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甲状腺相关性眼病与开角型青光眼患者视盘及视野改变的特征

Characteristics of Optic Disc and Visual Field Changes in Patients with Thyroid-Associated Orbitopathy and Open-Angle Glaucoma.

作者信息

Hsu Chih-Kang, Yao Hsin-Yu, Lin Che-Min, Chang Hsu-Chieh, Lu Da-Wen, Chen Yi-Hao, Chien Ke-Hung

机构信息

Department of Ophthalmology, Songshan Branch, Tri-Service General Hospital, Songshan 10581, Taiwan.

Hau-Ming Eye Clinic Center, New Taipei City 22158, Taiwan.

出版信息

J Clin Med. 2021 Aug 27;10(17):3839. doi: 10.3390/jcm10173839.

Abstract

This study aimed to characterize the changes in the visual field (VF) patterns and disc morphology of patients with thyroid-associated orbitopathy (TAO) and open-angle glaucoma (OAG). A retrospective review of the medical records at the Tri-Service General Hospital in Taiwan identified 396 eyes of 198 patients with thyroid-associated glaucoma. A final follow-up of VF examination in 140 eyes revealed 114 eyes with VF defects, indicating disease progression. The characteristics of and changes in disc morphology, optical coherence tomography findings, and VF defects were statistically analyzed. The most common VF defects at the initial diagnosis and the end of the follow-up period were inferior partial arcuate (17%) and paracentral (15%) defects, respectively. The most common VF defect in patients with unspecific disc signs was an unspecific scotoma (13%). The most common optic disc feature was disc cupping (51%), followed by parapapillary atrophy (48%). The most frequent location of nerve fiber layer thinning was the inferotemporal region (48%). VF defects showed a significantly more pronounced progression in the non-nerve fiber bundle group than in the nerve fiber bundle group ( < 0.001). This study details the characteristics and progression of disc morphology and VF defects in patients with TAO and OAG.

摘要

本研究旨在描述甲状腺相关性眼病(TAO)合并开角型青光眼(OAG)患者的视野(VF)模式和视盘形态变化。对台湾三军总医院的病历进行回顾性分析,确定了198例甲状腺相关性青光眼患者的396只眼。对140只眼进行VF检查的最终随访发现,114只眼存在VF缺损,提示疾病进展。对视盘形态、光学相干断层扫描结果和VF缺损的特征及变化进行了统计学分析。初始诊断时和随访期末最常见的VF缺损分别为下方部分弓形缺损(17%)和旁中心缺损(15%)。非特异性视盘体征患者最常见的VF缺损为非特异性暗点(13%)。最常见的视盘特征是视盘凹陷(51%),其次是视盘旁萎缩(48%)。神经纤维层变薄最常见的部位是颞下区域(48%)。VF缺损在非神经纤维束组中的进展明显比神经纤维束组更显著(<0.001)。本研究详细描述了TAO和OAG患者视盘形态和VF缺损的特征及进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2420/8432097/7413cd7fe854/jcm-10-03839-g001.jpg

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