国际眼科纵览

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筛板结构及影像学研究进展

吴建  王宁利   

  1. 首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科研究所 眼科学与视觉科学北京市重点实验室 100005
  • 出版日期:2019-10-22 发布日期:2019-10-30
  • 通讯作者: 王宁利,Email:wningli@vip.163.com
  • 基金资助:

    国家自然科学基金面上项目(81271005);北京市自然科学基金(7122038)

Research advances in structure and imaging of lamina cribrosa

Wu Jian, Wang Ningli   

  1. Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing  Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University,  Beijing 100005, China
  • Online:2019-10-22 Published:2019-10-30
  • Contact: Wang Ningli, Email: wningli@vip.163.com
  • Supported by:
    National Natural Science Foundation of China (81271005); Beijing Natural Science Foundation(7122038)

摘要:

筛板为一种网状筛孔结构,无髓鞘的视网膜神经节细胞轴突从中穿过。长期以来筛板被认为是轴突损伤的主要部位,因而在青光眼发病机制中具有重要意义。随着OCT技术及图像处理技术的不断革新,筛板形态学研究及生物力学分析成为可能。本文着重关注临床中筛板所产生的生物力学特性及跨筛板压力差(TLPD)概念,同时突出影像学领域的技术进步及其所产生的临床意义,为未来研究提供可能的方向。除眼压外,脑脊液压力(CSFP)及TLPD在青光眼致病机制中发挥重要作用。筛板的位移方向不仅取决于TLPD带来的应力改变,同时也受周围巩膜结构生物力学特性影响。青光眼患者视野暗点的产生与筛板小梁层的局部损伤/缺损或重塑(如不规则凹陷、断层及孔洞等)有关。OCT检测的筛板前表面相关参数筛板深度(LCD)、筛板曲率(LCC)和筛板整体形状指数(LC\|GSI)等也与青光眼的发生与进展相关。(国际眼科纵览,2019, 43:300-305

 

Abstract:

The lamina cribrosa(LC) is a reticulated, sieve\|like structure, which unmyelinated retinal ganglion cell (RGC) axons pass through. The LC has long been identified as the main site of RGC axonal injury and hence important in the pathogenesis of glaucoma. Improvements in imaging such as optical coherence tomography(OCT) image capture and image processing have allowed detailed of LC macro\|biomechanical and micro\|architectural characteristics. In this review, we first aim to frame the biomechanical considerations of lamina cribrosa in a clinical context and to discuss the concept of the translaminar pressure gradient (TLPD). At the same time, we aim to highlight the technological advances in imaging the LC and its accompanying clinical implications, and future research directions in this field. In addition to the changes in intraocular pressure, cerebrospinal fluid pressure (CSFP) and TLPD play an important role in the pathogenesis of glaucoma. The displacement direction of the LC effects not only on the mechanical stress change caused by TLPD, but also included the biomechanical properties of the surrounding scleral structure. Scotoma in the glaucoma patient’s is associated with local damage, defects or remodeling of the LC. However, the anterior surface parameters of OCT imaging including LC depth (LCD), LC curvature (LCC) and LC global shape index (LC\|GSI) were also correlated with the occurrence and progression of glaucoma.(Int Rev Ophthalmol, 2019, 43:  300-305)