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正常眼中青光眼的眼部危险因素与视盘边缘的关系。

Relationship between ocular risk factors for glaucoma and optic disc rim in normal eyes.

机构信息

Tajimi Iwase Eye Clinic, Tajimi, Gifu, Japan

Ophthalmology, University of the Ryukyus, Nakagami-gun, Okinawa, Japan.

出版信息

Br J Ophthalmol. 2020 Aug;104(8):1120-1124. doi: 10.1136/bjophthalmol-2019-314696. Epub 2019 Nov 15.

Abstract

AIM

To study relationships between reported risk factors for glaucoma and neuroretinal rim area in normal eyes.

METHODS

The Kumejima study participants, 3762 of the 4632 eligible Kumejima residents 40 years and older, underwent a detailed ocular examination including sequential disc stereo photography. In a randomly chosen eye of a subject whose both eyes met the inclusion criteria, fundus photographs of 2474 ophthalmologically normal eyes of the 2474 subjects were analysed by computer-assisted planimetry to measure the disc, rim and β-peripapillary atrophy (PPA) areas. The rim was divided into the superior and inferior halves by a line connecting the fovea and disc centre.

RESULTS

The disc, superior and inferior halves rim and β-PPA areas averaged 2.53±0.50 (SD), 0.82±0.15, 0.84±0.16 and 0.45±0.66 mm. After adjustment for other systemic and ocular factors including age, disc and β-PPA areas, disc-fovea distance (p=0.013, 0.016) correlated positively and intraocular pressure (IOP) (p=0.004, 0.006) and axial length (AL) (p<0.000, 0.004) negatively with the superior and inferior halves rim area, respectively; central corneal thickness (CCT) (p=0.008) and mean blood pressure (mBP) (p=0.020) correlated positively and male gender (p=0.012) negatively only with the superior half rims.

CONCLUSIONS

Besides previously reported risk factors for glaucoma such as age or IOP, thinner CCT, lower mBP and male gender were newly found to significantly correlate with smaller rim area only in the superior half disc, and a greater disc-fovea distance with greater superior and inferior half rim areas in normal adult eyes.

摘要

目的

研究青光眼报道的危险因素与正常眼中神经视网膜边缘区域之间的关系。

方法

在久米岛研究参与者中,对符合条件的 4632 名久米岛居民中的 3762 名 40 岁及以上的居民进行了详细的眼部检查,包括连续视盘立体摄影。在符合纳入标准的受试者的双眼的一只眼中,随机选择一只眼,对 2474 名受试者的 2474 只眼的眼底照片进行计算机辅助平面测量,以测量视盘、边缘和 β-视盘周围萎缩(PPA)区域。通过连接视盘中心和黄斑中心的线将边缘分为上下两部分。

结果

视盘、上半部分边缘、下半部分边缘和 β-PPA 区域的平均值分别为 2.53±0.50(SD)、0.82±0.15、0.84±0.16 和 0.45±0.66 mm。在调整其他全身和眼部因素(包括年龄、视盘和 β-PPA 区域)后,视盘-黄斑中心距离(p=0.013,0.016)与上半部分边缘呈正相关,而眼内压(IOP)(p=0.004,0.006)和眼轴长度(AL)(p<0.000,0.004)与下半部分边缘呈负相关;中央角膜厚度(CCT)(p=0.008)和平均血压(mBP)(p=0.020)与上半部分边缘呈正相关,而男性(p=0.012)与上半部分边缘呈负相关。

结论

除了先前报道的青光眼危险因素(如年龄或 IOP)外,还发现更薄的 CCT、更低的 mBP 和男性与正常成年人眼中上半部分视盘的边缘区域较小显著相关,而视盘-黄斑中心距离较大与上半部分和下半部分边缘区域较大相关。

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