Stroman G A, Stewart W C, Golnik K C, Curé J K, Olinger R E
Department of Ophthalmology, Medical University of South Carolina, Charleston.
Arch Ophthalmol. 1995 Feb;113(2):168-72. doi: 10.1001/archopht.1995.01100020050027.
To study diagnoses and anatomic findings found on magnetic resonance imaging in patients with low-tension glaucoma.
We included in this study magnetic resonance images of 20 consecutive patients with low-tension glaucoma. We individually matched each patient with low-tension glaucoma to a control with normal ocular findings who had magnetic resonance imaging for reasons unrelated to the visual pathway.
We studied axial and coronal images of the orbit and optic nerve with digitizing software (Image-Pro Plus, Media Cybernetics, Silver Spring, Md). Statistical evaluation was with a Wilcoxon Signed Rank Test for anatomic findings and a McNemar Test for diagnosis.
We found no difference between groups in the optic nerve diameter or length, the carotid artery area, or the distance from the optic nerve to the carotid artery (P > .05). Left optic nerve area was greater in the control patients than patients with low-tension glaucoma (P = .026). The prevalence of intracranial abnormalities, including meningioma, aneurysm, and arteriovenous abnormality, was similar between groups (P > .05). However, diffuse cerebral small-vessel ischemic changes were found more in patients with low-tension glaucoma (n = 8) than control patients (n = 1) (P = .0196).
This study proposes a hypothesis that cerebral small-vessel ischemia is more common in patients with low-tension glaucoma and potentially reflects indirectly a vascular cause of the optic nerve head damage at least in a subgroup of patients. Importantly, further research still is required to provide direct evidence for a vascular cause involved in low-tension glaucoma.
研究低眼压性青光眼患者磁共振成像的诊断结果及解剖学发现。
本研究纳入了连续20例低眼压性青光眼患者的磁共振图像。我们将每例低眼压性青光眼患者分别与一名眼部检查正常的对照者匹配，该对照者因与视觉通路无关的原因接受了磁共振成像检查。
我们使用数字化软件（Image-Pro Plus，Media Cybernetics，银泉，马里兰州）研究眼眶和视神经的轴位及冠状位图像。对解剖学发现采用Wilcoxon符号秩检验进行统计学评估，对诊断采用McNemar检验。
两组在视神经直径、长度、颈动脉面积或视神经到颈动脉的距离方面无差异（P > 0.05）。对照患者的左侧视神经面积大于低眼压性青光眼患者（P = 0.026）。两组颅内异常（包括脑膜瘤、动脉瘤和动静脉畸形）的患病率相似（P > 0.05）。然而，低眼压性青光眼患者（n = 8）中发现弥漫性脑小血管缺血性改变的情况比对照患者（n = 1）更多（P = 0.0196）。
本研究提出一个假设，即脑小血管缺血在低眼压性青光眼患者中更常见，并且可能至少在一部分患者中间接反映了视神经乳头损害的血管原因。重要的是，仍需要进一步研究为低眼压性青光眼所涉及的血管原因提供直接证据。
