Tay Eugene, Seah Steve K, Chan Siew-Pang, Lim Albert T H, Chew Sek-Jin, Foster Paul J, Aung Tin
Moorfields Eye Hospital, Institute of Ophthalmology, London, England.
Am J Ophthalmol. 2005 Feb;139(2):247-52. doi: 10.1016/j.ajo.2004.08.076.
To examine the association of optic disk ovality with myopic refractive error, axial length, and the visual field.
Prospective observational case series.
The study included 150 randomly recruited male subjects with myopia. In all cases, one eye was randomly selected, and subjective refraction, slit-lamp examination, applanation tonometry, gonioscopy, A-scan ultrasonography, funduscopy, and color optic disk stereo photography were performed. Disk ovality was assessed using the ratio of minimum to maximum disk diameter (index of tilt). A ratio of < or = 0.8 was considered as significant disk tilt. Visual fields were tested using static automated threshold perimetry with two methods of optical correction: trial lenses and contact lenses.
Of the total sample, 137 subjects completed the study. Mean age was 21.2 +/- 1.1 year, and mean spherical equivalent was -6.36 +/- 3.56 diopters. Mean ovality ratio was 0.83 +/- 0.09; 55 subjects (40.2%) had significant tilted optic disks. Greater optic disk ovality (tilt) correlated with greater myopia (P = .009) and longer axial length (P = .009); 95.6% of subjects had normal visual fields with both methods of optical correction. Using multiple linear regression analysis, greater tilt was independently related to a higher mean defect on testing with trial lenses (P < .01).
Increased optic disk tilt was associated with higher myopia and reduced sensitivity on field testing. These factors are important in the assessment of glaucoma in patients with myopia.
研究视盘椭圆度与近视屈光不正、眼轴长度及视野之间的关系。
前瞻性观察病例系列。
该研究纳入了150名随机招募的近视男性受试者。所有病例中，随机选择一只眼，进行主观验光、裂隙灯检查、压平眼压测量、前房角镜检查、A超超声检查、眼底镜检查以及彩色视盘立体照相。使用视盘最小直径与最大直径之比（倾斜指数）评估视盘椭圆度。比值≤0.8被视为明显的视盘倾斜。采用静态自动阈值视野检查法，使用两种光学矫正方法（试镜和隐形眼镜）检测视野。
总样本中，137名受试者完成了研究。平均年龄为21.2±1.1岁，平均等效球镜度为-6.36±3.56屈光度。平均椭圆度比值为0.83±0.09；55名受试者（40.2%）有明显倾斜的视盘。更大的视盘椭圆度（倾斜）与更高的近视度数（P = 0.009）和更长的眼轴长度（P = 0.009）相关；95.6%的受试者在两种光学矫正方法下视野均正常。使用多元线性回归分析，更大的倾斜度与试镜检查时更高的平均缺损独立相关（P < 0.01）。
视盘倾斜度增加与更高度数的近视及视野检查时敏感性降低相关。这些因素在近视患者青光眼的评估中很重要。
