正常眼压性青光眼与高眼压性青光眼的比较：神经纤维层及视神经乳头损害

Comparison of normal- and high-tension glaucoma: nerve fiber layer and optic nerve head damage.

作者信息

Häntzschel Janek, Terai Naim, Furashova Olga, Pillunat Karin, Pillunat Lutz E

机构信息

Department of Ophthalmology, Carl Gustav Carus University Hospital, Dresden, Germany.

出版信息

Ophthalmologica. 2014;231(3):160-5. doi: 10.1159/000355326. Epub 2013 Dec 7.

DOI:10.1159/000355326

PMID:24334967

Abstract

PURPOSE

The aim of this study was to investigate differences in the nerve fiber layer and glaucoma-induced structural optic nerve head (ONH) damage in patients with normal- (NTG) and high-tension (HTG) glaucoma.

METHODS

In this retrospective pair-matched comparative study, 22 NTG and 22 HTG eyes were matched according to the same glaucomatous damage based on rim volume, rim area and disk size, as measured by Heidelberg retinal tomography (HRT III). Visual fields (VF) were assessed by Humphrey perimetry, and nerve fiber layer thickness was determined both by scanning laser polarimetry (GDxVCC) and spectral-domain optical coherence tomography (SD-OCT). Comparisons of all measured parameters were made between NTG and HTG groups.

RESULTS

Based on HRT results, both NTG and HTG eyes displayed comparable structural damage to the ONH (NTG/HTG, mean: disk area, 2.30/2.31 mm(2), p = 0.942; rim area, 1.02/0.86 mm(2), p = 0.082; rim volume, 0.19/0.17 mm(3), p = 0.398). NTG eyes had significantly less VF damage than HTG eyes (NTG/HTG, mean deviation: -4.23/-12.12 dB, p = 0.002; pattern standard deviation: 5.39/8.23 dB, p = 0.022). The inferior nerve fiber layer of NTG patients was significantly thicker than that of HTG patients (NTG/HTG, mean: GDx inferior: 53.5/46.3 µm, p = 0.046). SD-OCT revealed a significantly thicker nerve fiber in NTG compared with HTG patients in all quadrants (NTG/HTG, total mean: 72.72/58.45 µm, p = 0.002).

CONCLUSION

At comparable glaucomatous stages, nerve fiber loss was more advanced in HTG patients compared with NTG patients.

摘要

目的

本研究旨在调查正常眼压性青光眼（NTG）和高眼压性青光眼（HTG）患者神经纤维层及青光眼所致视神经乳头（ONH）结构损害的差异。

方法

在这项回顾性配对比较研究中，根据海德堡视网膜断层扫描（HRT III）测量的视盘边缘体积、边缘面积和视盘大小，将22只NTG患眼和22只HTG患眼按照相同的青光眼损害程度进行配对。采用Humphrey视野计评估视野（VF），并通过扫描激光偏振仪（GDxVCC）和光谱域光学相干断层扫描（SD-OCT）测定神经纤维层厚度。对NTG组和HTG组所有测量参数进行比较。

结果

基于HRT结果，NTG和HTG患眼对视神经乳头的结构损害相当（NTG/HTG，平均值：视盘面积，2.30/2.31mm²，p = 0.942；边缘面积，1.02/0.86mm²，p = 0.082；边缘体积，0.19/0.17mm³，p = 0.398）。NTG患眼的视野损害明显少于HTG患眼（NTG/HTG，平均偏差：-4.23/-12.12dB，p = 0.002；模式标准差：5.39/8.23dB，p = 0.022）。NTG患者的下方神经纤维层明显厚于HTG患者（NTG/HTG，平均值：GDx下方：53.5/46.3µm，p = 0.046）。SD-OCT显示，与HTG患者相比，NTG患者所有象限的神经纤维均明显更厚（NTG/HTG，总平均值：72.72/58.45µm，p = 0.002）。