Grippo Tomas M, Shihadeh Wisam A, Schargus Marc, Gramer Eugen, Tello Celso, Liebmann Jeffrey M, Ritch Robert
Einhorn Clinical Research Center, The New York Eye and Ear Infirmary, New York, USA.
J Glaucoma. 2008 Mar;17(2):100-4. doi: 10.1097/IJG.0b013e31814b995a.
To compare visual field loss (VFL) in eyes with optic nerve head drusen (ONHD) with or without ocular hypertension (OHT).
The records of all patients aged 45 years or older with a diagnosis of ONHD at 2 centers were reviewed. OHT was defined as intraocular pressure >or=22 mm Hg. We categorized ONHD into 3 grades based on visibility on disc photographs.
We identified 22 eyes (13 patients) with both ONHD and OHT and 81 normotensive eyes (47 patients) with ONHD. VFL was present in 20/22 (90.9%) of hypertensive eyes compared with 54/81 (66.7%) of normotensive eyes (P=0.03, Fisher exact test). Drusen grade III and OHT were both independently and significantly associated with greater incidence of VFL (logistic regression analysis).
VFL occurs more frequently in eyes with ONHD that also have OHT. Eyes with grade III ONHD are at increased risk for VFL compared to eyes with grade I drusen with the same intraocular pressure status. Patients with OHT and ONHD should undergo close surveillance for disease progression and be treated appropriately to prevent additional VFL.
比较伴有或不伴有高眼压症（OHT）的视神经乳头 drusen（ONHD）患者的视野缺损（VFL）情况。
回顾了两个中心所有年龄在 45 岁及以上且诊断为 ONHD 的患者记录。OHT 定义为眼压≥22 mmHg。我们根据视盘照片上的可见性将 ONHD 分为 3 级。
我们确定了 22 只眼（13 名患者）患有 ONHD 且伴有 OHT，以及 81 只眼压正常的眼（47 名患者）患有 ONHD。高血压眼组中 20/22（90.9%）存在 VFL，而眼压正常眼组中 54/81（66.7%）存在 VFL（P = 0.03，Fisher 精确检验）。Drusen Ⅲ级和 OHT 均与 VFL 的更高发生率独立且显著相关（逻辑回归分析）。
VFL 在患有 ONHD 且伴有 OHT 的眼中更频繁发生。与相同眼压状态下的Ⅰ级 drusen 眼相比，Ⅲ级 ONHD 眼发生 VFL 的风险增加。患有 OHT 和 ONHD 的患者应密切监测疾病进展，并进行适当治疗以预防进一步的 VFL。
