Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Invest Ophthalmol Vis Sci. 2012 Jul 20;53(8):4813-20. doi: 10.1167/iovs.12-9908.
We investigated the amount and location of optic nerve head (ONH) abnormal points and the retinal nerve fiber layer (RNFL) thickness with paracentral scotoma compared to peripheral scotoma.
Totals of 35 normal tension glaucoma (NTG) patients with isolated parafoveal scotoma (PFS) within a 10° radius in one hemifield, and 35 patients with isolated peripheral nasal step (PNS) within the nasal periphery outside 10° of fixation in one hemifield were enrolled if their mean deviation was greater than -10 decibels (dB). Global and sector optic disc stereometric parameters obtained by Heidelberg retina tomography and analyzed by Moorfields regression analysis (MRA), and retinal RNFL thickness measured using Cirrus spectral domain-optical coherence tomography were compared between the two groups. The percentages of superior and inferior field defects were evaluated.
In PFS, superior field defects (82.9%) were found to be dominant, whereas PNS showed a predominance of inferior field defects (80.0%). The PFS group revealed smaller rim area, more glaucomatous cup shape than the PNS group (P = 0.036, 0.012, respectively). In MRA classification, the percentage outside of normal limits (ONL) was greater in the PFS group (P = 0.006). Compared to the PNS group, the PFS group exhibited more glaucomatous ONH morphology in the temporal and inferotemporal sectors in a sector analysis of optic disc parameters, and had thinner RNFLs in the inferior quadrant, and at 7 and 8 o'clock (P = 0.007, 0.003, 0.005, respectively).
In early NTG, paracentral scotoma may be more significant than peripheral scotoma because of narrower optic disc rim and larger cup, especially inferotemporally.
我们研究了与旁中心暗点相比，周边暗点的视神经头（ONH）异常点数量和位置以及视网膜神经纤维层（RNFL）厚度。
共纳入 35 例正常眼压性青光眼（NTG）患者，这些患者在一个半视野中存在 10°半径内孤立的旁中心暗点（PFS），以及 35 例在一个半视野中鼻侧周边 10°以外存在孤立的周边鼻侧台阶（PNS）的患者，如果他们的平均偏差大于-10 分贝（dB）。使用海德堡视网膜断层扫描仪获得的全局和扇形视神经盘立体测量参数，并通过 Moorfields 回归分析（MRA）进行分析，以及使用 Cirrus 光谱域光学相干断层扫描测量的视网膜 RNFL 厚度，在两组之间进行比较。评估了上、下视野缺损的百分比。
在 PFS 中，发现上视野缺损（82.9%）占主导地位，而 PNS 则表现出以下视野缺损为主（80.0%）。与 PNS 组相比，PFS 组的视盘边缘面积更小，青光眼杯形更明显（P = 0.036，0.012）。在 MRA 分类中，PFS 组超出正常范围（ONL）的百分比更高（P = 0.006）。与 PNS 组相比，PFS 组在视盘参数的扇形分析中，颞侧和下颞侧象限的青光眼视神经头形态更为明显，在下象限以及 7 点和 8 点处的 RNFL 更薄（P = 0.007，0.003，0.005）。
在早期 NTG 中，旁中心暗点可能比周边暗点更为显著，因为视盘边缘更窄，杯形更大，尤其是在下颞侧。
