Rebolleda Gema, Pérez-Sarriegui Ane, Díez-Álvarez Laura, De Juan Victoria, Muñoz-Negrete Francisco J
1 Department of Ophthalmology, Hospital Universitario Ramón y Cajal, Madrid, Spain.
2 Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, Madrid, Spain.
Eur J Ophthalmol. 2019 Mar;29(2):202-209. doi: 10.1177/1120672118782101. Epub 2018 Jun 18.
: To compare the optic nerve head morphology among primary open-angle glaucoma, non-arteritic anterior ischemic optic neuropathy eyes, their fellow healthy eyes and control eyes, using spectral-domain optical coherence tomography with enhanced depth imaging.
: Observational cross-sectional study including 88 eyes of 68 patients. In this study, 23 non-arteritic anterior ischemic optic neuropathy eyes, 17 fellow unaffected eyes, 25 primary open-angle glaucoma eyes, and 23 age-matched control eyes were included. Peripapillary retinal nerve fiber layer thickness and optic disk area were evaluated. Bruch's membrane opening diameter, optic cup depth, anterior lamina cribrosa depth, and prelaminar tissue thickness were assessed.
: Non-arteritic anterior ischemic optic neuropathy and primary open-angle glaucoma eyes had similar visual field mean deviation and peripapillary retinal nerve fiber layer thickness (P = 0.6 and P = 0.56, respectively). Bruch's membrane opening diameter was significantly larger in primary open-angle glaucoma eyes than in control eyes (P = 0.02). Lamina cribrosa and disk cup were deeper in eyes with primary open-angle glaucoma than both control and non-arteritic anterior ischemic optic neuropathy eyes (P < 0.001). Prelaminar tissue thickness was significantly thinner in primary open-angle glaucoma eyes than in non-arteritic anterior ischemic optic neuropathy eyes (P < 0.001). Lamina cribrosa was shallower in both non-arteritic anterior ischemic optic neuropathy and unaffected fellow eyes compared to healthy eyes (P < 0.001 and P = 0.04, respectively). No differences were found in the optic disk area.
: A forward lamina cribrosa placement and not a smaller disk could be involved in the pathogenesis of non-arteritic anterior ischemic optic neuropathy. A significantly larger Bruch's membrane opening diameter was found in primary open-angle glaucoma eyes compared with control eyes. This issue has clinical implications because Bruch's membrane opening has been considered a stable reference for disk-related measures.
使用具有增强深度成像功能的光谱域光学相干断层扫描技术，比较原发性开角型青光眼、非动脉炎性前部缺血性视神经病变患者的患眼、对侧健康眼以及对照眼的视神经乳头形态。
对68例患者的88只眼睛进行观察性横断面研究。本研究纳入了23只非动脉炎性前部缺血性视神经病变患眼、17只对侧未受影响的眼睛、25只原发性开角型青光眼患眼以及23只年龄匹配的对照眼。评估了视乳头周围视网膜神经纤维层厚度和视盘面积。测量了布鲁赫膜开口直径、视杯深度、筛板前深度和板层前组织厚度。
非动脉炎性前部缺血性视神经病变患眼和原发性开角型青光眼患眼的视野平均偏差和视乳头周围视网膜神经纤维层厚度相似（分别为P = 0.6和P = 0.56）。原发性开角型青光眼患眼的布鲁赫膜开口直径显著大于对照眼（P = 0.02）。原发性开角型青光眼患眼的筛板和视盘杯比对照眼和非动脉炎性前部缺血性视神经病变患眼更深（P < 0.001）。原发性开角型青光眼患眼的板层前组织厚度显著薄于非动脉炎性前部缺血性视神经病变患眼（P < 0.001）。与健康眼相比，非动脉炎性前部缺血性视神经病变患眼和未受影响的对侧眼的筛板均较浅（分别为P < 0.001和P = 0.04）。视盘面积未发现差异。
筛板向前移位而非视盘变小可能参与了非动脉炎性前部缺血性视神经病变的发病机制。与对照眼相比，原发性开角型青光眼患眼的布鲁赫膜开口直径显著更大。这一问题具有临床意义，因为布鲁赫膜开口一直被视为与视盘相关测量的稳定参考指标。
