Jonas J B, Fernández M C, Naumann G O
Department of Ophthalmology, University Erlangen-Nürnberg, Germany.
Invest Ophthalmol Vis Sci. 1991 Oct;32(11):2942-7.
Parapapillary chorioretinal atrophy and decreased retinal vessel diameter occur in glaucomatous eyes. To evaluate the frequency and degree of these signs in nonglaucomatous optic neuropathy, the authors evaluated morphometrically and compared 47 patients with nonglaucomatous optic nerve atrophy from extraocular causes with 292 patients with primary open-angle glaucoma and 179 normal subjects. Eyes with anterior ischemic optic neuropathy were excluded. The parapapillary atrophy was differentiated into a central zone (beta) with sclera and large choroidal vessels visible by ophthalmoscopy and a peripheral zone (alpha) with irregular pigmentation. Both zones did not differ significantly in the eyes with nonglaucomatous optic neuropathy and the normal eyes. In the glaucomatous eyes, they were significantly larger and occurred more frequently. The retinal vessel diameter was significantly smaller in both groups with optic nerve atrophy than in the normal group. It was concluded that decreased retinal vessel diameters unspecifically suggest optic nerve atrophy. Evaluation of parapapillary chorioretinal atrophy can be helpful in differentiating nonglaucomatous from glaucomatous optic neuropathy.
青光眼患者的视乳头周围脉络膜视网膜萎缩和视网膜血管直径减小。为评估这些体征在非青光眼性视神经病变中的发生频率和程度，作者对47例由眼外原因导致的非青光眼性视神经萎缩患者、292例原发性开角型青光眼患者和179例正常受试者进行了形态学评估并比较。排除了前部缺血性视神经病变的眼睛。视乳头周围萎缩被分为中央区（β区）和周边区（α区），通过检眼镜检查，中央区可见巩膜和大的脉络膜血管，周边区有不规则色素沉着。在非青光眼性视神经病变的眼睛和正常眼睛中，这两个区域没有显著差异。在青光眼患者的眼睛中，它们明显更大且更频繁出现。两组视神经萎缩患者的视网膜血管直径均显著小于正常组。得出的结论是，视网膜血管直径减小非特异性地提示视神经萎缩。对视乳头周围脉络膜视网膜萎缩的评估有助于区分非青光眼性和青光眼性视神经病变。
