Quigley H A
Am J Ophthalmol. 1977 Sep;84(3):358-70. doi: 10.1016/0002-9394(77)90680-8.
The pathogenesis of reversible cupping of the optic disk in congenital glaucoma was examined by two approaches. Human fetal, neonatal, and adult eyes were examined by histochemistry and electron microscopy to delineate the embryologic development of the optic nerve head. While the neural, glial, and vascular elements of the nerve head attain their adult configuration by midgestation, the connective tissues of the lamina cribrosa are incompletely developed at birth. The response of the optic disk cup to elevated intraocular pressure (IOP) was observed in enucleated infant and adult eyes. While no disk changes were seen in adult eyes subjected to an IOP up to 90 mm Hg for 24 hours, enlargement of the disk cup in infant eyes was documented photographically and histologically after eight to 24 hours of IOP elevations to 50 mg Hg. Reversible cupping in congenital glaucoma can be best explained by compression or posterior movement of optic disk tissues--a result of the incomplete collagenous structural framework of the lamina cribrosa during late gestation and early neonatal life.
通过两种方法研究了先天性青光眼视盘可逆性杯状凹陷的发病机制。采用组织化学和电子显微镜检查人胎儿、新生儿及成人眼睛，以描绘视神经乳头的胚胎发育。虽然神经乳头的神经、胶质和血管成分在妊娠中期达到成人形态，但筛板的结缔组织在出生时发育不完全。在摘除的婴儿和成人眼睛中观察视盘杯对眼内压升高的反应。当成人眼睛眼内压高达90mmHg持续24小时时未观察到视盘变化，但当婴儿眼睛眼内压升高至50mmHg持续8至24小时后，通过摄影和组织学记录到视盘杯扩大。先天性青光眼中的可逆性杯状凹陷最好用视盘组织的受压或后移来解释，这是妊娠晚期和新生儿早期筛板胶原结构框架不完全的结果。
