Yun Sung-Cheol, Hahn In Kyun, Sung Kyung Rim, Yoon Joo Young, Jeong Daun, Chung Ho Seok
Department of Clinical Epidemiology and Biostatistics, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
Graefes Arch Clin Exp Ophthalmol. 2015 Dec;253(12):2247-53. doi: 10.1007/s00417-015-3131-y. Epub 2015 Aug 13.
To compare the lamina cribrosa (LC) depth of the optic nerve head in normal and glaucomatous eyes over a wide range of axial length (AXL).
A total of 402 eyes, including 210 normal and 192 glaucomatous eyes, were imaged by spectral domain optical coherence tomography. Normal and glaucomatous eyes were each divided into three subgroups according to the level of AXL; long (> 26 mm), mid-level (23-26 mm), and short (< 23 mm). Visual field mean deviation (VF MD), LC thickness, and LC depth were compared between normal and glaucomatous eyes in each of the AXL subgroups. These parameters were also compared between normal and glaucomatous eyes in the three AXL subgroups. Factors associated with LC depth in each AXL subgroup were evaluated by univariate and multivariate regression analyses.
A comparison of the three AXL subgroups in normal eyes showed that the LC was thinnest in the long AXL subgroup (short; 189.7 ± 24.1 μm, mid-level; 179.9 ± 34.3 μm, long; 149.2 ± 36.2 μm, p < 0.001), but LC depth did not differ significantly in the three subgroups (short; 527.1 ± 144.4 μm, mid-level; 578.2 ± 163.5 μm, long; 594.4 ± 187.5 μm, p = 0.144). In glaucomatous eyes, glaucoma severity assessed by VF MD did not differ significantly among the three AXL subgroups (short; -6.99 ± 8.50 dB, mid-level; -6.40 ± 7.64 dB, long; -4.61 ± 5.22 dB, p = 0.168). However, LC depth was greater in the long than in the short AXL subgroup (679.5 ± 192.7 μm and 555.9 ± 134.1 μm, respectively, p = 0.004), although neither subgroup differed significantly in LC depth from the mid-level AXL subgroup (611.8 ± 162.3 μm, p = 0.385, p = 0.090). LC thickness was significantly different between normal and glaucomatous eyes (p < 0.001). LC depth was not different between normal and glaucomatous eyes in both short and mid-level AXL subgroups (p = 0.297, 0.222), but differed in the long AXL subgroup (p = 0.022). The presence of glaucoma was associated with greater LC depth only in the long AXL subgroup (p = 0.012).
LC depth may vary according to the level of AXL in glaucomatous eyes with a similar level of glaucoma severity, with the greatest LC depth found in eyes with long AXL. Those findings suggest that glaucomatous optic disc cupping would manifest differently according to the level of AXL.
比较正常眼和青光眼眼中不同眼轴长度（AXL）范围内视神经乳头筛板（LC）的深度。
采用光谱域光学相干断层扫描技术对402只眼睛进行成像，其中包括210只正常眼和192只青光眼眼。根据眼轴长度水平，将正常眼和青光眼眼各分为三个亚组：长眼轴（>26mm）、中水平眼轴（23 - 26mm）和短眼轴（<23mm）。比较各AXL亚组中正常眼和青光眼眼的视野平均偏差（VF MD）、LC厚度和LC深度。还比较了三个AXL亚组中正常眼和青光眼眼之间的这些参数。通过单因素和多因素回归分析评估每个AXL亚组中与LC深度相关的因素。
正常眼中三个AXL亚组的比较显示，长眼轴亚组的LC最薄（短眼轴；189.7±24.1μm，中水平眼轴；179.9±34.3μm，长眼轴；149.2±36.2μm，p<0.001），但三个亚组的LC深度无显著差异（短眼轴；527.1±144.4μm，中水平眼轴；578.2±163.5μm，长眼轴；594.4±187.5μm，p = 0.144）。在青光眼眼中，通过VF MD评估的青光眼严重程度在三个AXL亚组之间无显著差异（短眼轴；-6.99±8.50dB，中水平眼轴；-6.40±7.64dB，长眼轴；-4.61±5.22dB，p = 0.168）。然而，长眼轴亚组的LC深度大于短眼轴亚组（分别为679.5±192.7μm和555.9±134.1μm，p = 0.004），尽管两个亚组与中水平眼轴亚组的LC深度均无显著差异（611.8±162.3μm，p = 0.385，p = 0.090）。正常眼和青光眼眼的LC厚度存在显著差异（p<0.001）。短眼轴和中水平眼轴亚组中正常眼和青光眼眼的LC深度无差异（p = 0.297，0.222），但在长眼轴亚组中存在差异（p = 0.022）。仅在长眼轴亚组中，青光眼的存在与更大的LC深度相关（p = 0.012）。
在青光眼严重程度相似的青光眼眼中，LC深度可能因AXL水平而异，长眼轴的眼睛LC深度最大。这些发现表明，青光眼性视盘凹陷会因AXL水平而表现不同。
