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[生理性大视杯和早期青光眼的神经视网膜边缘形态学研究]

[A study of neuroretinal rim morphology in physiologic large cups and early glaucoma].

作者信息

Xu L, Liu L, Yang H

机构信息

Beijing Institute of Ophthalmology, Beijing Tong Ren Hospital.

出版信息

Zhonghua Yan Ke Za Zhi. 1996 Mar;32(2):114-7.

PMID:9206227
Abstract

OBJECTIVE

To find the differences of the physiologic large cups from the optic cup of early glaucoma.

METHODS

The morphology of neuroretinal rim was studied. The subjects were divided into two groups: (1) 54 cases 88 eyes with physiologic large cups defined by cup/disk (C/D) ratio more than 0.6, optic disk areas more than 2.8 mm2, without neuroretinal rim loss within 3-6 years of follow-up, normal intraocular pressure and visual field. (2) 68 cases 89 eyes with early glaucoma defined by visual field defects, neuroretinal rim loss in follow-up and C/D ratio less than 0.8. The indexes of neuroretinal rim related to morphology are a series of rim widths and a parameter of cupping morphology which is a ratio of the vertical C/D over the horizontal C/D.

RESULTS

The characteristics of a physiologic large cup are a large optic disk, a horizontal elliptic cupping and the widest neuroretinal rim at the inferior, followed by superior, nasal and temporal, while the characteristics of optic nerve head of glaucoma are normal size of optic disk, vertical elliptic cupping and the widest rim not at the inferior, since the inferior rim is subject to glaucomatous damage.

CONCLUSION

To differentiate a physiologic large cup from a glaucomatous one, the most effective way is to apply the parameter of cupping morphology in combination with neuroretinal rim area and optic disk area in the multivariate discrimination.

摘要

目的

找出生理性大视杯与早期青光眼视杯之间的差异。

方法

研究神经视网膜边缘的形态。将受试者分为两组:(1)54例88眼,杯盘比(C/D)大于0.6,视盘面积大于2.8mm²,随访3 - 6年内无神经视网膜边缘丢失,眼压和视野正常,定义为生理性大视杯。(2)68例89眼,有视野缺损、随访中有神经视网膜边缘丢失且C/D比小于0.8,定义为早期青光眼。与形态相关的神经视网膜边缘指标是一系列边缘宽度和一个杯状形态参数,即垂直C/D与水平C/D之比。

结果

生理性大视杯的特征是视盘大、水平椭圆形杯状凹陷且神经视网膜边缘最宽处位于下方,其次是上方、鼻侧和颞侧,而青光眼视神经乳头的特征是视盘大小正常、垂直椭圆形杯状凹陷且最宽边缘不在下方,因为下方边缘易受青光眼损害。

结论

要区分生理性大视杯和青光眼性视杯,最有效的方法是在多变量判别中应用杯状形态参数并结合神经视网膜边缘面积和视盘面积。

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