Caprioli J, Miller J M, Sears M
Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT 06510.
Ophthalmology. 1987 Nov;94(11):1484-7. doi: 10.1016/s0161-6420(87)33264-6.
Measurable structural alterations of the optic nerve head may precede visual field abnormalities in early open-angle glaucoma. The authors studied the optic nerve heads of 10 patients with unilateral visual field loss from primary open-angle glaucoma, and 12 age- and sex-matched normal subjects. Topographic optic nerve head parameters were measured with a system of computerized image analysis (Rodenstock Analyzer, G. Rodenstock Instrumente GMBH, Munich, W. Germany). In patients with asymmetric primary open-angle glaucoma, eyes with normal visual fields had a slightly larger mean (+/- standard error of the mean) disc rim area (0.90 +/- 0.04 mm2) than eyes with glaucomatous visual field defects (0.78 +/- 0.05 mm2). However, both sets of eyes in the asymmetric primary open-angle glaucoma patients had smaller mean disc rim areas (P less than 0.0007) than did the control group (1.27 +/- 0.09 mm2). These findings support the hypothesis that loss of the optic disc rim can be detected before perimetric abnormalities develop in primary open-angle glaucoma.
在早期开角型青光眼中，视神经乳头可测量的结构改变可能先于视野异常出现。作者研究了10例因原发性开角型青光眼导致单侧视野缺损的患者以及12名年龄和性别匹配的正常受试者的视神经乳头。使用计算机图像分析系统（德国慕尼黑罗敦司得公司生产的罗敦司得分析仪）测量视神经乳头的地形学参数。在不对称性原发性开角型青光眼患者中，视野正常的眼睛平均视盘边缘面积（±平均标准误差）略大于有青光眼性视野缺损的眼睛，分别为0.90±0.04mm²和0.78±0.05mm²。然而，不对称性原发性开角型青光眼患者的两组眼睛的平均视盘边缘面积（P<0.0007）均小于对照组（1.27±0.09mm²）。这些发现支持了这样的假说，即在原发性开角型青光眼中，在视野异常出现之前就能检测到视盘边缘的丢失。
