Xu L, Liu L, Yang H
Beijing Institute of Ophthalmology.
Zhonghua Yan Ke Za Zhi. 1994 Jul;30(4):245-8.
Quigley's hypothesis indicates that the dense connective tissue is the least and the pores of the lamina cribrosa are the largest at the superior and inferior poles of the lamina cribrosa, therefore they are the most vulnerable locations to be involved by the characteristic glaucomatous optic nerve damage. To get clinical evidences of the hypothesis, the reversal or contraction of glaucomatous optic cup after reduction of intraocular pressure (IOP) was examined (The change is primarily caused by intraocular hypertension--induced distortion and posterior ectasia of the lamina cribrosa which moves forward reversely, leading to dilated optic cup contraction.). The method of examination was a stereoscopic flicker comparison with a computerized image system, alternatively displaying superposed 2 serial stereo pairs rapidly and the changing part presenting jumping appearance. Under stereoscopic observations, the changes of 3-dimension optic cup end be seen and the false positive phenomena caused by photographic angle variation, vascular pulsation, etc. can be differentiated from the characteristic changes of the cup. Stereo fundus photographs were taken from 31 eyes with high intraocular pressures before and after treatment for reduction of IOPs which was either diamox administration or trabeculectomy. The results show that the reversal of optic cups after reduction of IOPs are mostly asymmetrical, especially at the superior and/or inferior poles. By multiple stepwise regression, it is known that the amount of the change is only correlated with the initial IOP.(ABSTRACT TRUNCATED AT 250 WORDS)
奎格利假说表明,在筛板的上下极,致密结缔组织最少,筛板孔最大,因此它们是最易受典型青光眼性视神经损害累及的部位。为获得该假说的临床证据,对眼压降低后青光眼性视杯的逆转或收缩情况进行了检查(这种变化主要是由高眼压引起的筛板变形和向后膨隆,筛板向后反向移动,导致视杯扩张收缩)。检查方法是使用计算机图像系统进行立体闪烁比较,快速交替显示叠加的两组连续立体图像对,变化部分呈现跳动外观。在立体观察下,可以看到三维视杯的变化,并且可以将由摄影角度变化、血管搏动等引起的假阳性现象与视杯的特征性变化区分开来。对31只高眼压眼在进行降低眼压治疗(即服用醋甲唑胺或小梁切除术)前后拍摄了立体眼底照片。结果表明,眼压降低后视杯的逆转大多不对称,尤其是在上下极。通过多元逐步回归可知,变化量仅与初始眼压相关。(摘要截取自250字)