Sung M S, Heo H, Ji Y S, Park S W
Department of Ophthalmology and Research Institute of Medical Sciences, Chonnam National University Medical School and Hospital, Gwangju, South Korea.
Center for Creative Biomedical Scientists, Chonnam National University, Gwangju, South Korea.
Eye (Lond). 2017 Jul;31(7):1051-1059. doi: 10.1038/eye.2017.33. Epub 2017 Mar 10.
PurposeThe purpose of the study was to evaluate the factors associated with development of parafoveal scotoma in early myopic normal tension glaucoma (NTG).Patients and methodsNinety-nine myopic NTG patients with mean deviation (MD) >-6.0 decibels (dB) were enrolled. Parafoveal scotoma was defined as a visual field (VF) defect within 10° of fixation with at least one point at P<1% lying at the four innermost central points. Systemic factors, optic disc characteristics including tilt ratio, rotation degree, β-zone parapapillary atrophy, disc hemorrhage, and peripapillary retinal nerve fiber layer and macular ganglion cell-inner plexiform layer (mGCIPL) thickness parameters using optical coherence tomography were evaluated. Logistic regression analysis was performed to identify factors associated with the development of parafoveal scotoma.ResultsThe mean spherical equivalent refractive error and MD were -6.07±2.83 diopters and -3.29±1.70 dB, respectively. Among 99 eyes, 42 (42.42%) showed parafoveal scotoma. Eyes with parafoveal scotoma had greater disc tilt, lesser disc rotation, lower MD, thinner minimum mGCIPL, and a higher proportion of VF defect in the superior hemifield than eyes without parafoveal scotoma. Multivariate logistic regression showed that all these parameters were significantly associated with development of parafoveal scotoma (P=0.047, P=0.011, P=0.032, P=0.010, and P=0.001, respectively).ConclusionIn addition to the previously reported risk factors, optic disc characteristics, such as tilt ratio and optic disc rotation, were also significantly associated with development of parafoveal scotoma in patients with myopic NTG.
目的
本研究的目的是评估早期近视性正常眼压性青光眼（NTG）中与旁中心暗点形成相关的因素。
患者与方法
纳入99例平均偏差（MD）>-6.0分贝（dB）的近视性NTG患者。旁中心暗点定义为注视点10°范围内的视野（VF）缺损，在最内侧的四个中心点至少有一个点的P<1%。评估全身因素、视盘特征，包括倾斜率、旋转度、β区视盘旁萎缩、视盘出血，以及使用光学相干断层扫描测量的视盘周围视网膜神经纤维层和黄斑神经节细胞-内丛状层（mGCIPL）厚度参数。进行逻辑回归分析以确定与旁中心暗点形成相关的因素。
结果
平均等效球镜屈光不正和MD分别为-6.07±2.83屈光度和-3.29±1.70 dB。在99只眼中，42只（42.42%）出现旁中心暗点。与没有旁中心暗点的眼睛相比，有旁中心暗点的眼睛视盘倾斜度更大、视盘旋转度更小、MD更低、最小mGCIPL更薄，且上半视野VF缺损比例更高。多因素逻辑回归显示，所有这些参数均与旁中心暗点的形成显著相关（P分别为0.047、0.011、0.032、0.010和0.001）。
结论
除了先前报道的危险因素外，视盘特征，如倾斜率和视盘旋转，也与近视性NTG患者旁中心暗点的形成显著相关。
