Nevarez J, Rockwood E J, Anderson D R
Bascom Palmer Eye Institute, University of Miami School of Medicine, FL 33101.
Arch Ophthalmol. 1988 Jul;106(7):901-3. doi: 10.1001/archopht.1988.01060140047021.
We compared the peripapillary scleral and choroidal halos and crescents in the two eyes of 42 patients with unilateral glaucoma. In most cases, the edge of the three tissue layers (the retinal pigment epithelium [RPE], the choroid, and the sclera) that encircle the optic nerve head of the glaucomatous eye superimposed exactly on the mirror images of the edges in the fellow nonglaucomatous eye. Although the size of the peripapillary crescent or halo was the same in both eyes, it and the scleral rim were often more conspicuous in the eye with glaucomatous damage because the tissue edges were seen more easily through the reduced thickness of nerve fiber layer tissue. There were nine exceptions. In five cases, the peripapillary choroidal crescent (the area of choroid not covered by RPE) was larger in the glaucomatous eye. In four eyes, however, the crescent was larger in the nonglaucomatous eye, although the magnitude of the asymmetry was less in these four cases. Thus, in late stages of optic nerve damage, there was some RPE atrophy, but in most cases of glaucoma, the area of bared choroid was the inherent anatomic configuration of the optic nerve exit canal.
我们比较了42名单侧青光眼患者双眼的视乳头周围巩膜和脉络膜晕及半月形区域。在大多数情况下，青光眼患眼环绕视神经乳头的三层组织（视网膜色素上皮[RPE]、脉络膜和巩膜）的边缘与对侧非青光眼眼边缘的镜像完全重叠。尽管视乳头周围半月形区域或晕在双眼大小相同，但由于通过变薄的神经纤维层组织更容易看到组织边缘，所以它和巩膜边缘在有青光眼损害的眼中通常更明显。有9个例外情况。在5例中，青光眼患眼的视乳头周围脉络膜半月形区域（未被RPE覆盖的脉络膜区域）更大。然而，在4只眼中，非青光眼眼的半月形区域更大，尽管这4例中的不对称程度较小。因此，在视神经损害的晚期，存在一些RPE萎缩，但在大多数青光眼病例中，裸露脉络膜的区域是视神经出口管的固有解剖结构。
