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发生单侧视网膜分支静脉阻塞的青光眼患者未受影响的对侧眼中青光眼的进展情况。

Glaucoma Progression in the Unaffected Fellow Eye of Glaucoma Patients Who Developed Unilateral Branch Retinal Vein Occlusion.

作者信息

Lopilly Park Hae-Young, Jeon Sooji, Lee Mee Yon, Park Chan Kee

机构信息

Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.

Department of Ophthalmology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.

出版信息

Am J Ophthalmol. 2017 Mar;175:194-200. doi: 10.1016/j.ajo.2016.10.009. Epub 2016 Oct 25.

Abstract

PURPOSE

To investigate glaucoma progression in eyes with glaucoma that developed unilateral branch retinal vein occlusion (BRVO) in the contralateral eye.

DESIGN

Retrospective, case-control study.

METHODS

Participants: Forty glaucoma patients with unilateral BRVO and 40 age- and baseline mean deviation (MD) of the visual field (VF)-matched glaucoma patients were evaluated during at least 4 years of follow-up.

OBSERVATION PROCEDURES

Glaucoma progression was defined as VF progression using the modified Anderson criteria of the MD of the VF. Kaplan-Meier life table analyses were performed to compare times to confirmed VF progression, and related risk factors were evaluated using the Cox proportional hazards model.

MAIN OUTCOME MEASURES

VF progression.

RESULTS

Comparison of the baseline characteristics between the glaucomatous eyes that developed BRVO and the contralateral glaucomatous eyes that did not develop BRVO showed that BRVO occurred in the more advanced-stage eyes. Patients with glaucoma with BRVO in the fellow eyes had significant and frequent detection of disc hemorrhage (35.0%), which was 7.5% in patients with glaucoma without BRVO (P = .003). Four (10%) patients from the glaucoma group without BRVO and 22 (55.0%) patients from the glaucoma group with BRVO in the fellow eye showed progression according to the modified Anderson criteria (P < .001). Disc hemorrhage and the presence of BRVO in the fellow eye were found to be significantly predictive of VF progression using the Cox proportional hazards model.

CONCLUSIONS

More advanced glaucomatous eyes develop BRVO. Patients who developed BRVO showed more rapid glaucoma progression in the contralateral eyes without BRVO compared with glaucoma patients who did not develop BRVO.

摘要

目的

研究对侧眼发生单侧视网膜分支静脉阻塞(BRVO)的青光眼患者的青光眼进展情况。

设计

回顾性病例对照研究。

方法

参与者:40例单侧BRVO的青光眼患者和40例年龄及视野(VF)平均偏差(MD)相匹配的青光眼患者接受了至少4年的随访评估。

观察程序

采用改良的安德森视野MD标准将青光眼进展定义为视野进展。进行Kaplan-Meier生存表分析以比较确诊视野进展的时间,并使用Cox比例风险模型评估相关危险因素。

主要观察指标

视野进展。

结果

发生BRVO的青光眼患眼与未发生BRVO的对侧青光眼患眼的基线特征比较显示,BRVO发生在病情更严重的患眼中。对侧眼发生BRVO的青光眼患者中,视盘出血的检出率显著且频繁(35.0%),而未发生BRVO的青光眼患者中这一比例为7.5%(P = .003)。根据改良的安德森标准,未发生BRVO的青光眼组中有4例(10%)患者和对侧眼发生BRVO的青光眼组中有22例(55.0%)患者出现进展(P < .001)。使用Cox比例风险模型发现,视盘出血和对侧眼存在BRVO是视野进展的显著预测因素。

结论

病情更严重的青光眼患眼会发生BRVO。与未发生BRVO的青光眼患者相比,发生BRVO的患者在对侧未发生BRVO的眼中青光眼进展更快。

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