease in the volume of late CPACG group,and the difference was statistically significant(P<0.05).The volume of the early CPACG group,advance CPACG group and late CPACG group was significantly reduced compared with the control group,the difference was statistically significant(P<0.05).There was no statistically significant difference between the other parameters(P>0.05).Conclusion:The late CPACG patients showed diffuse thinning of the inner and outer retinal thickness in the macula.In the early stage,the thickness of the retinal parafovea in the macular area was characterized by thinning.There was no significant change in the volume of the macular fovea retinal of CPACG patients.The retinal volume of the macular area with CPACG patients occurs only in the parafovea and perifovea.There was no significant change in the rest.