Department of Ophthalmology, Kyorin University, School of Medicine, Tokyo, Japan.
Eye (Lond). 2024 Feb;38(2):266-273. doi: 10.1038/s41433-023-02671-0. Epub 2023 Jul 31.
To investigate the relationship between the shape of the optic nerve head (ONH) margin detected by optical coherence tomography (OCT) and the clinical characteristics of glaucomatous eyes with papillomacular retinoschisis (PMRS).
The medical record of patients with a PMRS in a glaucomatous eye were reviewed. The eyes were placed into two groups determined by the shape of the ONH margin in the OCT images; eyes with an externally oblique ONH margin (Group 1) and eyes with an internally oblique ONH margin (Group 2). We compared the clinical characteristics of the PMRS of these two groups.
We studied 31 eyes of 29 patients with PMRS and glaucoma with 24 eyes in Group 1 and 7 eyes in Group 2. The optic nerve fibre layer schisis on the lamina cribrosa (LC), beta zone, and gamma zone, and found that the LC defects were detected significantly more frequently in Group 1 than in Group 2 eyes (P < 0.05). A retinal nerve fibre schisis was observed around the ONH significantly more frequently in Group 2 than in Group 1 eyes (P < 0.01).
The cases of glaucoma-associated PMRS could be classified into two groups according to the obliquity of the ONH. They had differences in the findings of OCT and FA. The possibility that the mechanism of PMRS development is different in both groups is suggested.
探讨光学相干断层扫描(OCT)检测到的视神经头(ONH)边缘形状与伴有黄斑神经视网膜劈裂(PMRS)的青光眼眼的临床特征之间的关系。
回顾了青光眼合并 PMRS 患者的病历。根据 OCT 图像中 ONH 边缘的形状将这些眼分为两组:ONH 边缘外斜组(第 1 组)和 ONH 边缘内斜组(第 2 组)。我们比较了这两组 PMRS 的临床特征。
我们研究了 31 只患有 PMRS 和青光眼的眼,其中 24 只眼位于第 1 组,7 只眼位于第 2 组。在筛板层(LC)、β区和γ区的神经纤维层劈裂,发现 LC 缺损在第 1 组中比第 2 组更频繁地检测到(P < 0.05)。在第 2 组中,ONH 周围的视网膜神经纤维劈裂明显比第 1 组更频繁(P < 0.01)。
根据 ONH 的倾斜度,青光眼相关性 PMRS 病例可分为两组。它们在 OCT 和 FA 的发现上存在差异。提示两组 PMRS 发展的机制可能不同。