原发性开角型青光眼眼内压与自发性视网膜静脉搏动频率的关系。

Relationship of intraocular pressure and frequency of spontaneous retinal venous pulsation in primary open-angle glaucoma.

机构信息

Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

出版信息

Ophthalmology. 2012 Nov;119(11):2254-60. doi: 10.1016/j.ophtha.2012.06.007. Epub 2012 Sep 12.

DOI:10.1016/j.ophtha.2012.06.007

PMID:22980741

Abstract

PURPOSE

To investigate the relationship of intraocular pressure (IOP) and the frequency of spontaneous venous pulsation (SVP) in primary open-angle glaucoma (POAG).

DESIGN

Cross-sectional study.

PARTICIPANTS

A total of 229 eyes of 229 patients with POAG and 205 eyes of 205 glaucoma suspects as a control.

METHODS

The SVP was assessed using a confocal scanning laser ophthalmoscope (Spectralis HRA, Heidelberg Engineering, Heidelberg, Germany) movie tool. Patients with POAG were divided into 3 groups on the basis of the frequency distribution of untreated IOP: lower tertile (IOP ≤ 15 mmHg; group A), middle tertile (IOP >15 and ≤ 21 mmHg; group B), and upper tertile (IOP >21 mmHg; group C). The frequency of SVP was compared between the glaucoma suspects and patients with POAG and among the 3 groups of POAG. Logistic regression analysis was performed to determine the factors associated with the frequency of SVP.

MAIN OUTCOME MEASURES

Frequency of SVP in patients with POAG and glaucoma suspects.

RESULTS

Spontaneous venous pulsation was more frequently found in glaucoma suspects than in patients with POAG (86.3% vs. 53.3%, P<0.0001). Within the POAG group, the frequency of SVP was significantly lower in group A (40.2%) than in group B (57.3%, P = 0.03) and group C (63.9%, P = 0.003). There was no significant difference between groups B and C (P = 0.42). In addition to IOP (P = 0.007), visual field mean deviation (MD) and refractive error were associated with the frequency of SVP (P<0.0001 and P = 0.011, respectively). When analyzed within the same stage of disease, SVP was less frequently found in group A than in group C in early (P = 0.011) and advanced (P = 0.044) glaucoma and marginally less frequently found in moderate glaucoma (P = 0.080).

CONCLUSIONS

Spontaneous venous pulsation was less common in patients with POAG than in glaucoma suspects. Among the patients with POAG, SVP was less common in patients with low IOP at all stages of disease. These results are consistent with vascular factors having a more significant role in patients with POAG with low IOP than in patients with POAG with higher IOP.

摘要

目的

研究原发性开角型青光眼（POAG）患者眼内压（IOP）与自发性静脉搏动（SVP）频率的关系。

设计

横断面研究。

参与者

共纳入 229 例 POAG 患者的 229 只眼和 205 例青光眼疑似患者的 205 只眼作为对照组。

方法

使用共焦扫描激光检眼镜（Spectralis HRA，Heidelberg Engineering，Heidelberg，德国）电影工具评估 SVP。根据未经治疗的 IOP 的频率分布，将 POAG 患者分为 3 组：低三分位组（IOP≤15mmHg；组 A）、中三分位组（IOP＞15mmHg 且≤21mmHg；组 B）和高三分位组（IOP＞21mmHg；组 C）。比较青光眼疑似患者和 POAG 患者之间以及 POAG 患者 3 组之间的 SVP 频率。采用 logistic 回归分析确定与 SVP 频率相关的因素。

主要观察指标

POAG 患者和青光眼疑似患者的 SVP 频率。

结果

与 POAG 患者相比，青光眼疑似患者的 SVP 更为常见（86.3%比 53.3%，P＜0.0001）。在 POAG 组中，组 A（40.2%）的 SVP 频率明显低于组 B（57.3%，P=0.03）和组 C（63.9%，P=0.003）。组 B 和组 C 之间无显著差异（P=0.42）。除 IOP（P=0.007）外，视野平均偏差（MD）和屈光不正也与 SVP 频率相关（P＜0.0001 和 P=0.011）。在同一疾病阶段进行分析时，在早期（P=0.011）和晚期（P=0.044）青光眼以及中度青光眼（P=0.080）中，组 A 的 SVP 频率明显低于组 C，而在轻度青光眼患者中，SVP 频率则略低。