[青光眼视乳头的形态学。II. 继发性慢性开角型青光眼]

Budde W M, Jonas J B

Augenklinik mit Poliklinik, Friedrich-Alexander-Universität Erlangen-Nürnberg.

Klin Monbl Augenheilkd. 1999 Oct;215(4):221-7. doi: 10.1055/s-2008-1034703.

UNLABELLED

Previous studies have shown that the chronic open-angle glaucomas form a heterogeneous spectrum of diseases which have in common an open anterior chamber angle and glaucomatous optic nerve damage. Purpose of this study was to evaluate whether the appearance of the optic disc shows specific features among various types of secondary chronic open-angle glaucoma.

METHODS

Clinical data and color-stereo optic disc photographs of 126 patients with pseudoexfoliative glaucoma and 47 patients with pigmentary glaucoma were compared with those of 501 patients with primary open-angle glaucoma (POAG) and of 481 normal subjects. The glaucoma groups did not differ in neuroretinal rim nor in perimetric mean defect.

RESULTS

Mean optic disc area was significantly smaller in the pseudoexfoliative glaucoma eyes (2.54 +/- 0.51 mm2 vs. 2.71 +/- 0.63 mm2, p = 0.03) than in the primary open-angle glaucoma eyes. The pigmentary glaucoma group did not vary significantly from the primary open-angle glaucoma group in size of the optic disc. No significant differences were found for neuroretinal rim area, configuration of neuroretinal rim, depth of optic cup and diameters of the retinal arterioles and venules at the disc border between the secondary glaucoma groups and the POAG group respectively. Size of zone beta of the parapapillary atrophy was slightly, but not significantly smaller in the secondary glaucoma groups than in POAG. In the secondary glaucoma groups, the maximal intraocular pressure measurements were significantly (p < 0.001) higher than in the group with POAG. All glaucoma groups had a significantly smaller neuroretinal rim, significantly smaller retinal arterioles, and significantly larger parapapillary atrophy compared to the normal group.

CONCLUSIONS

Except of a slightly smaller optic disc in eyes with pseudoexfoliative glaucoma, eyes with secondary glaucoma due to pseudoexfoliation or due to pigmentary dispersion do not vary significantly in their optic disc morphology compared to POAG and do not show pathognomonic features of the optic disc despite marked changes in the anterior segment of the eye.

未标注

以往研究表明，慢性开角型青光眼构成了一组异质性疾病谱，其共同特征是前房角开放和青光眼性视神经损害。本研究的目的是评估在各种类型的继发性慢性开角型青光眼中，视盘外观是否呈现出特定特征。

方法

将126例剥脱性青光眼患者和47例色素性青光眼患者的临床资料及彩色立体视盘照片与501例原发性开角型青光眼（POAG）患者及481例正常受试者的资料进行比较。青光眼组在神经视网膜边缘和视野平均缺损方面无差异。

结果

剥脱性青光眼眼的平均视盘面积（2.54±0.51mm²对2.71±0.63mm²，p = 0.03）明显小于原发性开角型青光眼眼。色素性青光眼组的视盘大小与原发性开角型青光眼组相比无显著差异。继发性青光眼组与POAG组在神经视网膜边缘面积、神经视网膜边缘形态、视杯深度以及视盘边界处视网膜动静脉直径方面均未发现显著差异。继发性青光眼组视乳头旁萎缩β区的大小略小于POAG组，但差异不显著。在继发性青光眼组中，最大眼压测量值显著高于POAG组（p < 0.001）。与正常组相比，所有青光眼组的神经视网膜边缘明显更小，视网膜小动脉明显更小，视乳头旁萎缩明显更大。