Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Sci Rep. 2017 Jun 14;7(1):3489. doi: 10.1038/s41598-017-03828-0.
Both disc hemorrhages (DH) and focal lamina cribrosa (LC) defects are recently considered as a progression factor in glaucoma. However, the clinical relevance of the presence of LC findings at the site of the DH has not yet been determined. We conducted a prospective study enrolling a total of 98 glaucoma eyes with DH and 37 OAG eyes with focal LC defect without DH to determine whether visual field (VF) progression differs according to the findings of the LC that had been evaluated by enhanced depth imaging (EDI) of optical coherence tomography (OCT) and its relationship with DH. Only the presence of focal LC defects was significantly different between the progressing and stable patients (P < 0.001). Baseline intraocular pressure (hazard ratio [HR], 1.076; P = 0.098) and the presence of focal LC defects at the DH site (HR, 2.620; P = 0.002) were found to be associated with VF progression. Glaucoma eyes with DH at the site of focal LC defects showed frequent and faster VF progression compared with DH not accompanied by LC alterations or LC alterations not accompanied by DH. Evaluating LC alterations in glaucoma eyes with DH may be important in predicting the progression of glaucoma.
盘状出血 (DH) 和局限性视盘筛板缺损 (LC) 最近都被认为是青光眼进展的一个因素。然而，在 DH 部位存在 LC 发现的临床相关性尚未确定。我们进行了一项前瞻性研究，共纳入 98 只 DH 青光眼眼和 37 只无 DH 的局限性 LC 缺损的 OAG 眼，以确定是否根据通过光学相干断层扫描 (OCT) 的增强深度成像 (EDI) 评估的 LC 发现，视野 (VF) 进展是否存在差异及其与 DH 的关系。只有局限性 LC 缺损的存在在进展性和稳定性患者之间存在显著差异 (P < 0.001)。发现基线眼内压 (危险比 [HR]，1.076；P = 0.098) 和 DH 部位存在局限性 LC 缺损 (HR，2.620；P = 0.002) 与 VF 进展相关。与 DH 不伴有 LC 改变或 LC 改变不伴有 DH 的 DH 相比，局限性 LC 缺损部位存在 DH 的青光眼眼显示出更频繁和更快的 VF 进展。在 DH 青光眼眼中评估 LC 改变可能对预测青光眼的进展很重要。
