Jonas J B, Fernandez M C, Naumann G O
Department of Ophthalmology, University Erlangen-Nürnberg, Federal Republic of Germany.
Ophthalmology. 1990 Sep;97(9):1211-5. doi: 10.1016/s0161-6420(90)32434-x.
Glaucomatous optic nerve damage has generally been associated with high cup-to-disc ratios. Fifteen eyes of nine patients with increased intraocular pressure and glaucomatous visual field loss but low cup-to-disc ratios are reported. The optic disc area was significantly (P less than 0.01) smaller than in 429 normal subjects and 556 glaucoma patients with high cup-to-disc ratios. Parapapillary chorioretinal atrophy was significantly larger and retinal nerve fiber bundles were significantly less visible than in the normal group. The latter two parameters were not significantly different in the glaucoma groups with low and high cup-to-disc ratios when the groups were matched for mean perimetric loss. The authors conclude that in eyes with small optic discs, glaucomatous optic nerve damage may be indicated more sensitively by parapapillary changes than by cup-to-disc ratios. Glaucomatous eyes with small optic nerve heads can have misleadingly low cup-to-disc ratios.
青光眼性视神经损伤通常与高杯盘比相关。本文报告了9例眼压升高且有青光眼性视野缺损但杯盘比低的患者的15只眼睛。这些患者的视盘面积显著小于429名正常受试者以及556名杯盘比高的青光眼患者（P<0.01）。与正常组相比，视盘周围脉络膜视网膜萎缩明显更大，视网膜神经纤维束明显更难观察到。当根据平均视野缺损程度对杯盘比低和高的青光眼组进行匹配时，后两个参数在这两组中无显著差异。作者得出结论，在视盘较小的眼睛中，视盘周围的变化可能比杯盘比对青光眼性视神经损伤的指示更敏感。视神经乳头较小的青光眼性眼睛可能具有误导性的低杯盘比。
