青光眼ß-区视盘旁萎缩的十年及以上纵向变化：与视网膜神经纤维层缺损的关系。

Ten-year-and-beyond longitudinal change of ß-zone parapapillary atrophy in glaucoma: association with retinal nerve fibre layer defect.

机构信息

Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.

Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea

出版信息

Br J Ophthalmol. 2022 Oct;106(10):1393-1398. doi: 10.1136/bjophthalmol-2020-318464. Epub 2021 Apr 30.

DOI:10.1136/bjophthalmol-2020-318464

PMID:33931391

Abstract

BACKGROUND

To investigate the longitudinal change of localised retinal nerve fibre layer (RNFL) defects associated with change of ß-zone parapapillary atrophy (PPA) in primary open-angle glaucoma (POAG) eyes.

METHODS

POAG patients with a localised RNFL defect and ß-zone PPA who had undergone disc/RNFL photography at 1-year intervals for 10 years or longer were enrolled. The topographic parameters of ß-zone PPA (area, maximal radial extent and angular extent around disc) were measured. Progression of RNFL defect was defined as widening of defect and/or appearance of new defect. The factors associated with progression of RNFL defect were assessed by OR using multivariable logistic regression.

RESULTS

A total of 209 patients (209 eyes) with POAG were included (mean: 54 years old). Over the course of 11.5±2.3-year follow-up period, progression of RNFL defect was detected in 114 eyes (54.5%). Enlargement of PPA parameters (area and angular extent) was significantly more common in patients with RNFL defect progression than in eyes without progression (all p<0.001, respectively). Widening of radial extent did not show a significant difference in both groups (p=0.61). Increment of angular extent was in the direction of RNFL defect progression in 82.1% of eyes. Progression of RNFL defect was significantly associated with disc haemorrhage (OR: 6.653, p<0.001), enlargement of PPA area (OR: 4.114, p=0.004) and angular extent (OR: 6.572, p<0.001).

CONCLUSIONS

Progression of RNFL defect is associated with increment of angular extent of PPA in POAG eyes.

摘要

背景

研究原发性开角型青光眼（POAG）患者局限性视网膜神经纤维层（RNFL）缺损与β-区旁视盘萎缩（PPA）变化相关的纵向变化。

方法

纳入了具有局限性 RNFL 缺损和β-区 PPA 的 POAG 患者，这些患者在 10 年或更长时间内每隔 1 年接受 1 次眼底/RNFL 摄影检查。测量β-区 PPA 的拓扑参数（面积、最大放射状延伸和围绕视盘的角度延伸）。RNFL 缺损进展定义为缺损变宽和/或出现新的缺损。使用多变量逻辑回归的 OR 评估与 RNFL 缺损进展相关的因素。

结果

共纳入 209 例（209 只眼）POAG 患者（平均年龄：54 岁）。在 11.5±2.3 年的随访期间，114 只眼（54.5%）检测到 RNFL 缺损进展。与无进展组相比，RNFL 缺损进展患者的 PPA 参数（面积和角度延伸）增大更为常见（均 p<0.001）。两组之间放射状延伸的扩大没有显著差异（p=0.61）。82.1%的眼的角度延伸增量与 RNFL 缺损进展方向一致。RNFL 缺损进展与视盘出血（OR：6.653，p<0.001）、PPA 面积（OR：4.114，p=0.004）和角度延伸（OR：6.572，p<0.001）增大显著相关。