Jonas J B, Zäch F M, Gusek G C, Naumann G O
Department of Ophthalmology, University Erlangen-Nürnberg, West Germany.
Am J Ophthalmol. 1989 Feb 15;107(2):137-44. doi: 10.1016/0002-9394(89)90212-2.
Using planimetric analysis of stereoscopic optic disk photographs, we studied 21 optic nerve heads of 11 subjects who shared the common feature of optic cups that were larger than the mean + 2 S.D. within the normal population. A comparison of these findings to those of 571 normal optic disks and 706 optic nerve heads in eyes with chronic primary open-angle glaucoma showed the following morphologic characteristics: (1) abnormally large optic disk area (mean +/- S.D., 4.49 +/- 0.56 mm2), (2) large cup/disk ratios with the horizontal ratio (0.78 +/- 0.03) significantly (P less than .001) larger that the vertical (0.71 +/- 0.03), (3) increased incidence of cilioretinal arteries, (4) normal neuroretinal rim area (2.06 +/- 0.35 mm2), (5) normal neuroretinal rim configuration, inferiorly (0.43 +/- 0.08 mm) broader (P less than .001, Wilcoxon test) than superiorly (0.33 +/- 0.06 mm), smallest (P less than .0001) temporally (0.20 +/- 0.04 mm), (6) normal form of zone alpha (irregular hypopigmentation and hyperpigmentation) of the parapapillary chorioretinal atrophy with its widest extension in the temporal horizontal area, (7) no zone beta (visible large choroidal vessels and sclera), (8) normal caliber of the parapapillary retinal vessels, and (9) normal parapillary retinal nerve fiber layer. These characteristics are helpful in the differentiation of primary and secondary large cups.
我们使用立体视盘照片的平面分析方法，研究了11名受试者的21个视神经乳头，这些受试者的视杯具有大于正常人群平均值+2标准差的共同特征。将这些结果与571个正常视盘和706个慢性原发性开角型青光眼患者的视神经乳头的结果进行比较，发现了以下形态学特征：（1）视盘面积异常大（平均值±标准差，4.49±0.56mm²），（2）杯盘比大，水平比（0.78±0.03）显著（P＜0.001）大于垂直比（0.71±0.03），（3）睫状视网膜动脉发生率增加，（4）神经视网膜边缘面积正常（2.06±0.35mm²），（5）神经视网膜边缘形态正常，下方（0.43±0.08mm）比上方（0.33±0.06mm）宽（P＜0.001，Wilcoxon检验），颞侧（0.20±0.04mm）最窄（P＜0.0001），（6）视乳头旁脉络膜视网膜萎缩的α区（不规则色素减退和色素沉着）形态正常，在颞侧水平区域延伸最宽，（7）无β区（可见大的脉络膜血管和巩膜），（8）视乳头旁视网膜血管管径正常，（9）视乳头旁视网膜神经纤维层正常。这些特征有助于鉴别原发性和继发性大视杯。
