Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
Ohkubo Eye Clinic, Kanazawa, Japan.
PLoS One. 2020 Nov 6;15(11):e0242090. doi: 10.1371/journal.pone.0242090. eCollection 2020.
To elucidate glaucoma-related fundus abnormalities in patients with primary aldosteronism (PA).
The study compared 272 eyes from 137 PA patients and 352 eyes from 177 control subjects selected randomly from 1173 participants of a public glaucoma screening. The presence of glaucomatous optic disc appearance (rim thinning and cup enlargement) and retinal nerve fiber layer defects (RNFLDs) was determined independently from fundus photographs. The results were compared between the PA and control groups.
There were 9 patients (6.6%) with glaucomatous optic disc abnormalities in the PA group and 10 cases (5.6%) identified in the control group (p = 0.92). RNFLDs were detected more frequently in the PA group (55 eyes, 20.2%) than in the control group (26 eyes, 7.4%; p<0.001). The two types of RNFLDs were classified as either having their central ends at the disc margin (D) or away from the disc margin and around the retinal vessels (V). Type D and V RNFLDs were detected in 35 (12.9%) and 26 (9.6%) eyes in the PA group and in 25 (7.1%) and 4 (1.1%) eyes in the control group, respectively. Both types of RNFLDs were more frequent in the PA group than in the control group (Type D and V, p = 0.03, <0.001, respectively).
Although the prevalence of glaucomatous optic disc appearance did not differ between the two groups, RNFLDs were more frequent in PA patients than in the control group. Moreover, RNFLDs with their central ends located around retinal vessels were characteristic of PA patients.
阐明原发性醛固酮增多症（PA）患者的青光眼相关眼底异常。
该研究比较了 137 例 PA 患者的 272 只眼和从 1173 名公共青光眼筛查参与者中随机选择的 177 例对照者的 352 只眼。通过眼底照片独立确定青光眼视盘外观（边缘变薄和杯扩大）和视网膜神经纤维层缺损（RNFLD）的存在。将结果与 PA 和对照组进行比较。
PA 组中有 9 例（6.6%）患者存在青光眼视盘异常，对照组中有 10 例（5.6%）患者存在青光眼视盘异常（p = 0.92）。PA 组中更频繁地检测到 RNFLD（55 只眼，20.2%），而对照组中则为 26 只眼（7.4%）（p<0.001）。这两种类型的 RNFLD 分为其中心端位于视盘边缘（D）或远离视盘边缘并围绕视网膜血管（V）的类型。PA 组中检测到 35 只（12.9%）和 26 只（9.6%）眼的 D 型和 V 型 RNFLD，而对照组中分别为 25 只（7.1%）和 4 只（1.1%）眼。PA 组中两种类型的 RNFLD均比对照组更常见（D 型和 V 型，p = 0.03，<0.001）。
尽管两组之间的青光眼视盘外观患病率没有差异，但 PA 患者的 RNFLD 比对照组更常见。此外，视盘边缘周围中央端位于视网膜血管的 RNFLD 是 PA 患者的特征。
