Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Am J Ophthalmol. 2013 May;155(5):852-7. doi: 10.1016/j.ajo.2012.11.020. Epub 2013 Jan 23.
To detect potential differences in the phenotypes between Western normal-tension glaucoma (NTG) and Korean NTG.
A retrospective, cross-sectional study.
One hundred eighty-four NTG eyes of 71 patients of the Jules Stein Eye Institute, University of California, Los Angeles, and 113 patients of the Seoul National University Hospital, Seoul, Korea, were studied after reviewing medical charts retrospectively. All eligible patients from both institutions who were evaluated between July 2007 and June 2008 were included. The groups were matched for stage of glaucoma severity based on the visual field mean deviation value. All patients underwent a complete ophthalmic examination, Humphrey perimetry, Heidelberg Retina Tomography, Stratus optical coherence tomography, and pachymetry. Structural and functional parameters between the 2 groups were compared.
There were no statistically significant differences in the baseline intraocular pressure, disc area, frequency of disc hemorrhage, or peripapillary atrophy (P > .05). Cup-shape measure (by Heidelberg Retina Tomography), average RNFL thickness (by Stratus optical coherence tomography), and central corneal thickness were significantly different (P < .002). The eyes of Korean NTG patients showed higher values for cup-shape measure, higher average RNFL thicknesses, and thinner central corneal thicknesses than Western NTG patients. The difference was significant (P < .001) while controlling for age, sex, disc area, mean deviation, pattern standard deviation, and spherical equivalent with multivariate analysis.
Korean NTG patients showed steeper cup shapes, thicker RNFL thickness, and thinner central corneal thickness compared with Western NTG patients with similar amounts of visual field loss. This result may help clinicians understand the clinical characteristics of NTG patients and points to the heterogeneous character of the glaucomas.
检测西方正常眼压性青光眼（NTG）和韩国 NTG 之间表型的潜在差异。
回顾性、横断面研究。
回顾性查阅病历，对加利福尼亚大学洛杉矶分校 Jules Stein 眼科研究所的 71 例患者（共 184 只眼）和韩国首尔国立大学医院的 113 例患者（共 113 只眼）进行研究。纳入了这两个机构中在 2007 年 7 月至 2008 年 6 月间接受评估且符合条件的所有患者。根据视野平均偏差值，两组患者的青光眼严重程度分期相匹配。所有患者均接受了全面的眼科检查、Humphrey 视野计检查、Heidelberg 视网膜断层扫描仪检查、Stratus 光学相干断层扫描仪检查和角膜测厚仪检查。比较了两组间的结构和功能参数。
两组患者的基线眼压、视盘面积、视盘出血频率或视盘周围萎缩程度无统计学差异（P＞.05）。杯盘比（由 Heidelberg 视网膜断层扫描仪测量）、平均 RNFL 厚度（由 Stratus 光学相干断层扫描仪测量）和中央角膜厚度有显著差异（P＜.002）。与西方 NTG 患者相比，韩国 NTG 患者的杯盘比更大、平均 RNFL 厚度更高、中央角膜厚度更薄。当通过多元分析控制年龄、性别、视盘面积、平均偏差、模式标准差和等效球镜时，这种差异具有统计学意义（P＜.001）。
与具有相似视野缺损的西方 NTG 患者相比，韩国 NTG 患者的杯盘形状更陡峭、RNFL 厚度更厚、中央角膜厚度更薄。这一结果有助于临床医生了解 NTG 患者的临床特征，并表明青光眼存在异质性。
