Nicolela M T, Drance S M
Department of Ophthalmology, University of British Columbia, Vancouver, Canada.
Ophthalmology. 1996 Apr;103(4):640-9. doi: 10.1016/s0161-6420(96)30640-4.
To study the prevalence of risk factors for glaucoma as well as the pattern of visual field defects and their progression in patients with open angle glaucoma with different and distinct optic nerve appearances.
One thousand seven hundred eleven optic disc stereo photographs of patients with glaucoma and ocular hypertension and of those suspected of having glaucoma were reviewed to identify pure examples of discs with four different optic disc appearances: focal ischemic discs, myopic glaucomatous discs, senile sclerotic discs, and generalized enlargement of the optic cup discs. The clinical charts of the selected patients were reviewed, with emphasis on the presence of predetermined ocular and systemic risk factors. Their automated visual fields also were analyzed.
Thiry-four patients with focal ischemic discs, 38 with myopic glaucomatous discs, 22 with senile sclerotic discs, and 23 with generalized enlargement of the optic cup discs were selected. Patients with myopic glaucoma and generalized enlargement of the optic cup discs were significantly younger than patients with focal ischemic and senile sclerotic discs. There were more women in the focal ischemic group. Patients with senile sclerotic discs had a significantly higher prevalence of ischemic heart disease; they also had a higher prevalence of systemic hypertension, which did not reach statistical significance. Migraine was 2.5 times more frequent in the focal ischemic group than in the other groups. Intraocular pressure was significantly higher in the generalized enlargement group. The pattern of visual field defect in the four groups also was distinctly different.
Patients with different disc appearances, selected only from their disc photographs, showed differences in their demographic characteristics, prevalence of certain systemic risk factors, intraocular pressure levels, and the pattern of their visual field damage. These findings suggest that these various disc appearances probably represent different populations of patients with glaucoma with, possibly, different pathogenic mechanisms.
研究青光眼危险因素的患病率，以及不同视神经表现的开角型青光眼患者的视野缺损模式及其进展情况。
回顾了1711例青光眼、高眼压症患者以及疑似青光眼患者的视盘立体照片，以识别具有四种不同视盘表现的纯视盘示例：局灶性缺血性视盘、近视性青光眼视盘、老年性硬化性视盘和视杯普遍扩大的视盘。对所选患者的临床病历进行了回顾，重点关注预先确定的眼部和全身危险因素的存在情况。还分析了他们的自动视野。
选择了34例局灶性缺血性视盘患者、38例近视性青光眼视盘患者、22例老年性硬化性视盘患者和23例视杯普遍扩大的视盘患者。近视性青光眼和视杯普遍扩大的视盘患者明显比局灶性缺血性和老年性硬化性视盘患者年轻。局灶性缺血组女性更多。老年性硬化性视盘患者缺血性心脏病的患病率显著更高；他们的系统性高血压患病率也更高，但未达到统计学意义。局灶性缺血组偏头痛的发生率是其他组的2.5倍。普遍扩大组的眼压明显更高。四组的视野缺损模式也明显不同。
仅从视盘照片中选择的具有不同视盘表现的患者在人口统计学特征、某些全身危险因素的患病率、眼压水平以及视野损害模式方面存在差异。这些发现表明，这些不同的视盘表现可能代表了不同人群的青光眼患者，其致病机制可能不同。
