Park K H, Tomita G, Liou S Y, Kitazawa Y
Department of Ophthalmology, College of Medicine, Seoul National University Hospital, Korea.
Ophthalmology. 1996 Nov;103(11):1899-906. doi: 10.1016/s0161-6420(96)30409-0.
To investigate the correlation between peripapillary atrophy and visual field defects as well as optic nerve head configurations in patients with normal-tension glaucoma (NTG).
Topographic measurements for peripapillary atrophy and optic nerve head using confocal scanning laser tomography and automated static threshold perimetry were performed on 102 eyes of 51 patients with NTG. Peripapillary atrophy was divided into (1) a central zone (zone Beta) with visible, large choroidal vessels and sclera, and (2) a peripheral zone (zone Alpha) with irregular hyper- and hypopigmentation. The area, angular extent around the disc, and radial extent of each zone were measured.
The area and extent of zone Beta increased significantly with increasing visual field defects expressed in terms of mean deviation, corrected pattern standard deviation, central visual field defects within 5 degrees of fixation, and superior hemifield defects (r = 0.3770-0.5291, P < 0.01). The angular extent of zone Beta represented localized field defects better (r = 0.5217, P < 0.001) than diffuse field defects (r = -0.3770, P < 0.01). Zone Beta significantly correlated with optic nerve head topography. Intraindividual right-left-side differences of corrected pattern standard deviation showed the highest correlation with the side differences of zone Beta area (r = 0.6305, P < 0.001). The location of visual field defects correlated significantly with the location of peripapillary atrophy (chi-square = 9.0484, P = 0.011). Zone Alpha was not significantly correlated with visual field defects or optic nerve head configurations (P > 0.05).
Peripapillary atrophy is significantly associated with functional and structural optic nerve damage in NTG.
研究正常眼压性青光眼（NTG）患者视乳头周围萎缩与视野缺损以及视神经乳头形态之间的相关性。
对51例NTG患者的102只眼进行共焦扫描激光断层扫描对视乳头周围萎缩和视神经乳头进行地形图测量，并进行自动静态阈值视野检查。视乳头周围萎缩分为：（1）中央区（β区），可见粗大脉络膜血管和巩膜；（2）周边区（α区），色素沉着不规则，有色素增多和色素脱失。测量每个区域的面积、视盘周围的角度范围和径向范围。
β区的面积和范围随着以平均偏差、校正模式标准差、固定点5度范围内的中央视野缺损和上半视野缺损表示的视野缺损增加而显著增加（r = 0.3770 - 0.5291，P < 0.01）。β区的角度范围比弥漫性视野缺损（r = -0.3770，P < 0.01）能更好地反映局限性视野缺损（r = 0.5217，P < 0.001）。β区与视神经乳头地形图显著相关。校正模式标准差的个体左右侧差异与β区面积的侧别差异相关性最高（r = 0.6305，P < 0.001）。视野缺损的位置与视乳头周围萎缩的位置显著相关（χ² = 9.0484，P = 0.011）。α区与视野缺损或视神经乳头形态无显著相关性（P > 0.05）。
视乳头周围萎缩与NTG患者的视神经功能和结构损害显著相关。
