高度近视合并早期青光眼的视网膜神经纤维层缺损。

Retinal nerve fiber layer defects in highly myopic eyes with early glaucoma.

机构信息

Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.

出版信息

Invest Ophthalmol Vis Sci. 2012 Sep 21;53(10):6472-8. doi: 10.1167/iovs.12-10319.

DOI:10.1167/iovs.12-10319

PMID:22915038

Abstract

PURPOSE

To compare the retinal nerve fiber layer (RNFL) defects in early glaucomatous eyes between highly and non-highly myopic eyes.

METHODS

Sixty-one highly myopic eyes (< -6.0 diopters [D]) of 61 patients and 55 non-highly myopic eyes of 55 patients with early visual field (VF) defects were studied. The angular locations and widths of the RNFL defects were measured from red-free fundus photographs. The RNFL defect closest to the fovea was designated the "nearest RNFL defect" of each hemisphere.

RESULTS

In total, 131 RNFL defects were found in highly myopic eyes and 82 in non-highly myopic eyes. Twenty-seven (44.3%) of the 61 highly myopic eyes, but only 8 (14.5%) of the 55 non-highly myopic eyes had their nearest RNFL defects between 0° and 10° (P < 0.001). Although the frequencies of paracentral scotomas were comparable between the two groups, the rate of inferotemporal paracentral scotomas was significantly higher in the high myopia group (P = 0.02). The numbers of nearest RNFL defects in the superior hemisphere or extending over both hemispheres were significantly higher in the high-myopia group. Multiple logistic regression analyses showed that high myopia and the nearest RNFL defect involving the papillomacular bundle were significantly associated with paracentral scotomas (odds ratio [OR]: 4.78, P < 0.05, and OR: 5.31, P < 0.001, respectively). High myopia was significantly associated with the nearest RNFL defect involving the papillomacular bundle (OR: 2.95, P < 0.05).

CONCLUSIONS

These findings suggest that highly myopic eyes are more susceptible to papillomacular bundle damage in early glaucoma.

摘要

目的

比较高度近视和非高度近视早期青光眼患者的视网膜神经纤维层（RNFL）缺损。

方法

研究了 61 例高度近视患者（<-6.0 屈光度[D]）的 61 只眼和 55 例早期视野（VF）缺损的非高度近视患者的 55 只眼。从眼底自发荧光照片中测量 RNFL 缺损的角度位置和宽度。每个半球的最靠近黄斑的 RNFL 缺损被指定为“最近的 RNFL 缺损”。

结果

在高度近视眼中共发现 131 个 RNFL 缺损，在非高度近视眼中共发现 82 个。61 只高度近视眼中有 27 只（44.3%），而 55 只非高度近视眼中只有 8 只（14.5%）的最近的 RNFL 缺损位于 0°至 10°之间（P<0.001）。尽管两组的旁中心暗点的频率相当，但高度近视组的下颞侧旁中心暗点的发生率明显更高（P=0.02）。上半球或跨半球的最近 RNFL 缺损数量在高度近视组中明显更高。多变量逻辑回归分析显示，高度近视和累及视盘黄斑束的最近 RNFL 缺损与旁中心暗点显著相关（比值比[OR]：4.78，P<0.05 和 OR：5.31，P<0.001）。高度近视与累及视盘黄斑束的最近 RNFL 缺损显著相关（OR：2.95，P<0.05）。