Department of Ophthalmology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea.
PLoS One. 2018 Apr 30;13(4):e0196001. doi: 10.1371/journal.pone.0196001. eCollection 2018.
To investigate the prevalence and risk factors for visual field defect in patients with optic disc drusen (ODD).
We assessed the visual field status of patients with ODD whose diagnosis were confirmed by spectral-domain optical coherence tomography (SD-OCT). Visual field defects were classified as normal, enlarged blind spot, or other defects. ODD were classified into either type 1 (without hyperreflective border and heterogenic internal reflectance) or type 2 (with hyperreflective border and lower internal reflectance). The prevalence and risk factors for each visual field defect was analyzed using logistic regression analysis and classification and regression tree (CART) modeling.
Of the 40 eyes with ODD, 33 (83%) eyes were categorized as type 1 and 7 (17%) eyes were categorized as type 2 ODD. Regarding the visual field defects, 19 (48%) eyes showed normal visual field, 11 (28%) eyes showed enlarged blind spot, and 9 (24%) eyes showed other defects. The latter was more frequent in type 2 ODD (P = 0.001). Logistic regression analysis revealed that the factor associated with other defects was the thinning of the average retinal nerve fiber layer (RNFL) (per 10 μm decrease, OR = 3.436, P = 0.004), and the factor associated with enlarged blind spot was the height of ODD (per 100 μm increase, OR = 3.956, P = 0.023). CART modeling revealed that the average RNFL thickness lesser than 85.5 μm, and then the ODD height larger than 348 μm were the best split-up factors for predicting the type of visual field defects.
In this study, one-quarter of ODD patients showed abnormal visual field defect other than enlarged blind spot. These other visual field defects appeared to be associated with the axonal loss in the eyes with type 2 ODD.
研究视盘玻璃膜疣（ODD）患者视野缺损的患病率和危险因素。
我们评估了经谱域光相干断层扫描（SD-OCT）确诊的 ODD 患者的视野状态。视野缺损分为正常、扩大的盲点或其他缺损。ODD 分为 1 型（无高反射边界和异质内部反射）或 2 型（有高反射边界和低内部反射）。使用逻辑回归分析和分类回归树（CART）模型分析每种视野缺损的患病率和危险因素。
在 40 只 ODD 眼中，33 只（83%）眼为 1 型，7 只（17%）眼为 2 型 ODD。关于视野缺损，19 只（48%）眼表现为正常视野，11 只（28%）眼表现为扩大的盲点，9 只（24%）眼表现为其他缺损。后者在 2 型 ODD 中更为常见（P = 0.001）。逻辑回归分析显示，与其他缺损相关的因素是平均视网膜神经纤维层（RNFL）变薄（每减少 10 μm，OR = 3.436，P = 0.004），与扩大的盲点相关的因素是 ODD 的高度（每增加 100 μm，OR = 3.956，P = 0.023）。CART 模型显示，平均 RNFL 厚度小于 85.5 μm，然后 ODD 高度大于 348 μm 是预测视野缺损类型的最佳分割因素。
在这项研究中，四分之一的 ODD 患者除了扩大的盲点外，还表现出异常的视野缺损。这些其他视野缺损似乎与 2 型 ODD 眼中的轴突丢失有关。
