Jonas Jost B, Holbach Leonard, Panda-Jonas Songhomitra
Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
PLoS One. 2013 Nov 1;8(11):e78867. doi: 10.1371/journal.pone.0078867. eCollection 2013.
To measure histomorphometrically the location of the peripapillary arterial circle of Zinn-Haller (ZHAC) and assess its associations with axial length.
Using a light microscope, we measured the distance from the ZHAC to the peripapillary ring (optic disc border), the merging point of the dura mater with the posterior sclera ("dura-sclera point"), and the inner scleral surface. In the parapapillary region, we differentiated between beta zone (presence of Bruch's membrane, absence of retinal pigment epithelium) and gamma zone (absence of Bruch's membrane). The peripapillary scleral flange as roof of the orbital cerebrospinal fluid space was the connection between the end of the lamina cribrosa and the posterior full-thickness sclera starting at the dura-sclera point.
The study included 101 human globes (101 patients) with a mean axial length of 26.7 ± 3.7 mm (range: 20.0-39.0 mm). The distance between the ZHAC and the peripapillary ring increased significantly with longer axial length (P<0.001; correlation coefficient r=0.49), longer parapapillary gamma zone (P<0.001;r=0.85), longer (P<0.001;r=0.73) and thinner (P<0.001;r=-0.45) peripapillary scleral flange, and thinner sclera posterior to the equator (P<0.001). ZHAC distance to the peripapillary ring was not significantly associated with length of parapapillary beta zone (P=0.33). Including only non-highly myopic eyes (axial length <26.5 mm), the ZHAC distance to the disc border was not related with axial length (P=0.84). In non-highly myopic eyes, the ZHAC was located close to the dura-sclera point. With increasing axial length and decreasing thickness of the peripapillary scleral flange, the ZHAC was located closer to the inner scleral surface.
The distance between the ZHAC and the optic disc border is markedly enlarged in highly myopic eyes. Since the ZHAC is the main arterial source for the lamina cribrosa blood supply, the finding may be of interest for the pathogenesis of the increased glaucoma susceptibility in highly myopic eyes.
通过组织形态测量法测定Zinn-Haller视乳头周围动脉环（ZHAC）的位置，并评估其与眼轴长度的关系。
使用光学显微镜，我们测量了ZHAC到视乳头周围环（视盘边界）、硬脑膜与后巩膜的融合点（“硬脑膜-巩膜点”）以及巩膜内表面的距离。在视乳头旁区域，我们区分了β区（存在Bruch膜，不存在视网膜色素上皮）和γ区（不存在Bruch膜）。作为眶脑脊髓液间隙顶部的视乳头周围巩膜嵴是筛板末端与始于硬脑膜-巩膜点的后全层巩膜之间的连接。
该研究纳入了101个眼球（101例患者），平均眼轴长度为26.7±3.7mm（范围：20.0 - 39.0mm）。ZHAC与视乳头周围环之间的距离随着眼轴长度增加（P<0.001；相关系数r = 0.49）、视乳头旁γ区变长（P<0.001；r = 0.85）、视乳头周围巩膜嵴变长（P<0.001；r = 0.73）和变薄（P<0.001；r = -0.45）以及赤道后巩膜变薄（P<0.001）而显著增加。ZHAC到视乳头周围环的距离与视乳头旁β区的长度无显著相关性（P = 0.33）。仅纳入非高度近视眼（眼轴长度<26.5mm）时，ZHAC到视盘边界的距离与眼轴长度无关（P = 0.84）。在非高度近视眼中，ZHAC靠近硬脑膜-巩膜点。随着眼轴长度增加和视乳头周围巩膜嵴厚度减小，ZHAC更靠近巩膜内表面。
在高度近视眼中，ZHAC与视盘边界之间的距离明显增大。由于ZHAC是筛板血液供应的主要动脉来源，这一发现可能对高度近视眼中青光眼易感性增加的发病机制具有重要意义。
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