The retinal nerve fibre layer thickness in glaucomatous hydrophthalmic eyes assessed by scanning laser polarimetry with variable corneal compensation in comparison with age-matched healthy children

A review of the human retina with emphasis on nerve fibre layer and macula thicknesses

The retina is the innermost neural layer of the eye, and is the site of transformation of light energy into a neural signal. Knowledge and assessment of the human retinal structural parameters are important for the appropriate diagnosis and management of various ocular diseases. For instance, potentially blinding eye diseases, such as glaucoma and age-related macula degeneration, cause structural changes in the retina. Clinical evidence with ocular coherence tomography also suggests that eyes with glaucoma lose retinal nerve fibre layer and ganglion cells axons before loss of visual function. These losses appear as a visible change in the optic nerve head and can be seen before visual field abnormalities are noticed by the patient. This review discusses certain aspects (anatomical structures, structural changes with eye diseases and assessment methods) involving the human retina, their clinical importance and factors that may influence them. The content of this article will be useful to optometrists and ophthalmologists who assess these parameters in normal patients as well as in those with eye conditions such as glaucoma.Keywords: Retinal parameters; optic disc; nerve fibre layer thickness; macula thickness; glaucoma 

Therapeutic effect analysis on the treatment of congenital glaucoma through modified combined trabeculotomy-trabeculectomy

AIM

To evaluate the therapeutic effect and the safety of the treatment of congenital glaucoma through modified combined trabeculotomy-trabeculectomy.

METHODS

The clinical data of 27 cases (altogether 42 eyes), which included 7 cases of infants (10 eyes) and 20 cases of teenagers (32 eyes), of congenital glaucoma undertook modified combined trabeculotomy-trabeculectomy were analyzed retrospectively. The parameters evaluated included the post operation visual acuity, the anterior chamber, the filtering bleb, the intraocular pressure, the C/D ratio, visual field, the retinal nerve fiber layer changes and the complications.

RESULTS

The follow-up period was 1 to 29mo, averaging 13.3±7.7mo. Upon the last visit after the operation, functional filtering blebs developed in all the involved eyes. The intraocular pressure was controlled under 21 mm Hg, which was decreased by 60% when compared with that before the operation, without using any medication. There were no significant changes in the post operation visual acuity and the retinal nerve fiber layer thickness before and after the operation in teenager group (P>0.05), and both the post operation C/D ratio and the visual field mean defect (MD) were reduced compared with those before the operation (P<0.05). There were no severe complications in any of the patients.

CONCLUSION

The modified combined trabeculotomy-trabeculectomy can effectively reduce the intraocular pressure and control the development of glaucoma in cases of congenital glaucoma. It is a safe and effective operative method for the treatment of congenital glaucoma.