Tuulonen A, Jonas J B, Välimäki S, Alanko H I, Airaksinen P J
Department of Ophthalmology, University of Oulu, Finland.
Ophthalmology. 1996 Mar;103(3):535-41. doi: 10.1016/s0161-6420(96)30661-1.
The purpose of this retrospective study is to compare the measurements of intrapapillary and peripapillary parameters between two observers and test the usefulness of measuring different types of crescents.
Optic disc photographs of 23 eyes of 23 patients with glaucoma and 23 age-matched normal eyes were measured in Oulu and in Erlangen using manual planimetric techniques. The authors measured the following magnification corrected intrapapillary and peripapillary areas: optic disc, neuroretinal rim, cup: disc area ratio, scleral ring, central (zone beta), and peripheral peripapillary atrophy (zone alpha). Twenty-one patients with glaucoma had a follow-up of 3.2 years (range, 1.1-4.7 years), and follow-up for 19 control eyes was 3.7 years (range, 2.5-5.9 years). The measurements were performed in a masked fashion for the diagnosis and temporal sequence of the photographs.
Central peripapillary atrophy (zone beta) was statistically significantly largest in primary open-angle glaucoma in both centers (Oulu, P=0.003; Erlangen, P=0.004), whereas normal and exfoliative eyes did not differ significantly from each other. The results for peripheral peripapillary atrophy (zone alpha) and scleral ring were less consistent. Despite statistically significant interobserver correlations ranging from r=0.30 (scleral ring area; P=0.0472) to r=0.97 (optic disc area; P=0.0001), the means of all parameters, except for zone alpha and beta, differed statistically significantly between the two observers.
The central peripapillary atrophy, or zone beta, is the most reproducible parameter when measuring peripapillary atrophy in glaucoma. Nonetheless, its measurement is of limited usefulness in the recognition of glaucoma or progression of glaucomatous nerve damage.
本回顾性研究旨在比较两名观察者对乳头内和乳头周围参数的测量结果，并测试测量不同类型新月形区域的实用性。
使用手动平面测量技术，在奥卢和埃尔朗根对23例青光眼患者的23只眼睛以及23只年龄匹配的正常眼睛的视盘照片进行测量。作者测量了以下经放大校正的乳头内和乳头周围区域：视盘、神经视网膜边缘、杯盘面积比、巩膜环、中央（β区）和周边乳头周围萎缩（α区）。21例青光眼患者的随访时间为3.2年（范围1.1 - 4.7年），19只对照眼睛的随访时间为3.7年（范围2.5 - 5.9年）。测量过程以盲法进行，不考虑照片的诊断和时间顺序。
在两个中心，原发性开角型青光眼的中央乳头周围萎缩（β区）在统计学上均显著最大（奥卢，P = 0.003；埃尔朗根，P = 0.004），而正常眼睛和剥脱性青光眼眼睛之间差异不显著。周边乳头周围萎缩（α区）和巩膜环的结果不太一致。尽管观察者间的相关性在统计学上显著，范围从r = 0.30（巩膜环面积；P = 0.0472）到r = 0.97（视盘面积；P = 0.0001），但除α区和β区外，所有参数的均值在两名观察者之间在统计学上均有显著差异。
在测量青光眼的乳头周围萎缩时，中央乳头周围萎缩即β区是最可重复的参数。然而，其测量在青光眼的识别或青光眼性神经损伤的进展评估中作用有限。
