Stefanović Ivan, Marjanović Ivan, Vlajković Gordana
Srp Arh Celok Lek. 2009 Mar-Apr;137(3-4):130-3. doi: 10.2298/sarh0904130s.
The ultrasound diagnostics of the optic nerve includes the analysis of the optic nerve disc (PNO) and measuring of its retrobulbar diameter. With B-scan, by Schraeder's method, it is possible to measure very precisely the optic nerve, the pial diameter, the normal values for the pial diameter being 2.8-4.1 mm. In glaucoma, the disease that is most frequently associated with higher intraocular pressure, there comes the destruction of nerve fibres, which can be visualized as the excavation of the optic nerve disc.
In this paper, we were interested in finding whether in glaucoma, and in what phase of the disease, the optic nerve starts growing thinner. Aware of many forms of this very complex disease, we were interested in knowing if the visualization of excavation on the optic nerve disc is related to diminishing of the pial diameter of the retrobulbar nerve part.
There were treated the patients who had already had the diagnosis of glaucoma and the visualized excavation of the optic disc of various dimensions. Echographically, there was measured the thickness of the retrobulbar part of the optic nerve and the finding compared in relation to the excavation of the optic disc.
In all eyes with glaucoma, a normal size of the retrobulbar part of the optic nerve was measured, ranging from 3.01 to 3.91 mm with the median of 3.36 mm. Also, by testing the correlation between the thickness of the optic nerve and the excavation of the PNO, by Pearson test, we found that there was no correlation between these two parameters (r = 0.109; p > 0.05).
In the patients with glaucoma, the retrobulbar part of the optic nerve is not thinner (it has normal values), even not in the cases with a totally excavated optic disc. There is no connection between the size of the PNO excavation and the thickness of the retrobulbar part of the optic nerve.
视神经的超声诊断包括对视神经盘(PNO)的分析及其球后直径的测量。使用B超扫描,通过施拉德方法,可以非常精确地测量视神经、软膜直径,软膜直径的正常值为2.8 - 4.1毫米。在青光眼这种最常与高眼压相关的疾病中,会出现神经纤维的破坏,这可表现为视神经盘的凹陷。
在本文中,我们感兴趣的是探究青光眼患者在疾病的哪个阶段视神经开始变细。鉴于这种非常复杂的疾病有多种形式,我们想了解视神经盘凹陷的可视化是否与球后神经部分软膜直径的减小有关。
对已被诊断为青光眼且视神经盘有不同程度可视化凹陷的患者进行治疗。通过超声检查测量视神经球后部分的厚度,并将结果与视神经盘的凹陷情况进行比较。
在所有青光眼患者的眼中,视神经球后部分的大小均正常,范围为3.01至3.91毫米,中位数为3.36毫米。此外,通过皮尔逊检验对视神经厚度与PNO凹陷之间的相关性进行测试,我们发现这两个参数之间没有相关性(r = 0.109;p > 0.05)。
在青光眼患者中,视神经的球后部分并不变细(其值正常),即使在视神经盘完全凹陷的情况下也是如此。PNO凹陷的大小与视神经球后部分的厚度之间没有关联。