Yokoyama Yu, Tanito Masaki, Nitta Koji, Katai Maki, Kitaoka Yasushi, Omodaka Kazuko, Tsuda Satoru, Nakagawa Toshiaki, Nakazawa Toru
Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Department of Ophthalmology, Shimane University Faculty of Medicine, Shimane, Japan.
PLoS One. 2014 Jun 12;9(6):e99138. doi: 10.1371/journal.pone.0099138. eCollection 2014.
The Glaucoma Stereo Analysis Study (GSAS), a cross sectional multicenter collaborative study, used a stereo fundus camera to assess various morphological parameters of the optic nerve head (ONH) in glaucoma patients and investigated the relationships between these parameters and patient characteristics.
The study included 187 eyes of 187 subjects with primary open angle glaucoma or normal tension glaucoma (male: female = 100: 87, age = 61±9 years). Stereo pairs of ONH photographs were made with a stereo fundus camera (nonmyd WX). ONH morphological parameters were calculated with prototype analysis software. In addition to 35 standard parameters, we defined three novel parameters: disc tilt angle, rim decentering, and the absolute value of rim decentering. The correlation between each parameter and patient characteristics was analyzed with Spearman's rank correlation coefficient.
Patient characteristics included refractive error of -3.38±3.75 diopters, intraocular pressure (IOP) of 13.6±2.6 mmHg, and visual field mean deviation (MD) of -4.71±3.26 dB. Representative ONH parameters included a horizontal disc width of 1.66±0.28 mm, vertical disc width of 1.86±0.23 mm, disc area of 2.42±0.63 mm2, cup area of 1.45±0.57 mm2, and cup volume of 0.31±0.22 mm3. Correlation analysis revealed significant negative associations between vertical cup-to-disc ratio (0.82±0.08) and MD (r = -0.40, P<0.01) and between disc tilt angle (10.5±12.5 degrees) and refractive error (r = -0.36, P<0.01). Seventy-five percent of the eyes had a positive value for rim decentering (0.30±0.42), indicating that rim thinning manifested more often as an inferior lesion than a superior lesion.
We used stereoscopic analysis to establish a database of ONH parameters, which may facilitate future studies of glaucomatous changes in ONH morphology.
青光眼立体分析研究（GSAS）是一项横断面多中心合作研究，使用立体眼底相机评估青光眼患者视神经乳头（ONH）的各种形态学参数，并研究这些参数与患者特征之间的关系。
该研究纳入了187例原发性开角型青光眼或正常眼压性青光眼患者的187只眼（男∶女 = 100∶87，年龄 = 61±9岁）。使用立体眼底相机（非散瞳WX）拍摄ONH的立体照片对。使用原型分析软件计算ONH形态学参数。除了35个标准参数外，我们还定义了三个新参数：视盘倾斜角、边缘偏心度和边缘偏心度绝对值。使用Spearman等级相关系数分析每个参数与患者特征之间的相关性。
患者特征包括：屈光度为-3.38±3.75 屈光度，眼压（IOP）为13.6±2.6 mmHg，视野平均偏差（MD）为-4.71±3.26 dB。代表性的ONH参数包括：水平视盘宽度为1.66±0.28 mm，垂直视盘宽度为1.86±0.23 mm，视盘面积为2.42±0.63 mm²，杯盘面积为1.45±0.57 mm²，杯盘容积为0.31±0.22 mm³。相关性分析显示，垂直杯盘比（0.82±0.08）与MD之间存在显著负相关（r = -0.40，P<0.01），视盘倾斜角（10.5±12.5度）与屈光不正之间存在显著负相关（r = -0.36，P<0.01）。75%的眼睛边缘偏心度为正值（0.30±0.42），表明边缘变薄更多表现为下方病变而非上方病变。
我们使用立体分析建立了ONH参数数据库，这可能有助于未来对视神经乳头形态学青光眼变化的研究。
