Schwartz B
Jpn J Ophthalmol. 1986;30(2):143-53.
Most ophthalmologists use subjective methods to evaluate the optic disc for abnormalities and changes that occur in ocular hypertension and glaucoma. We have developed new techniques that allow more accurate evaluation of the blood supply to the optic disc and of changes in disc cupping and pallor. To evaluate the blood supply we use the technique of fluorescein angiography of the optic disc. With this technique, we have found that fluorescein defects commonly appear in open-angle glaucoma and ocular hypertension and are more frequent and larger in glaucomatous and ocular hypertensive discs than in normal optic discs. Fluorescein angiography demonstrates distinct changes in the blood supply to the optic disc in the glaucomatous or ocular hypertensive eye. Cupping of the optic disc is measured by photogrammetry from stereophotographs, which provide three-dimensional measurements not only of the volume of the cup, but of the depth, the slopes of the walls of the optic cup, and the area of the surface opening. This technique also allows us to determine a volume profile of the cup: that is, its cross-sectional area from top to bottom. The volume profile characterizes the shape of the optic cup and shows distinct differences in shape between normal, ocular hypertensive and glaucomatous cups. Pallor is measured by computerized image analysis. This technique allows us to determine the percent area of pallor of the optic disc. These three techniques permit us not only to evaluate abnormalities, but to measure changes over time in the optic disc in ocular hypertension and glaucoma, thereby increasing our diagnostic capability and improving patient management.
大多数眼科医生采用主观方法来评估视盘是否存在高眼压症和青光眼所出现的异常及变化。我们已经开发出了新的技术，能够对视盘的血液供应以及视盘杯状凹陷和苍白的变化进行更准确的评估。为了评估血液供应，我们采用视盘荧光血管造影技术。通过这项技术，我们发现荧光素缺损在开角型青光眼和高眼压症中普遍出现，并且在青光眼和高眼压症患者的视盘中比正常视盘更频繁且范围更大。荧光血管造影显示了青光眼或高眼压症患者眼睛视盘血液供应的明显变化。视盘杯状凹陷通过立体照片的摄影测量法进行测量，这种方法不仅能提供杯状凹陷的三维测量，还能测量其深度、视杯壁的斜率以及表面开口的面积。这项技术还使我们能够确定杯状凹陷的体积轮廓，即从顶部到底部的横截面积。体积轮廓描绘了视杯的形状，并显示出正常、高眼压症和青光眼视杯在形状上的明显差异。苍白通过计算机图像分析进行测量。这项技术使我们能够确定视盘苍白的面积百分比。这三种技术不仅使我们能够评估异常情况，还能测量高眼压症和青光眼患者视盘随时间的变化，从而提高我们的诊断能力并改善患者管理。
