Vision, Imaging and Performance Laboratory (TE, AAJ, FAM), Duke Eye Center and Department of Ophthalmology, Duke University, Durham, North Carolina; Department of Ophthalmology and Visual Sciences (TE), Paulista School of Medicine, Universidade Federal de Sao Paulo, São Paulo, Brazil ; Neuro-Ophthalmology Department (ME-D), Duke Eye Center and Department of Ophthalmology, Duke University, Durham, North Carolina; and Department of Electrical and Computer Engineering (FAM), Pratt School of Engineering, Duke University, Durham, North Carolina.
J Neuroophthalmol. 2023 Sep 1;43(3):353-358. doi: 10.1097/WNO.0000000000001801. Epub 2023 Jan 18.
Optic disc drusen (ODD) are calcified deposits in the prelaminar portion of the optic nerve head. Although often asymptomatic, these deposits can cause progressive visual field defects and vision loss. The purpose of this study was to evaluate rates of functional loss in eyes with ODD and to investigate risk factors associated with rates of visual field progression.
This was a retrospective cohort study including 65 eyes of 43 patients with ODD from the Duke Ophthalmic Registry. All eyes had at least 12 months of follow-up and at least 3 reliable standard automated perimetry (SAP) tests. Linear mixed models were used to estimate rates of SAP mean deviation (MD) loss over time. Univariable and multivariable models were used to assess the effect of clinical variables and intraocular pressure (IOP) on rates of change.
Subjects were followed for an average of 7.6 ± 5.3 years. The mean rate of SAP MD change was -0.23 ± 0.26 dB/year, ranging from -1.19 to 0.13 dB/year. Fifty-seven eyes (87.7%) had slow progression (slower than -0.5 dB/year), 6 eyes (9.2%) had moderate progression (between -0.5 dB/year and -1 dB/year), and 2 eyes (3.1%) had fast progression (faster than -1 dB/year). In multivariable models, older age and worse SAP MD at baseline were significantly associated with faster rates of change. Mean IOP was not associated with faster rates of MD change in both univariable and multivariable analyses.
Most eyes with ODD had slow rates of visual field loss over time. Age and baseline severity were significantly associated with faster rates of visual field loss.
视盘玻璃膜疣（ODD）是视神经头部前层部分的钙化沉积物。尽管这些沉积物通常无症状，但它们可能导致进行性视野缺损和视力丧失。本研究的目的是评估 ODD 眼中功能丧失的发生率，并研究与视野进展相关的危险因素。
这是一项回顾性队列研究，纳入了来自杜克眼科登记处的 43 名患者的 65 只眼的 ODD。所有眼睛都有至少 12 个月的随访和至少 3 次可靠的标准自动视野检查（SAP）。线性混合模型用于估计 SAP 平均偏差（MD）随时间的损失率。单变量和多变量模型用于评估临床变量和眼压（IOP）对变化率的影响。
受试者平均随访 7.6±5.3 年。SAP MD 变化的平均率为-0.23±0.26 dB/年，范围为-1.19 至 0.13 dB/年。57 只眼（87.7%）进展缓慢（低于-0.5 dB/年），6 只眼（9.2%）进展中度（-0.5 dB/年至-1 dB/年），2 只眼（3.1%）进展迅速（高于-1 dB/年）。多变量模型显示，年龄较大和基线 SAP MD 较差与变化率较快显著相关。在单变量和多变量分析中，平均 IOP 与 MD 变化率较快均无相关性。
大多数 ODD 眼中的视野损失随时间呈缓慢进展。年龄和基线严重程度与视野丧失的较快速度显著相关。
