Ophthalmology Department, University Hospital Basel, University of Basel, Basel, Switzerland.
J Glaucoma. 2013 Aug;22(6):501-5. doi: 10.1097/IJG.0b013e3182447d9b.
To analyze an association between the presumed risk factors for glaucoma and the actual extent of glaucomatous damage in untreated primary open-angle glaucoma.
In 50 untreated open-angle glaucoma patients, we analyzed an association between the level of glaucomatous damage and presumed glaucoma risk factors: mean untreated intraocular pressure (IOP) and short-term IOP variability, ocular pulse amplitude, corneal thickness, acral and corneal temperature, retinal arterial diameter and retinal venous diameter, choroidal blood flow (laser Doppler flowmetry flow, velocity, volume), heart rate, and ocular perfusion pressure. Morphologic damage (mean retinal nerve fiber layer thickness, measured by ocular coherence tomography) and functional damage (visual field mean defect) were evaluated separately in 2 forward-stepwise multiple regression models.
The mean retinal nerve fiber layer thickness was significantly (P<0.05) associated with IOP (r=-0.35), retinal arterial diameter (r=0.36), and choroidal blood flow (r=0.30); mean defect was associated with ocular perfusion pressure (r=-0.30), laser Doppler flowmetry volume (r=-0.33), and IOP variability (0.36).
Despite small differences between the morphologic and functional glaucomatous damage, IOP and perfusion parameters seem to contribute, at least in part, independently to both.
分析原发性开角型青光眼未经治疗患者中,疑似青光眼危险因素与实际青光眼损害程度之间的关系。
在 50 例未经治疗的开角型青光眼患者中,我们分析了青光眼损害程度与疑似青光眼危险因素之间的关系:未治疗的平均眼内压(IOP)和短期 IOP 变异性、眼脉冲幅度、角膜厚度、肢端和角膜温度、视网膜动脉直径和视网膜静脉直径、脉络膜血流(激光多普勒血流计流量、速度、体积)、心率和眼灌注压。通过眼相干断层扫描(OCT)分别评估形态学损伤(平均视网膜神经纤维层厚度)和功能损伤(视野平均缺损)。
视网膜神经纤维层厚度与眼压(r=-0.35)、视网膜动脉直径(r=0.36)和脉络膜血流(r=0.30)显著相关(P<0.05);平均缺损与眼灌注压(r=-0.30)、激光多普勒血流计体积(r=-0.33)和 IOP 变异性(0.36)相关。
尽管形态和功能青光眼损害之间存在细微差异,但眼压和灌注参数似乎至少部分独立地对两者均有贡献。