Kim Ko Eun, Kim Dong Myung, Flammer Josef, Kim Kyoung Nam
Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
Department of Ophthalmology, University of Basel, Basel, Switzerland.
PLoS One. 2015 May 21;10(5):e0127920. doi: 10.1371/journal.pone.0127920. eCollection 2015.
To compare central retinal venous pressure (CRVP) among eyes with and without optic disc hemorrhage (ODH) in bilateral normal-tension glaucoma (NTG) patients and NTG eyes without an episode of ODH.
In this prospective study, 22 bilateral NTG patients showing a unilateral ODH and 29 bilateral NTG patients without an episode of ODH were included. Eyes were categorized into group A (n = 22, eyes with ODH), group B (n = 22, fellow eyes without ODH), and group C (n = 29, NTG eyes without an episode of ODH). A contact lens ophthalmodynamometer was used to measure CRVP and central retinal arterial pressure (CRAP).
Intraocular pressure (IOP) measured on the day of contact lens ophthalmodynamometry showed no difference among groups. However, the mean baseline IOP in group A was significantly lower than that in group C (P = .008). The CRVP in group A (29.1 ± 10.8 mmHg) was significantly lower than that in group C (40.1 ± 8.8 mmHg, P = .001), but similar to that in group B (30.5 ± 8.7 mmHg, P = .409). A similar relationship was noted for CRAP. No significant eye-associated variable for ODH was found in group A and B by conditional logistic regression analysis (all P > 0.05). However, multivariate logistic regression analysis in groups A and C revealed that low mean baseline IOP (odds ratio [OR] = 0.69, 95% confidence interval [CI] 0.49-0.98, P = 0.043) and low CRVP (OR = 0.88, 95% CI 0.80-0.95, P = 0.003) were associated with ODH.
CRVP was lower in NTG eyes with ODH than in eyes without an episode of ODH, but similar to that of fellow eyes without ODH. These imply less likelihood of association between increased central retinal venous resistance and ODH.
比较双侧正常眼压性青光眼(NTG)患者中出现和未出现视盘出血(ODH)的患眼以及未发生过ODH的NTG患眼的视网膜中央静脉压(CRVP)。
在这项前瞻性研究中,纳入了22例出现单侧ODH的双侧NTG患者和29例未发生过ODH的双侧NTG患者。将患眼分为A组(n = 22,出现ODH的患眼)、B组(n = 22,对侧未出现ODH的患眼)和C组(n = 29,未发生过ODH的NTG患眼)。使用接触式眼压计测量CRVP和视网膜中央动脉压(CRAP)。
在接触式眼压计测量当天测得的眼压(IOP)在各组之间无差异。然而,A组的平均基线眼压显著低于C组(P = .008)。A组的CRVP(29.1 ± 10.8 mmHg)显著低于C组(40.1 ± 8.8 mmHg,P = .001),但与B组(30.5 ± 8.7 mmHg,P = .409)相似。CRAP也呈现类似关系。通过条件逻辑回归分析,在A组和B组中未发现与ODH相关的显著眼相关变量(所有P > 0.05)。然而,A组和C组的多因素逻辑回归分析显示,低平均基线眼压(比值比[OR] = 0.69,95%置信区间[CI] 0.49 - 0.98,P = 0.043)和低CRVP(OR = 0.88,95% CI 0.80 - 0.95,P = 0.003)与ODH相关。
出现ODH的NTG患眼的CRVP低于未发生过ODH的患眼,但与对侧未出现ODH的患眼相似。这表明视网膜中央静脉阻力增加与ODH之间关联的可能性较小。