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原发性开角型青光眼与正常眼压性青光眼视神经损害的对比研究

[A comparative study of optic nerve damage between primary open angle glaucoma and normal tension glaucoma].

作者信息

Xia Cui-ran, Xu Liang, Yang Ye

机构信息

Tongren Ophthamic Center, Capital University of Medical Sciences, Beijing 100730, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2005 Feb;41(2):136-40.

Abstract

OBJECTIVE

To investigate the differences in the characteristics of optic nerve damage in patients with primary open angle glaucoma (POAG)and normal tension glaucoma (NTG).

METHOD

The optic disc parameters and retinal nerve fiber layer (RNFL) of 47 eyes of 39 subjects with POAG (IOP > 24 mmHg) and 38 eyes of 32 subjects with NTG (IOP < 21 mmHg) were measured by using a Heidelberg retina tomograph II, color stereo-optic disc photographs, and an Octopus automated perimetry.

RESULTS

(1) Rim area, rim/disc area ratios and three sectors except temporal quadrant of optic disc were significantly smaller, whereas C/D was significantly larger in patients with NTG than those of POAG. The mean RNFL thickness and RNFL cross-sectional areas at temporal/interior and temporal/superior in those with NTG were significantly (P < 0.05) smaller than those of POAG. The rim volume was significantly (P < 0.05) smaller and mean cup depth was significantly (P < 0.05) larger in patients with NTG than POAG. (2) The defect types of RNFL: RNFL diffuse loss and local defect ratio were 53.19% and 4.26% in POAG, respectively; while were 21.05% and 55.26% in NTG, respectively. The difference between the proportions of the defect type of RNFL in patients with POAG and those of NTG is statistically significant (P < 0.01).

CONCLUSIONS

Our results demonstrate that the varieties of C/D area ratio, rim area, RNFL thickness, and defect types of RNFL with NTG and POAG indicate that the different mechanisms are involved in optic nerve damage in the two types of glaucoma.

摘要

目的

探讨原发性开角型青光眼(POAG)和正常眼压性青光眼(NTG)患者视神经损害特征的差异。

方法

使用海德堡视网膜断层扫描仪II、彩色立体视盘照片和Octopus自动视野计,测量39例POAG患者(眼压>24 mmHg)的47只眼以及32例NTG患者(眼压<21 mmHg)的38只眼的视盘参数和视网膜神经纤维层(RNFL)。

结果

(1)NTG患者的视盘边缘面积、边缘/视盘面积比以及除颞侧象限外的三个象限均明显小于POAG患者,而杯盘比(C/D)则明显大于POAG患者。NTG患者颞侧/鼻侧和颞侧/上方的平均RNFL厚度和RNFL横截面积明显(P<0.05)小于POAG患者。NTG患者的边缘体积明显(P<0.05)较小,平均杯深明显(P<0.05)大于POAG患者。(2)RNFL的缺损类型:POAG患者中RNFL弥漫性缺失和局部缺损的比例分别为53.19%和4.26%;而NTG患者中分别为21.05%和55.26%。POAG患者和NTG患者RNFL缺损类型比例之间的差异具有统计学意义(P<0.01)。

结论

我们的结果表明,NTG和POAG患者的C/D面积比、边缘面积、RNFL厚度以及RNFL缺损类型的差异表明,这两种类型青光眼的视神经损害涉及不同机制。

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