Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China.
Transl Vis Sci Technol. 2022 Jun 1;11(6):10. doi: 10.1167/tvst.11.6.10.
To compare the ocular biomechanical differences between normal controls and patients with untreated primary open angle glaucoma, including normal-tension glaucoma (NTG) and high-tension glaucoma (HTG), and to investigate the association between ocular biomechanics and glaucoma severity in each group.
One hundred fifty-three eyes of 153 subjects, including 51 controls, 47 NTG, and 55 HTG cases, were enrolled in this cross-sectional study. Each participant underwent biomechanical measurements by using the Corneal Visualization Scheimpflug Technology. Glaucoma severity was evaluated by mean deviation (MD), pattern standard deviation (PSD), ganglion cell complex (GCC), and retinal nerve fiber layer (RNFL) thickness.
Deformation amplitude (P = 0.001) significantly increased, whereas first applanation time (P < 0.0001), highest concavity time (P = 0.001), stiffness parameter at first applanation (P = 0.009), and time of whole eye movement (WEM, P = 0.008) decreased significantly in NTG eyes compared with controls. Besides, NTG had the highest first applanation velocity than controls (P < 0.0001) and HTG (P = 0.044). Shorter time of WEM was independently correlated with worse MD (P = 0.02) and higher values of PSD (P = 0.03) in NTG. Axial length was positively related to PSD (P = 0.02) and negatively related to GCC (P < 0.0001) and RNFL (P < 0.0001) thickness in HTG.
NTG corneas are more deformable than healthy ones and HTG. Time of WEM, which relates to orbital compliance, is significantly associated with glaucomatous visual field defect in NTG, whereas axial length is correlated with glaucoma severity in HTG.
Ocular biomechanics may partly account for the differences of pathogenic mechanisms between NTG and HTG.
比较正常对照者与未经治疗的原发性开角型青光眼(包括正常眼压性青光眼[NTG]和高眼压性青光眼[HTG])患者的眼生物力学差异,并探讨各组中眼生物力学与青光眼严重程度的关系。
本横断面研究纳入了 153 名受试者的 153 只眼,包括 51 名对照者、47 名 NTG 患者和 55 名 HTG 患者。每位受试者均接受角膜可视化 Scheimpflug 技术的生物力学测量。通过平均偏差(MD)、模式标准偏差(PSD)、节细胞复合体(GCC)和视网膜神经纤维层(RNFL)厚度评估青光眼严重程度。
与对照组相比,NTG 组的变形幅度(P = 0.001)显著增加,而首次压平时间(P < 0.0001)、最大凹陷时间(P = 0.001)、首次压平的刚性参数(P = 0.009)和整个眼球运动时间(WEM,P = 0.008)显著缩短。此外,NTG 的首次压平速度高于对照组(P < 0.0001)和 HTG(P = 0.044)。NTG 中 WEM 时间较短与 MD 更差(P = 0.02)和 PSD 更高(P = 0.03)独立相关。HTG 中眼轴长度与 PSD(P = 0.02)呈正相关,与 GCC(P < 0.0001)和 RNFL(P < 0.0001)厚度呈负相关。
NTG 角膜比健康角膜更具可变形性,HTG 也是如此。与眼眶顺应性相关的 WEM 时间与 NTG 中的青光眼视野缺损显著相关,而眼轴长度与 HTG 中的青光眼严重程度相关。
田莉