[正常眼压性青光眼伴楔形神经纤维层缺损时视盘出血频率与神经纤维层缺损扩大及视野缺损恶化速度的关系]

[Relationship between the frequency of disc hemorrhage and the enlargement of nerve fiber layer defects and the deterioration speed of visual field loss in normal-tension glaucoma with wedge-shaped nerve fiber layer defects].

作者信息

Nitta Koji, Sugiyama Kazuhisa, Tanahashi Toshiro

机构信息

Department of Ophthalmology, Fukui-ken Saiseikai Hospital, Japan.

出版信息

Nippon Ganka Gakkai Zasshi. 2011 Sep;115(9):839-47.

PMID:22073601

Abstract

PURPOSE

To examine progressive visual field loss in relation to disc hemorrhage (DH) and enlarged nerve fiber layer defects (NFLDs) in normal-tension glaucoma (NTG).

SUBJECTS AND METHODS

There were 106 eyes of 106 NTG patients (mean follow-up: 9.1 years) with well-defined NFLD borders and at least 3 years of follow-up. Examination was performed on their rate of visual field loss (MD slope and hemifield TD slope) and their rate of NFLD angle enlargement. For the NFLD angle, we took color fundus photographs and converted color photos into black-white photos extracted the blue ingredient. The midpoint between the fovea and the disc center was determined. The center was established as the disc, and the distance to the midpoint was established as the radius of a circle. The NFLD angle was defined as the angle formed by the two points where this circle intersected the NFLD and a third point which was the disc center.

RESULTS

DH was seen in 51/106 (48.1%)cases and it occurred 1.28 +/- 1.99 times. In the DH group, the MD slope was -0.30 dB/year, indicating a significantly faster rate of visual field loss than that of the non-DH group (-0.13 dB/year); the rate of NFLD enlargement was 1.90 degrees/year, indicating a significantly faster rate than that of the non-DH group at 0.64 degrees/year. As the occurrence of DH increased, the TD slope (r = -0.263, p = 0.0056) and the rate of NFLD enlargement (r = 0.410, p<0.0001) increased significantly.

CONCLUSION

Examination was performed on NTG eyes with well-defined NFLD borders which were divided into the groups of with and without DH. The DH eyes had a faster rate of NFLD enlargement and faster progression of visual field loss compared with the non-DH eyes. In addition, the rate of NFLD enlargement and progression of visual field loss increased in the cases with frequent DHs.

摘要

目的

研究正常眼压性青光眼（NTG）中与视盘出血（DH）和扩大的神经纤维层缺损（NFLD）相关的进行性视野缺损。

对象与方法

106例NTG患者的106只眼（平均随访时间：9.1年），NFLD边界清晰，随访至少3年。对其视野缺损率（平均缺损斜率和半视野颞侧缺损斜率）以及NFLD角度扩大率进行检查。对于NFLD角度，我们拍摄彩色眼底照片，并将彩色照片转换为黑白照片以提取蓝色成分。确定黄斑中心凹与视盘中心之间的中点。将视盘中心确定为圆心，到中点的距离确定为圆的半径。NFLD角度定义为该圆与NFLD相交的两点和视盘中心这第三个点所形成的夹角。

结果

51/106（48.1%）例出现DH，其发生1.28±1.99次。在DH组中，平均缺损斜率为-0.30 dB/年，表明视野缺损率显著快于非DH组（-0.13 dB/年）；NFLD扩大率为1.90度/年，表明显著快于非DH组的0.64度/年。随着DH发生次数增加，颞侧缺损斜率（r = -0.263，p = 0.0056）和NFLD扩大率（r = 0.410，p<0.0001）显著增加。