Ramm Lisa, Schwab Birte, Stodtmeister Richard, Hammer Martin, Sauer Lydia, Spörl Eberhard, Pillunat Lutz E, Terai Naim
a Department of Ophthalmology , University Hospital Carl Gustav Carus , TU Dresden , Dresden , Germany.
b Department of Ophthalmology , University Hospital Jena , Jena , Germany.
Curr Eye Res. 2017 Sep;42(9):1313-1318. doi: 10.1080/02713683.2017.1307415. Epub 2017 May 30.
To investigate optic nerve head (ONH) pallor quantitatively in patients with primary open-angle glaucoma (POAG) and in healthy subjects, and to examine the relationship to mean deviation in perimetry (MD), cup-disk ratio (CDR), and diameters of retinal vessels.
A total of 89 POAG patients (67.6 ± 11.1 years) and 48 healthy subjects (63.3 ± 14 years) were included. A dual-bandpass transmission filter was introduced in the illumination path of the fundus camera of the Dynamic Vessel Analyzer (Imedos Systems UG) and two monochromatic images at different wavelenghts (548 ± 10 and 610 ± 10 nm) were recorded simultaneously. ONH pallor was defined as the quotient of light reflection in both spectral channels. Pallor values were averaged over four fields which were positioned on the ONH. The mean of these measurements was calculated. In 47 of 89 POAG patients diameters of retinal vessels were determined peripapillary.
In POAG, the ONH showed a significantly higher pallor value compared to healthy subjects (82.34 ± 19.28 vs. 62.67 ± 10.41, p < 0.001). ONH pallor was correlated to indicators used to estimate disease severity: MD (r = -0.565, p < 0.001) and CDR (r = 0.561, p < 0.001). The pallor value was associated to diameters of retinal arterioles (r = -0.313, p = 0.032) and venules (r = -0.397, p = 0.006).
Pallor determined by this method was higher in POAG patients than in healthy subjects and increased in patients with advanced disease. ONH pallor might result from a reduced blood perfusion of the ONH or tissue atrophy accompanied by vessel obliteration in POAG. By measuring ONH pallor additional diagnostic information about the vitality of the neuroretinal rim might be gained in glaucoma patients.
定量研究原发性开角型青光眼（POAG）患者和健康受试者的视神经乳头（ONH）苍白情况，并探讨其与视野平均偏差（MD）、杯盘比（CDR）及视网膜血管直径的关系。
共纳入89例POAG患者（67.6±11.1岁）和48例健康受试者（63.3±14岁）。在动态血管分析仪（Imedos Systems UG）的眼底相机照明路径中引入双带通传输滤光片，同时记录不同波长（548±10和610±10nm）的两幅单色图像。ONH苍白定义为两个光谱通道中光反射的商。在位于ONH上的四个区域对苍白值进行平均。计算这些测量值的平均值。在89例POAG患者中的47例中，测定了视乳头周围视网膜血管的直径。
与健康受试者相比，POAG患者的ONH苍白值显著更高（82.34±19.28对62.67±10.41，p<0.001）。ONH苍白与用于评估疾病严重程度的指标相关：MD（r=-0.565，p<0.001）和CDR（r=0.561，p<0.001）。苍白值与视网膜小动脉直径（r=-0.313，p=0.032）和小静脉直径（r=-0.397，p=0.006）相关。
通过该方法测定的POAG患者苍白值高于健康受试者，且在疾病晚期患者中升高。POAG患者的ONH苍白可能是由于ONH血液灌注减少或组织萎缩伴血管闭塞所致。通过测量ONH苍白，可能会在青光眼患者中获得有关神经视网膜边缘活力的额外诊断信息。
