Sun Y X, Xie Y, Liu X X, Guo Y Q, Pang R Q, Zhang X, Cao K, Tian N, Wang H Z, Zhang C, Wang N L
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Ophthalmology & Visual Sciences Key Lab., Beijing 100730, China.
Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China.
Zhonghua Yan Ke Za Zhi. 2019 May 11;55(5):338-346. doi: 10.3760/cma.j.issn.0412-4081.2019.05.007.
To investigate the relationship between the spontaneous focal lamina cribrosa (LC) defect and the progression of visual field defect (VFD) in primary open-angle glaucoma (POAG). Case-control study. The patients who were diagnosed as POAG with at least 5 visual field results had been collected from June 2018 to January 2019 at Beijing Tongren Hospital Affiliated to Capital Medical University. Serial imaging by swept source optical coherence tomography B-Scan of the optic discs were acquired at the end of the follow-up and LC defects status were reviewed. Intraocular pressure, mean defects of visual field, central corneal thickness and axis length were recorded in the follow-up duration. Eyes were classified as having either progressive or nonprogressive VFD, and associating factors were evaluated by χ(2) or Fisher's test, mixed-effect model analysis and multivariate Logistical regression analysis. A total of 32 subjects (64 eyes) were enrolled in the study with mean age of (47±14) years, the group consisted of 17 males and 15 females. Fourty-five eyes showed nonprogressive VFD. LC defects were more common in eyes without (28/45) rather than with progressive VFD (5/19) (χ(2)=6.896, 0.009). Eyes with nonprogressive VFD showed longer axis length[(26.82±1.34) mm . (25.79±1.44) mm; 6.589, 0.013] and wider LC defects diameter[211 (165-326) μm . 114 (106-156) μm; 4.797, 0.042]. Multivariate Logistic regression analysis revealed that the presence of LC defect was significantly associated with nonprogressive VFD (odds ratio=0.217, 0.012). There were 7 subjects with asymmetry VFD and the incedence of LC defects without progression (7/7) is higher than fellow eye with progression (1/7, 0.002). There was only one patient with progressive VFD showed one LC defect with an smaller diameter (169 μm) than that in the contralateral eyes with stable VFD (269 μm). LC defects are more common in eyes with nonprogressive VFD. Spontaneous LC defects are associated with nonprogressive glaucomatous defects and could be a protective factor for POAG. .
探讨原发性开角型青光眼（POAG）中自发性视盘筛板（LC）缺损与视野缺损（VFD）进展之间的关系。病例对照研究。收集了2018年6月至2019年1月在首都医科大学附属北京同仁医院被诊断为POAG且至少有5次视野检查结果的患者。在随访结束时通过扫频光学相干断层扫描B超对视盘进行连续成像，并复查LC缺损情况。在随访期间记录眼压、视野平均缺损、中央角膜厚度和眼轴长度。将眼睛分为视野进展性或非进展性VFD，并通过χ²检验或Fisher检验、混合效应模型分析和多因素Logistic回归分析评估相关因素。共有32名受试者（64只眼）纳入研究，平均年龄为（47±14）岁，其中男性17名，女性15名。45只眼表现为非进展性VFD。LC缺损在非进展性VFD的眼中更常见（28/45），而非进展性VFD的眼中较少见（5/19）（χ²=6.896，P=0.009）。非进展性VFD的眼轴长度更长[（26.82±1.34）mm 比（25.79±1.44）mm；t=6.589，P=0.013]，LC缺损直径更宽[211（165 - 326）μm 比114（106 - 156）μm；t=4.797，P=0.042]。多因素Logistic回归分析显示，LC缺损的存在与非进展性VFD显著相关（比值比=0.217，P=0.012）。有7名受试者存在不对称性VFD，无进展的LC缺损发生率（7/7）高于对侧进展性眼（1/7，P=0.002）。只有1例进展性VFD患者表现出一个直径（169μm）小于对侧稳定VFD眼（269μm）的LC缺损。LC缺损在非进展性VFD的眼中更常见。自发性LC缺损与非进展性青光眼性缺损相关，可能是POAG的一个保护因素。
