Jonas Jost B, Martus Peter, Budde Wido M
Department of Ophthalmology and Eye Hospital, University Erlangen-Nürnberg, Germany.
Am J Ophthalmol. 2002 Oct;134(4):547-51. doi: 10.1016/s0002-9394(02)01644-6.
To address the question of whether the refractive error plays a role in the amount of optic nerve damage in glaucoma, we intraindividually compared inter-eye differences in refractive error with inter-eye differences in parameters indicating the degree of glaucomatous optic nerve damage, and we interindividually correlated refractive error with neuroretinal rim area and visual field loss.
Comparative clinical observational study.
This comparative clinical observational study was conducted in a university eye hospital. The study included 1,444 eyes of 876 patients with primary or secondary chronic open-angle glaucoma. Patients with a highly myopic refractive error (> or = -8 diopters) were excluded, owing to differences in the anatomy of the optic nerve head. Color stereo optic disk photographs were taken and morphometrically evaluated. The main outcome measures were refractive error, neuroretinal rim area, horizontal and vertical cup/disk diameter ratios, and visual field loss.
In an interindividual statistical analysis, area of neuroretinal rim, horizontal and vertical cup/disk diameter ratios, and mean visual field loss were not significantly (P >.10) correlated with refractive error. In an intraindividual comparison, inter-eye differences in refractive error were not significantly (P >.05) correlated with inter-eye differences in neuroretinal rim area and mean visual field defect. The eye with the more myopic refractive error and the contralateral eye with the less myopic refractive error did not vary significantly in neuroretinal rim area and mean visual field defect.
For nonhighly myopic (< -8 diopters) patients with primary or secondary chronic open-angle glaucoma, the refractive error may not play a major role for the amount of glaucomatous optic neuropathy. For nonhighly myopic (< -8 diopters) patients with primary or secondary chronic open-angle glaucoma, myopia may not be an important risk factor for glaucoma.
为探讨屈光不正是否在青光眼视神经损害程度中起作用，我们对个体眼间屈光不正差异与提示青光眼性视神经损害程度的参数的眼间差异进行了比较，并对个体的屈光不正与神经视网膜边缘面积和视野缺损进行了相关性分析。
比较性临床观察研究。
本比较性临床观察研究在一所大学眼科医院进行。研究纳入了876例原发性或继发性慢性开角型青光眼患者的1444只眼。由于视神经乳头解剖结构的差异，高度近视屈光不正（≥-8屈光度）的患者被排除。拍摄彩色立体视盘照片并进行形态学评估。主要观察指标为屈光不正、神经视网膜边缘面积、水平和垂直杯盘直径比以及视野缺损。
在个体间统计分析中，神经视网膜边缘面积、水平和垂直杯盘直径比以及平均视野缺损与屈光不正无显著相关性（P>.10）。在个体内比较中，屈光不正的眼间差异与神经视网膜边缘面积和平均视野缺损的眼间差异无显著相关性（P>.05）。屈光不正度数较高的眼与对侧屈光不正度数较低的眼在神经视网膜边缘面积和平均视野缺损方面无显著差异。
对于原发性或继发性慢性开角型青光眼的非高度近视（<-8屈光度）患者，屈光不正可能对青光眼性视神经病变的程度不起主要作用。对于原发性或继发性慢性开角型青光眼的非高度近视（<-8屈光度）患者，近视可能不是青光眼的重要危险因素。
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