Jonas J B, Gusek G C, Naumann G O
Augenklinik mit Poliklinik der Universität Erlangen-Nürnberg.
Klin Monbl Augenheilkd. 1988 Nov;193(5):481-8. doi: 10.1055/s-2008-1050286.
Using optic disk photographs, qualitative morphologic characteristics of the optic nerve head were determined in 251 nonselected normal eyes and 308 eyes with chronic primary open-angle glaucoma. These characteristics were correlated to morphometric (both intra- and parapapillary) and perimetric data. The highest degree of accuracy in distinguishing normal from glaucomatous optic disks was found with the characteristics "localization of narrowest point of neuroretinal rim outside the temporal horizontal optic disk sector" (85.5%) and "changes in the parapapillary retinal nerve fiber layer" (87.9%). The signs "baring of circumlinear vessels," "baring of cilioretinal arteries," "epipapillary flame-shaped hemorrhages," and "bridging of the vessel trunk" were highly specific for glaucomatous optic nerve damage (94.4%-100%) and less sensitive (5.8%-25.3%). Bayonetlike vessel kinking," "prevalence of cupping nasal to the main vessel trunk," "baring of the lamina cribrosa pores," and "undermining of the cup border" were less useful in qualitative evaluation of the optic disk. The location of the central artery in relation to the central vein (nasal in 98.4%), prevalence of the cilioretinal arteries, and the total number of circumlinear vessels were not significantly correlated to changes associated with glaucoma and are therefore of no importance for optic disk evaluation in glaucoma.
利用视盘照片，在251只未经挑选的正常眼睛和308只慢性原发性开角型青光眼眼中确定了视神经乳头的定性形态学特征。这些特征与形态测量学（视乳头内和视乳头旁）及视野数据相关。在区分正常视盘和青光眼性视盘时，发现“颞侧水平视盘扇形区外神经视网膜边缘最窄点的位置”（85.5%）和“视乳头旁视网膜神经纤维层的改变”（87.9%）这两个特征具有最高的准确性。“环形血管裸露”“睫状视网膜动脉裸露”“视乳头旁火焰状出血”和“血管主干桥接”这些体征对青光眼性视神经损伤具有高度特异性（94.4% - 100%），但敏感性较低（5.8% - 25.3%）。“刺刀样血管扭结”“主血管主干鼻侧杯状凹陷的发生率”“筛板孔裸露”和“杯缘侵蚀”在视盘的定性评估中作用较小。中央动脉相对于中央静脉的位置（98.4%为鼻侧）、睫状视网膜动脉的发生率以及环形血管的总数与青光眼相关变化无显著相关性，因此对青光眼的视盘评估无重要意义。
