Nork T M, Ver Hoeve J N, Poulsen G L, Nickells R W, Davis M D, Weber A J, Sarks S H, Lemley H L, Millecchia L L
Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison 53792-3220, USA.
Arch Ophthalmol. 2000 Feb;118(2):235-45. doi: 10.1001/archopht.118.2.235.
To determine whether outer retinal changes occur in chronic, presumed primary open-angle glaucoma (POAG).
The outer retinas from 128 human eyes with a diagnosis of chronic glaucoma (presumably POAG in most cases) and 90 control eyes were examined histologically by 3 masked observers for photoreceptor swelling and loss. Retinas from 9 rhesus monkeys with glaucoma induced experimentally by laser trabecular destruction were compared with 7 fellow (control) eyes. The mean pressure elevations in the eyes with laser trabecular destruction ranged from 26.6 to 53.6 mm Hg with durations varying from 7 to 33 weeks.
Swelling of the red- and green-sensitive cones was observed in a statistically significantly greater proportion of human eyes with presumed POAG compared with the control eyes. Patchy loss of red/green cones and rods was also found in some of the glaucomatous retinas. In a subset of the human eyes with end-stage disease, cone swelling was a variable finding. Although no photoreceptor loss was found in the 9 monkey eyes with experimental glaucoma, 8 had swelling of their red/green cones that was remarkably similar to that seen in the human eyes. Swelling was not present in any of the control monkey eyes.
The photoreceptors are affected by chronically elevated intraocular pressure.
These findings may explain some of the abnormalities of color vision and the electrophysiological effects that have been observed in patients with POAG.
确定慢性、疑似原发性开角型青光眼（POAG）患者是否会出现视网膜外层改变。
3名盲法观察者对128只诊断为慢性青光眼（大多数情况下可能为POAG）的人眼和90只对照眼的视网膜外层进行组织学检查，以观察光感受器肿胀和缺失情况。将9只经激光小梁破坏实验诱导出青光眼的恒河猴的视网膜与7只对侧（对照）眼进行比较。激光小梁破坏组的眼压平均升高范围为26.6至53.6毫米汞柱，持续时间为7至33周。
与对照眼相比，在统计学上，疑似POAG的人眼中，红敏和绿敏视锥细胞肿胀的比例显著更高。在一些青光眼视网膜中还发现了红/绿视锥细胞和视杆细胞的片状缺失。在一部分患有终末期疾病的人眼中，视锥细胞肿胀情况不一。虽然在9只实验性青光眼的猴眼中未发现光感受器缺失，但有8只猴的红/绿视锥细胞出现肿胀，与人类眼中所见极为相似。对照猴眼中均未出现肿胀。
光感受器受长期升高的眼压影响。
这些发现可能解释了POAG患者中观察到的一些色觉异常和电生理效应。
