脉络膜毛细血管、光感受器与视乳头旁α、β、γ和δ区的空间关系。
Choriocapillaris, Photoreceptors, and Inner Retinal Layer in Spatial Relationship to Parapapillary Alpha, Beta, Gamma, and Delta Zones.
机构信息
Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland.
出版信息
Invest Ophthalmol Vis Sci. 2023 Sep 1;64(12):12. doi: 10.1167/iovs.64.12.12.
PURPOSE
To examine the spatial relationships between the retinal inner nuclear layer (INL), outer nuclear layer (ONL), retinal pigment epithelium (RPE) layer, Bruch's membrane (BM), and choriocapillaris in the parapapillary region.
METHODS
Human eyes enucleated due to uveal melanomas or secondary angle-closure glaucoma were histomorphometrically examined. We compared the tissue dimensions between four groups of eyes categorized based on the presence/absence of high myopia and glaucoma.
RESULTS
The investigation consisted of 100 globes (axial length: 25.6 ± 3.1 mm; range: 20.0-35.0 mm). In non-highly myopic nonglaucomatous eyes, the INL, ONL, RPE, BM, and choriocapillaris ended approximately at the end of the RPE layer, with no significant (all P ≥ 0.10) difference between the layers in their distance to the RPE-layer end. From non-highly myopic nonglaucomatous eyes to non-highly myopic glaucomatous eyes, highly myopic nonglaucomatous eyes, and eventually highly myopic glaucomatous eyes, the choriocapillaris, INL, and ONL increasingly extended into the beta zone, most marked for the choriocapillaris and least marked for the ONL. A larger extension of the choriocapillaris into the parapapillary beta zone correlated with longer axial length (standardized regression coefficient β, 0.24; B, 23.0; 95% confidence interval [CI], 1.6-44.5; P = 0.04) and wider parapapillary beta zone (β, 0.59; B, 0.32; 95% CI, 0.22-0.41; P < 0.001); a larger extension of the INL correlated with longer axial length (β, 0.34; B, 43.7; 95% CI, 11.6-75.7; P = 0.009), longer gamma zone (β, 0.52; B, 0.28; 95% CI, 0.15-0.41; P < 0.001), and diagnosis of non-highly myopic glaucoma (β, 0.28; B, 267; 95% CI, 80.8-454; P = 0.006); and a larger extension of the ONL into parapapillary beta zone correlated with longer axial length (β, 0.50; B, 32.2; 95% CI, 21.6-42.8; P < 0.001) and wider parapapillary beta zone (β, 0.28; B, 0.10; 95% CI, 0.04-0.16; P < 0.001).
CONCLUSIONS
Nonglaucomatous non-highly myopic eyes differ from highly myopic eyes and glaucomatous eyes in the spatial relationship of the parapapillary tissue layers.
目的
研究视乳头旁组织视网膜内、外核层（INL 和 ONL）、视网膜色素上皮（RPE）层、Bruch 膜（BM）和脉络膜毛细血管在视乳头旁的空间关系。
方法
对因脉络膜黑色素瘤或继发性闭角型青光眼而被摘除眼球的人进行组织形态计量学检查。我们比较了根据是否存在高度近视和青光眼而分为四组的眼睛的组织尺寸。
结果
该研究共纳入 100 只眼球（眼轴长度：25.6 ± 3.1 毫米；范围：20.0-35.0 毫米）。在非高度近视非青光眼眼中，INL、ONL、RPE、BM 和脉络膜毛细血管终止于 RPE 层的末端，各层与 RPE 层末端的距离无显著差异（所有 P≥0.10）。从非高度近视非青光眼眼到非高度近视青光眼眼、高度近视非青光眼眼，最终到高度近视青光眼眼，脉络膜毛细血管、INL 和 ONL 越来越多地延伸到β区，脉络膜毛细血管最为明显，ONL 则最为不明显。脉络膜毛细血管向视乳头旁β区的更大延伸与更长的眼轴长度（标准化回归系数β，0.24；B，23.0；95%置信区间[CI]，1.6-44.5；P=0.04）和更宽的视乳头旁β区（β，0.59；B，0.32；95%CI，0.22-0.41；P<0.001）相关；INL 的更大延伸与更长的眼轴长度（β，0.34；B，43.7；95%CI，11.6-75.7；P=0.009）、更长的γ区（β，0.52；B，0.28；95%CI，0.15-0.41；P<0.001）和非高度近视青光眼的诊断（β，0.28；B，267；95%CI，80.8-454；P=0.006）相关；而 ONL 向视乳头旁β区的更大延伸与更长的眼轴长度（β，0.50；B，32.2；95%CI，21.6-42.8；P<0.001）和更宽的视乳头旁β区（β，0.28；B，0.10；95%CI，0.04-0.16；P<0.001）相关。
结论
非青光眼性非高度近视眼与高度近视眼和青光眼眼在视乳头旁组织层的空间关系上存在差异。
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