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片側性中心網膜動脈閉塞症患者の仲間眼における不顕性網膜内層厚の変化：パイロット研究
Subclinical inner retinal layer thickness changes in the fellow eyes of patients with unilateral central retinal artery occlusion: a pilot study.
PMID: 32632617 DOI: 10.1007/s10792-020-01481-7.
抄録
目的:
片側性中心網膜動脈閉塞症（CRAO）患者の交尾眼における黄斑内膜層の経時的な微細構造変化を調べることを目的とした。
PURPOSE: To investigate microstructural changes in the macular inner retinal layers over time in the fellow eyes of patients with unilateral central retinal artery occlusion (CRAO).
方法:
初診時（1日目），1ヶ月目，3ヶ月目，6ヶ月目にCRAO患者16名を対象に分光領域光コヒーレンストモグラフィー撮影を行い，各診察時の交尾眼の黄斑中央部厚さ（CMT）と網膜内層厚さを比較した。網膜神経線維層（RNFL）、神経節細胞層（GCL）、内側叢状層（IPL）、内側核層（INL）の厚さは、Early Treatment Diabetic Retinopathy Studyの定義に従って9象限で計算した。
METHODS: Spectral-domain optical coherence tomography scans of 16 patients with CRAO were performed at initial examination (1st day), at 1st month, at 3rd month, at 6th month, and the central macular thickness (CMT) and inner retinal layer thicknesses in the fellow eyes of the patients were compared between each visit. The thicknesses of retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), and inner nuclear layer (INL) were calculated in 9 quadrants according to the definition by the Early Treatment Diabetic Retinopathy Study.
結果:
CMTは6か月間で減少したが、来院間での差は有意ではなかった（p=0.072）。また、RNFLとGCLの厚さには来院間で有意差はなかった（全象限でp>0.05）。しかし、CRAO患者の仲間眼では、6ヶ月間の追跡期間中に、IPLの両眼側頭上および両眼側頭上象限（p=0.007、p=0.01）とINLの両眼側頭側頭上象限（p=0.033）に菲薄化が認められた。
RESULTS: CMT decreased over a 6-month period, but the difference was insignificant among visits (p = 0.072). Also, there were no significant differences in the thicknesses of RNFL and GCL among visits (p > 0.05 for all quadrants). But there was thinning in the parafoveal superior and perifoveal superior quadrants of the IPL (p = 0.007, p = 0.01) and in the parafoveal temporal quadrant of the INL (p = 0.033) within 6 months of follow-up in the fellow eyes of the patients with CRAO.
結論:
本研究では、CRAO患者の仲間眼における黄斑部網膜内層の不顕性変化を経時的に明らかにした。
CONCLUSION: This study demonstrated subclinical alterations of the macular inner retinal layers over time in the fellow eyes of CRAO patients.