Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Incheon St. Mary's Hospital, Incheon.
Department of Ophthalmology, College of medicine, Chuncheon Sacred Heart Hospital, Hallym University, Chuncheon-si, Gangwon-do, Republic of Korea.
J Glaucoma. 2020 Oct;29(10):890-898. doi: 10.1097/IJG.0000000000001573.
To characterize intereye differences in posterior segment parameters and determine their significance in open-angle glaucoma patients with unilateral damage.
Both eyes from 65 subjects without any nerve damage and 43 patients undergoing treatment for unilateral open-angle glaucoma were included in this study. A 12.0×9.0×2.6 mm volume of the posterior segment in each eye was scanned with swept-source optical coherence tomography. Coronally reconstructed optical coherence tomography images were analyzed to determine the deepest point of the eye (DPE), which we then calculated the distance (Disc-DPE distance), depth (Disc-DPE depth), angle (Disc-DPE angle) from the optic disc center to the DPE. Posterior pole shape was analyzed measuring the posterior pole-cross-sectional area, posterior pole-horizontal width (PP-HW), and posterior pole-vertical width) of the posterior pole. These measurements and their intereye absolute difference (IAD; absolute difference in measurements between the right and left eyes) values were compared between the healthy and unilateral glaucomatous patients.
The posterior sclera measurements, including the Disc-DPE distance, Disc-DPE depth, and posterior pole-cross-sectional area, were significantly different between the unilateral glaucoma eyes and contralateral healthy eyes (P=0.043, P=0.035, and P=0.049, respectively). By contrast, none of the intereye differences in optic nerve head parameters were significant in the unilateral glaucoma patients. In comparison with the IAD values, the baseline intraocular pressure and PP-HW of the posterior segment showed significant differences between the healthy and the unilateral glaucoma patients (P=0.019 and P=0.036, respectively). A multivariate analysis showed that a larger baseline intraocular pressure IAD [odds ratio (OR), 1.381; P=0.009)] and larger PP-HW IAD (OR, 1.324; P=0.032) were significantly associated with the presence of glaucoma.
Compared with the fellow healthy eyes, glaucomatous eyes had larger and more steeply curved posterior poles, which represent a structural variation of the posterior sclera that might be associated with glaucomatous optic neuropathy.
描述双眼后部参数的差异，并确定其在单侧损害的开角型青光眼患者中的意义。
本研究纳入了 65 名无神经损伤的受试者和 43 名接受单侧开角型青光眼治疗的患者的双眼。使用扫频源光学相干断层扫描仪对每只眼的 12.0×9.0×2.6mm 后节体积进行扫描。对冠状重建的光学相干断层扫描图像进行分析，以确定眼球最深处（DPE），然后计算从视盘中心到 DPE 的距离（Disc-DPE 距离）、深度（Disc-DPE 深度）和角度（Disc-DPE 角度）。通过测量后极的后极横截面积、后极水平宽度（PP-HW）和后极垂直宽度，分析后极形状。将这些测量值及其双眼绝对差值（IAD；右眼和左眼测量值之间的绝对差值）值与健康人和单侧青光眼患者进行比较。
单侧青光眼眼中的后巩膜测量值，包括 Disc-DPE 距离、Disc-DPE 深度和后极横截面积，与对侧健康眼相比差异有统计学意义（P=0.043、P=0.035 和 P=0.049）。相比之下，单侧青光眼患者的视神经头参数的双眼差异均无统计学意义。与 IAD 值相比，健康人和单侧青光眼患者的基线眼内压和后节 PP-HW 差异有统计学意义（P=0.019 和 P=0.036）。多变量分析显示，基线眼内压 IAD 较大（比值比（OR），1.381；P=0.009）和 PP-HW IAD 较大（OR，1.324；P=0.032）与青光眼的存在显著相关。
与对侧健康眼相比，青光眼眼中的后极更大且更陡峭弯曲，这代表了后巩膜的结构变化，可能与青光眼性视神经病变有关。
