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Invest Ophthalmol Vis Sci. 2020 Mar 9;61(3):17. doi: 10.1167/iovs.61.3.17.
The purpose of this study was to investigate the characteristics of focal γ-zone parapapillary atrophy (focal γPPA) in patients with primary open-angle glaucoma (POAG) using spectral-domain optical coherence tomography (SD-OCT).
Three groups of POAG eyes (n = 214) were defined according to the circumferential extent of Bruch's membrane (BM) within the β-zone PPA, as follows: (1) no γPPA (intact BM; n = 81), (2) conventional γPPA (γPPA involving the fovea-BM-opening axis; n = 89), and (3) focal γPPA (γPPA not involving the fovea-BM-opening axis; n = 44). Clinical and ocular characteristics, including age, axial length (AXL), and focal lamina cribrosa (LC) defects were compared among the three groups.
The focal γPPA group was significantly older (60.6 ± 11.0 years) and had shorter AXL (24.10 ± 1.34 mm) than those of the conventional γPPA group (46.2 ± 13.8 years and 26.53 ± 1.61 mm, respectively; P < 0.001). These values of the focal γPPA group were similar to those of the no γPPA group (23.73 ± 0.97 mm for AXL and 64.0 ± 13.0 years for age). The focal γPPA group had a significantly higher prevalence of focal LC defects than did the other two groups (70.5% [31/44] for the focal γPPA group versus 46.1% [41/89] for the conventional γPPA group versus 37.0% [30/81] for the no γPPA group; P = 0.002).
Focal γPPA was differentiated from conventional γPPA by older age and shorter AXL. Further, focal γPPA was frequently accompanied by focal LC defects. Longitudinal studies elucidating whether focal LC defects and focal γPPA share common pathogenesis are warranted.
本研究旨在使用频域光学相干断层扫描（SD-OCT）研究原发性开角型青光眼（POAG）患者中局限性γ-带旁视盘萎缩（focal γPPA）的特征。
根据β-带旁视盘内 Bruch 膜（BM）的周向范围，将三组 POAG 眼（n=214）定义如下：（1）无 γPPA（BM 完整；n=81），（2）传统 γPPA（γPPA 累及黄斑-BM 开口轴；n=89），（3）局限性 γPPA（γPPA 不累及黄斑-BM 开口轴；n=44）。比较三组间的临床和眼部特征，包括年龄、眼轴（AXL）和局限性筛板（LC）缺陷。
局限性 γPPA 组年龄明显较大（60.6±11.0 岁），眼轴较短（24.10±1.34mm），与传统 γPPA 组（46.2±13.8 岁和 26.53±1.61mm，分别；P＜0.001）相比。局限性 γPPA 组的这些值与无 γPPA 组相似（AXL 为 23.73±0.97mm，年龄为 64.0±13.0 岁）。局限性 γPPA 组局限性 LC 缺陷的患病率明显高于其他两组（局限性 γPPA 组为 70.5%[31/44]，传统 γPPA 组为 46.1%[41/89]，无 γPPA 组为 37.0%[30/81]；P=0.002）。
局限性 γPPA 与传统 γPPA 的区别在于年龄较大和眼轴较短。此外，局限性 γPPA 常伴有局限性 LC 缺陷。需要进行纵向研究阐明局限性 LC 缺陷和局限性 γPPA 是否具有共同的发病机制。
