Sampaolesi R, Sampaolesi J R
University of Buenos Aires, School of Medicine, Department of Ophthalmology, Argentina.
Int Ophthalmol. 2001;23(4-6):251-7. doi: 10.1023/a:1014409404579.
To evaluate megalopapillas in order to determine whether they constitute a different population, according to their specific features.
Evaluation of the optic nerve head of 405 eyes divided into 172 normal eyes, 168 pre-perimetric glaucomas (phase 3 or 4), 30 primary congenital glaucomas (children with pure congenital glaucomas operated more than once and diagnosed within the first year of age), and 35 megalopapillas.
The examinations were performed with the HRT (Heidelberg Retina Tomograph), using a wavelength of 680 nm and the new standard reference plane. Each examination results from the mean of 3 image acquisitions with a SD lower than n = 20. Each optic nerve head was studied in 360 degrees (segments), as well as in quadrants and octants separately (predefined segments). The visual fields were assessed with either the Octopus 1-2-3 or the Octopus 101, programs G2 and G2x (three complete phases). The intraocular pressure was measured by means of daily pressure curves including 7 measurements with applanation tonometry at the office and the first one at 6/7 a.m. with the patient still in bed. Gonioscopic examinations were also performed for classification purposes.
By comparing all the stereometric parameters with the Total Area (disc area) and the Rim Volume it has been concluded that the megalopapilla group is different from both the normal control group and the glaucoma group. The disc area of the congenital glaucomas was not statistically different from the megalopapillas, but it was in terms of rim volume and other parameters.
megalopapilla is an entity characterized by a large optic nerve head which may appear abnormal, with an increased cup, but associated with a normal rim volume, normal visual field and normal IOP. Special attention should be given to its differentiation from pseudoglaucomatous diseases.
The frequency of megalopapillas seems to be quite higher than in congenital optic nerve head anomalies, but is has been virtually ignored by the literature worldwide so far.
评估视乳头巨大症，根据其特定特征确定它们是否构成一个不同的群体。
对405只眼睛的视神经乳头进行评估，分为172只正常眼睛、168只视野检查前青光眼（3期或4期）、30只原发性先天性青光眼（一岁内确诊且接受过多次手术的单纯先天性青光眼患儿）以及35只视乳头巨大症眼睛。
使用HRT（海德堡视网膜断层扫描仪）进行检查，波长为680nm，采用新的标准参考平面。每次检查结果取3次图像采集的平均值，标准差低于n = 20。每个视神经乳头在360度（节段）进行研究，同时也分别在象限和八分位（预定义节段）进行研究。使用Octopus 1-2-3或Octopus 101的G2和G2x程序（三个完整阶段）评估视野。通过每日眼压曲线测量眼压，包括在诊室使用压平眼压计进行7次测量，以及患者仍卧床时在上午6/7点进行的第一次测量。还进行房角镜检查以进行分类。
通过将所有立体测量参数与总面积（视盘面积）和视盘边缘体积进行比较，得出视乳头巨大症组与正常对照组和青光眼组均不同。先天性青光眼的视盘面积与视乳头巨大症无统计学差异，但在视盘边缘体积和其他参数方面存在差异。
视乳头巨大症是一种以视神经乳头大且可能看似异常为特征的实体，杯盘比增大，但视盘边缘体积正常、视野正常且眼压正常。应特别注意将其与假性青光眼疾病相鉴别。
视乳头巨大症的发生率似乎比先天性视神经乳头异常要高得多，但迄今为止全球文献几乎都忽略了这一点。
