Department of Ophthalmology, Hanyang University College of Medicine.
Department of Ophthalmology, Hanyang University Seoul Hospital.
J Glaucoma. 2021 Jan 1;30(1):10-16. doi: 10.1097/IJG.0000000000001690.
Recognizing the shortcomings of poor consistency of the fovea-disc relationship at different time points and comparing PanoMaps may well facilitate the understanding of the spatial relationship between parapapillary and macular areas in glaucoma.
The aims of this study are to analyze the spatial distribution of the frequently damaged areas in early glaucoma, compare the patterns between nonprogressors and progressors using the combined wide-field parapapillary and macular deviation maps (PanoMap), and to evaluate the consistency of the fovea-disc relationship in PanoMap. The fovea-disc distance (FDD) and fovea-disc axis (FDA) were compared at baseline and at the last follow-up.
In total, 118 patients with early glaucoma and a minimum follow-up period of 3 years were included in this retrospective observational study. The pattern of structural changes was evaluated by averaging the PanoMaps of the enrolled patients at baseline and last follow-up. Longitudinal comparison of the FDD and FDA was performed at baseline and the last follow-up. Patients were divided into nonprogressor (n=44) and progressor (n=74), and the patterns of glaucoma progression in PanoMaps were compared between them.
At baseline, the glaucomatous damage was found more frequently in the macular compared with the parapapillary area. The spatial distribution of frequently damaged areas was similar between the nonprogressor and progressor. At the last follow-up, compared with the baseline structural change on the PanoMap, the progressive structural changes extended toward the fovea at both the parapapillary and macular areas in the progressor. The FDD and FDA were significantly different between the baseline and the last follow-up.
The PanoMaps showed a clear spatial distribution of early glaucomatous changes, indicating that the damaged area was frequently observed in the macular area. As the consistency of the fovea-disc relationship in PanoMaps was not excellent, this aspect should be considered when interpreting the PanoMap.
认识到不同时间点黄斑-视盘关系一致性差的缺点，并比较 PanoMap 可能有助于理解青光眼旁乳头和黄斑区之间的空间关系。
本研究旨在分析早期青光眼常受损区域的空间分布，使用联合广角旁乳头和黄斑偏距图（PanoMap）比较非进展者和进展者之间的模式，并评估 PanoMap 中黄斑-视盘关系的一致性。比较基线和最后一次随访时的黄斑-视盘距离（FDD）和黄斑-视盘轴（FDA）。
共纳入 118 例早期青光眼患者，随访时间至少 3 年。通过在基线和最后一次随访时对入组患者的 PanoMap 进行平均，评估结构变化的模式。在基线和最后一次随访时对 FDD 和 FDA 进行纵向比较。将患者分为非进展者（n=44）和进展者（n=74），比较他们在 PanoMap 中的青光眼进展模式。
基线时，黄斑区比旁乳头区更容易出现青光眼损害。非进展者和进展者之间的常受损区域的空间分布相似。在最后一次随访时，与 PanoMap 上的基线结构变化相比，进展者的旁乳头和黄斑区的结构进展向黄斑扩展。FDD 和 FDA 在基线和最后一次随访时均有显著差异。
PanoMap 显示了早期青光眼变化的清晰空间分布，表明受损区域经常出现在黄斑区。由于 PanoMap 中黄斑-视盘关系的一致性不是很好，在解释 PanoMap 时应考虑这一点。
