Nam Jeoung Woo, Kang Yeon Soo, Sung Mi Sun, Park Sang Woo
Department of Ophthalmology, Chonnam National University Hospital, Gwangju, Korea.
Chonnam Med J. 2021 May;57(2):144-151. doi: 10.4068/cmj.2021.57.2.144. Epub 2021 May 24.
To evaluate the clinical characteristics of unilateral open-angle glaucoma, patients diagnosed with unilateral open-angle glaucoma from January 2017 to October 2018 were divided into primary open-angle glaucoma and normal-tension glaucoma groups according to the type of glaucoma diagnosed. The glaucoma and the contralateral eyes were compared, and the contralateral eye was analyzed for conversion to glaucoma and its risk factors were assessed during the 2-year follow-up period. Among 99 patients, 36 were diagnosed with primary open-angle glaucoma and 63 with normal-tension glaucoma. When comparing the glaucoma eye with the contralateral eye, the visual field mean deviation value (all p<0.001), peripapillary retinal nerve fiber layer thickness (all p<0.001), macular ganglion cell layer-inner plexiform layer thickness (p<0.001, p=0.003), and optic nerve cup-disc ratio (p=0.005, p<0.001) were significantly different in both the primary open-angle glaucoma and normal-tension glaucoma groups. In normal-tension glaucoma, peripapillary retinal nerve fiber layer thickness was significantly thinner in the glaucoma conversion group than in the glaucoma non-conversion group (p=0.008). It was significantly associated with glaucoma conversion (odds ratio=0.97, p=0.023). In conclusion, in patients with unilateral open-angle glaucoma, the contralateral eye may develop glaucoma. In particular, if the peripapillary retinal nerve fiber layer thickness is decreased in normal-tension glaucoma, the possibility of glaucoma conversion is high; hence, careful examination is required.
为评估单侧开角型青光眼的临床特征,将2017年1月至2018年10月诊断为单侧开角型青光眼的患者,根据诊断的青光眼类型分为原发性开角型青光眼组和正常眼压性青光眼组。比较青光眼患眼与对侧眼,并在2年随访期内分析对侧眼青光眼的转化情况并评估其危险因素。99例患者中,36例诊断为原发性开角型青光眼,63例诊断为正常眼压性青光眼。原发性开角型青光眼组和正常眼压性青光眼组在比较青光眼患眼与对侧眼时,视野平均偏差值(均p<0.001)、视乳头周围视网膜神经纤维层厚度(均p<0.001)、黄斑神经节细胞层-内丛状层厚度(p<0.001,p=0.003)和视神经杯盘比(p=0.005,p<0.001)均有显著差异。在正常眼压性青光眼中,青光眼转化组的视乳头周围视网膜神经纤维层厚度明显薄于未转化组(p=0.008)。它与青光眼转化显著相关(比值比=0.97,p=0.023)。总之,单侧开角型青光眼患者的对侧眼可能发生青光眼。特别是在正常眼压性青光眼中,如果视乳头周围视网膜神经纤维层厚度降低,青光眼转化的可能性较高;因此,需要仔细检查。