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[有无视盘出血病史的正常眼压性青光眼视网膜血管血流情况]

[Blood flow in retinal vessels of normal-tension glaucoma with or without a history of optic disc hemorrhages].

作者信息

Takahashi S, Tomita G, Sugiyama K, Sato Y, Kitazawa Y

机构信息

Department of Ophthalmology, Gifu University School of Medicine, 40 Tsukasa-machi, Gifu 500-8705, Japan.

出版信息

Nippon Ganka Gakkai Zasshi. 2001 Mar;105(3):177-82.

Abstract

PURPOSE

To evaluate blood flow in retinal vessels of normal-tension glaucoma (NTG) with or without a history of optic disc hemorrhages (DH) and compare it with that in non-glaucomatous eyes using scanning laser fluorescein video angiography.

METHODS

We enrolled 14 eyes of 14 NTG patients with a history of DH (DH (+) group), 12 eyes of 12 NTG patients without history of DH (DH (-) group), and 10 eyes from 10 non-glaucomatous patients matched for age, intraocular pressure, and systemic blood pressure. No statistically significant difference was observed between the DH (+) and DH (-) groups of NTG in the global indices of the Humphrey visual field. Fluorescein angiography was performed using a scanning laser ophthalmoscope with an argon blue laser. A series of approximately 100 consecutive video images at 1/2 second intervals from just before the dye appearance in the central retinal artery was loaded into an external personal computer system. Based on this acquired image series, we obtained fluorescein filling curves for 10 x 10 pixel measuring areas placed on each of the superior-temporal and inferior-temporal branch retinal arteries and veins at 1/5 papillary diameter from the disc edge. In each vessel, time to the highest fluorescein intensity (peak time, sec) and the time constant of the filling curve (tau, sec) were obtained. Time difference between the peak times in vein and artery (peak time difference) was also calculated.

RESULTS

Statistically significant differences were observed among the three groups in the peak time of inferior-temporal artery and vein, and superior-temporal vein (ANOVA, p < 0.01). Also there were statistically significant differences in the tau of all vessels (ANOVA, p < 0.05). No statistically significant differences were observed in the peak time differences. By multivariate analysis, the DH (+) and DH (-) groups of NTG showed significantly longer peak times and tau s than did the non-glaucomatous eyes (p < 0.05). However, no statistically significant differences were observed in any parameters between the DH (+) and DH (-) groups of NTG.

CONCLUSIONS

In NTG, dye filling rate in both the central retinal arteries and veins seems to be delayed. However, this delay does not differ between DH (+) and DH (-) groups.

摘要

目的

使用扫描激光荧光血管造影术评估有或无视盘出血(DH)病史的正常眼压性青光眼(NTG)患者视网膜血管中的血流情况,并与非青光眼患者的视网膜血管血流情况进行比较。

方法

我们纳入了14例有DH病史的NTG患者的14只眼(DH(+)组)、12例无DH病史的NTG患者的12只眼(DH(-)组),以及10例年龄、眼压和全身血压相匹配的非青光眼患者的10只眼。在Humphrey视野的整体指标方面,NTG的DH(+)组和DH(-)组之间未观察到统计学上的显著差异。使用配备氩蓝激光的扫描激光检眼镜进行荧光血管造影。从视网膜中央动脉出现染料之前开始,以1/2秒的间隔获取一系列约100张连续的视频图像,并将其加载到外部个人计算机系统中。基于此获取的图像序列,我们在距视盘边缘1/5视乳头直径处的颞上和颞下分支视网膜动脉及静脉上,为10×10像素的测量区域获取了荧光素充盈曲线。在每条血管中,获取达到最高荧光素强度的时间(峰值时间,秒)和充盈曲线时间常数(τ,秒)。还计算了静脉和动脉峰值时间之间的时间差(峰值时间差)。

结果

三组在下颞动脉和静脉以及颞上静脉的峰值时间方面存在统计学上的显著差异(方差分析,p<0.01)。所有血管的τ也存在统计学上的显著差异(方差分析,p<0.05)。在峰值时间差方面未观察到统计学上的显著差异。通过多变量分析,NTG的DH(+)组和DH(-)组的峰值时间和τ均显著长于非青光眼眼(p<0.05)。然而,NTG的DH(+)组和DH(-)组在任何参数上均未观察到统计学上的显著差异。

结论

在NTG中,视网膜中央动脉和静脉的染料充盈率似乎均延迟。然而,这种延迟在DH(+)组和DH(-)组之间并无差异。

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