Jonas J B, Schiro D
Department of Ophthalmology, University Erlangen-Nürnberg, Germany.
Br J Ophthalmol. 1994 Apr;78(4):285-90. doi: 10.1136/bjo.78.4.285.
Glaucoma can be associated with a diffuse or localised loss of the retinal nerve fibre layer (RNFL). This study evaluated the wedge shaped localised RNFL defects. Red free wide angle RNFL photographs of 421 patients with glaucoma and 193 normal subjects were examined. Localised RNFL defects were described for one eye of the normal group and for 20% of the patients with glaucoma. They were usually located in the inferior temporal and superior temporal fundus regions. Within the glaucoma group, localised RNFL defects occurred most often (p < 0.05) in normal pressure glaucoma, followed by primary open angle glaucoma, and finally secondary open angle glaucoma. They were positively associated with disc haemorrhages. The localised RNFL defects had a high specificity to indicate optic nerve damage. The nerve fibre layer defects occurring more likely in mild rather than advanced glaucoma, they were helpful in the diagnosis of early glaucoma. The association between localised RNFL defects and disc haemorrhages and the varying frequency of localised RNFL defects in different types of glaucoma may be important diagnostically and pathogenetically.
青光眼可能与视网膜神经纤维层（RNFL）的弥漫性或局限性缺失有关。本研究评估了楔形局限性RNFL缺损。检查了421例青光眼患者和193例正常受试者的无赤广角RNFL照片。对正常组的一只眼睛和20%的青光眼患者描述了局限性RNFL缺损。它们通常位于颞下和颞上眼底区域。在青光眼组中，局限性RNFL缺损最常出现在正常眼压性青光眼中（p<0.05），其次是原发性开角型青光眼，最后是继发性开角型青光眼。它们与视盘出血呈正相关。局限性RNFL缺损对指示视神经损伤具有较高的特异性。神经纤维层缺损更可能发生在轻度而非晚期青光眼中，有助于早期青光眼的诊断。局限性RNFL缺损与视盘出血之间的关联以及不同类型青光眼中局限性RNFL缺损的不同频率在诊断和发病机制上可能具有重要意义。
