See Jovina L S, Nicolela Marcelo T, Chauhan Balwantray C
Department of Ophthalmology and Visual Sciences, Dalhousie University, 1278 Tower Road, Halifax, Nova Scotia, Canada.
Ophthalmology. 2009 May;116(5):840-7. doi: 10.1016/j.ophtha.2008.12.005.
To compare the rates of global and sectoral neuroretinal rim area (NRA) and peripapillary atrophy area (PPAA) change in open-angle glaucoma patients and normal control subjects and to determine the relationship between rates of NRA and PPAA change.
Prospective, longitudinal cohort study of cases and controls.
Ninety-four patients with open-angle glaucoma and 54 control subjects.
Patients and controls were imaged with confocal scanning laser tomography every 6 months. The NRA and PPAA in 1 eye were analyzed to determine the rate of change globally and in 12 30 degrees sectors by regression analysis. Rates of global NRA and PPAA change were correlated. Sectors were ranked from 1 to 12 each according to the magnitude of NRA and PPAA change and were compared between patients and controls using rank-order correlation. Spatial concordance between rates of NRA and PPAA change was calculated as sector rank distance between correspondingly ranked sectors.
Rates of global and sectoral NRA and PPAA change.
The mean (+/-standard deviation) follow-up was 8.6+/-2.9 years for patients and 7.1+/-3.6 years for controls. Globally, NRA declined more rapidly in patients compared with controls, expressed either in absolute units (medians, -5.33x10(-3) mm(2)/year and -1.25x10(-3) mm(2)/year, respectively; P = 0.006) or percentage of baseline NRA (medians, -0.42%/year and -0.07%/year, respectively; P = 0.001). The global rate of PPAA change was not significantly higher in patients compared with controls (12.66x10(-3) mm(2)/year and 9.43x10(-3) mm(2)/year, respectively; P = 0.173). Rates of global and sectoral NRA and PPAA change were correlated poorly in either group. There was a high correlation between ranked sectors of NRA change in patients and controls (P</=0.001), indicating similar patterns of NRA decline in patients and controls; however, this was not the case for rates of PPAA change.
These findings indicate an age-related regional susceptibility of the optic disc that may be accelerated in glaucoma. The poor relationship between rates of NRA and PPAA change suggests their temporal dynamics are uncoupled.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
比较开角型青光眼患者与正常对照者神经视网膜边缘区域（NRA）和视乳头周围萎缩区域（PPAA）的整体及扇形区域变化率，并确定NRA和PPAA变化率之间的关系。
对病例和对照进行前瞻性纵向队列研究。
94例开角型青光眼患者和54名对照者。
患者和对照者每6个月接受共焦扫描激光断层成像检查。通过回归分析，对1只眼中的NRA和PPAA进行分析，以确定整体及12个30度扇形区域的变化率。将NRA和PPAA的整体变化率进行相关性分析。根据NRA和PPAA变化幅度，将扇形区域分别从1到12进行排序，并使用等级相关分析比较患者和对照者之间的差异。计算NRA和PPAA变化率之间的空间一致性，即相应排序扇形区域之间的扇形等级距离。
NRA和PPAA的整体及扇形区域变化率。
患者的平均（±标准差）随访时间为8.6±2.9年，对照者为7.1±3.6年。整体而言，与对照者相比，患者的NRA下降更快，无论是以绝对单位表示（中位数分别为-5.33×10⁻³mm²/年和-1.25×10⁻³mm²/年；P = 0.006），还是以基线NRA的百分比表示（中位数分别为-0.42%/年和-0.07%/年；P = 0.001）。与对照者相比，患者的PPAA整体变化率没有显著更高（分别为12.66×10⁻³mm²/年和9.43×10⁻³mm²/年；P = 0.173）。在两组中，NRA和PPAA的整体及扇形区域变化率之间的相关性都很差。患者和对照者的NRA变化排序扇形区域之间存在高度相关性（P≤0.001），表明患者和对照者的NRA下降模式相似；然而，PPAA变化率并非如此。
这些发现表明视盘存在与年龄相关的区域易感性，在青光眼中可能会加速。NRA和PPAA变化率之间的关系不佳表明它们的时间动态是不相关的。
作者对本文讨论的任何材料均无所有权或商业利益。
