青光眼患者眼睛筛板孔形态的改变。
Alterations in the morphology of lamina cribrosa pores in glaucomatous eyes.
作者信息
Tezel G, Trinkaus K, Wax M B
机构信息
Department of Ophthalmology and Visual Sciences, University of Louisville School of Medicine, Kentucky Lions Eye Center, 301 E. Muhammad Ali Boulevard, Louisville, KY 40202, USA.
出版信息
Br J Ophthalmol. 2004 Feb;88(2):251-6. doi: 10.1136/bjo.2003.019281.
AIMS
To determine alterations which occur in the size and shape of lamina cribrosa (LC) pores in glaucomatous eyes over a period of time.
METHODS
Baseline and follow up optic disc photographs were retrospectively studied in 39 eyes of 39 patients with glaucoma. Only eyes with a vertical cup to disc ratio equal to or greater than 0.6 were included in the study. In addition, all selected eyes had to have serial optic disc photographs obtained at least 3 years apart allowing clear visualisation of LC surface. The association of the alterations in LC surface morphology with patient specific and eye specific characteristics was statistically analysed.
RESULTS
During a mean study period of 3.90 (SD 0.7) years, individual pore size (mean pore area to disc area ratio) exhibited a significant decrease between baseline and follow up measurements of each eye (p<0.0001). However, during the study period, total pore area to disc area ratio did not change (p>0.05), and the change in pore shape in some eyes (from circular to more oval and elongated) was statistically insignificant (p = 0.12). Although a relation was detectable between the optic disc and lamina cribrosa parameters at a given time, which reflects cumulative effects, during the study period, there was no significant association between the changes of the LC parameters and neural tissue damage. The rate and the magnitude of the changes in individual pore size during the study period were not significantly different among the eyes exhibiting progressive neural rim damage and those staying stable (p>0.05).
CONCLUSION
These findings demonstrate that the LC surface morphology exhibits changes along with the glaucomatous optic disc damage. However, the clinical appearance of LC surface in glaucomatous eyes may continue to change, even when the neural rim damage is clinically stable. These findings are probably associated with the chronic cellular events of tissue remodelling that occur in the glaucomatous optic nerve head.
目的
确定青光眼患者在一段时间内筛板（LC）孔隙大小和形状的变化。
方法
对39例青光眼患者的39只眼睛的基线和随访视盘照片进行回顾性研究。仅纳入垂直杯盘比等于或大于0.6的眼睛。此外，所有入选的眼睛必须有至少间隔3年拍摄的连续视盘照片，以便清晰观察LC表面。对LC表面形态变化与患者个体及眼部特征之间的关联进行统计学分析。
结果
在平均3.90（标准差0.7）年的研究期间，每只眼睛的个体孔隙大小（平均孔隙面积与视盘面积之比）在基线和随访测量之间呈现出显著下降（p<0.0001）。然而，在研究期间，总孔隙面积与视盘面积之比没有变化（p>0.05），并且一些眼睛的孔隙形状变化（从圆形变为更椭圆形和拉长）在统计学上不显著（p = 0.12）。尽管在给定时间视盘和筛板参数之间存在可检测到的关系，这反映了累积效应，但在研究期间，LC参数的变化与神经组织损伤之间没有显著关联。在表现出进行性神经边缘损伤的眼睛和保持稳定的眼睛之间，研究期间个体孔隙大小变化的速率和幅度没有显著差异（p>0.05）。
结论
这些发现表明，LC表面形态随着青光眼性视盘损伤而发生变化。然而，即使神经边缘损伤在临床上稳定，青光眼患者眼睛中LC表面的临床表现可能仍会继续变化。这些发现可能与青光眼性视神经乳头中发生的慢性组织重塑细胞事件有关。
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