Mackenzie Paul J, Mikelberg Frederick S
Division of Glaucoma, Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver Acute, 2550 Willow St, Vancouver, BC V5Z 3N9, Canada.
Open Ophthalmol J. 2009 Sep 17;3:54-8. doi: 10.2174/1874364100903020054.
Primary open-angle glaucoma is a progressive optic neuropathy involving loss of retinal ganglion cells and their axons at the level of the optic nerve head. This change manifests as thinning and excavation of the neural tissues and nerve fiber layer. Therefore, it has long been known that the structural appearance of the optic nerve head is paramount to both glaucoma diagnosis and to the detection of progression [1-4]. Quantitative imaging methods such as Heidelberg Retinal Tomography (HRT) and Ocular Coherence Tomography (OCT) show great promise for the diagnosis and management of glaucoma and as these technologies continue to improve, they will become more important in the care of glaucoma. However, these tests cannot replace good clinical examination and indeed they depend upon clinical correlation for correct interpretation. Thus, careful and systematic clinical examination of the optic nerve remains a cornerstone of glaucoma management. In this paper, we outline a few pearls for the examination of the optic nerve and some of the pitfalls to be avoided in optic disc examination.
原发性开角型青光眼是一种进行性视神经病变，涉及视网膜神经节细胞及其轴突在视神经乳头水平的丧失。这种变化表现为神经组织和神经纤维层的变薄和凹陷。因此，长期以来人们一直认为，视神经乳头的结构外观对于青光眼的诊断和病情进展的检测至关重要[1-4]。诸如海德堡视网膜断层扫描（HRT）和光学相干断层扫描（OCT）等定量成像方法在青光眼的诊断和管理方面显示出巨大的前景，并且随着这些技术的不断改进，它们在青光眼的治疗中将变得更加重要。然而，这些检查不能取代良好的临床检查，实际上它们依赖于临床相关性来进行正确解读。因此，对视神经进行仔细而系统的临床检查仍然是青光眼管理的基石。在本文中，我们概述了一些视神经检查的要点以及视盘检查中应避免的一些陷阱。
