Yoon Joo Young, Sung Kyung Rim, Yun Sung Cheol, Shin Joong Won
Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Division of Biostatistics, Center for Medical Research and Information, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2019 Dec;33(6):520-527. doi: 10.3341/kjo.2019.0069.
To explore the progressive change and associated factors of optic disc tilt in young myopic glaucomatous eyes by analyzing long-term follow-up data.
Optic disc images were obtained from spectral-domain optical coherence tomography enhanced depth imaging from at least five different visits. At each visit, the disc tilt angle (DTA), defined as the angle between the Bruch's membrane opening plane and the optic canal plane, was estimated at the central frame that passes through the optic disc. Glaucoma progression was assessed on the basis of changes noted on serial optic disc and retinal nerve fiber layer photographs or changes in the visual field (VF). A linear mixed effect model was used to assess the influence of parameters (age, sex, baseline and follow-up intraocular pressure, retinal nerve fiber layer thickness, VF mean deviation, axial length, central corneal thickness), and presence of glaucomatous progression upon DTA change.
A total of 26 eyes of 26 young myopic primary open-angle glaucoma patients (axial length >24.0 mm; mean age, 25.1 ± 4.0 years; mean follow-up, 3.3 ± 0.9 years) were included. DTA was 7.0 ± 3.4 degrees at baseline and 8.3 ± 3.8 degrees at last visit, which represents a significant difference ( < 0.001). Worse VF mean deviation ( < 0.001) and longer axial length ( = 0.006) were significantly associated with DTA increase.
Young myopic glaucomatous eyes showed progressive optic disc tilting. Progressive optic disc tilting in young myopic glaucomatous eyes may be related to either continuous axial myopic shift or glaucomatous structural change.
通过分析长期随访数据，探讨年轻近视性青光眼患者视盘倾斜的进展变化及相关因素。
从至少五次不同随访的光谱域光学相干断层扫描增强深度成像中获取视盘图像。每次随访时，在通过视盘的中央帧处估计视盘倾斜角（DTA），即布鲁赫膜开口平面与视神经管平面之间的夹角。根据连续视盘和视网膜神经纤维层照片上的变化或视野（VF）变化评估青光眼进展。采用线性混合效应模型评估参数（年龄、性别、基线和随访眼压、视网膜神经纤维层厚度、VF平均偏差、眼轴长度、中央角膜厚度）以及青光眼进展的存在对视盘倾斜角变化的影响。
纳入了26例年轻近视性原发性开角型青光眼患者的26只眼（眼轴长度>24.0 mm；平均年龄25.1±4.0岁；平均随访3.3±0.9年）。基线时视盘倾斜角为7.0±3.4度，末次随访时为8.3±3.8度，差异有统计学意义（<0.001）。较差的VF平均偏差（<0.001）和较长的眼轴长度（=0.006）与视盘倾斜角增加显著相关。
年轻近视性青光眼患者的视盘显示出进行性倾斜。年轻近视性青光眼患者视盘的进行性倾斜可能与眼轴近视的持续进展或青光眼结构变化有关。
