Barry C J, Cooper R L, Eikelboom R H
Centre for Ophthalmology and Visual Science, Lions Eye Institute, Perth, Australia.
Aust N Z J Ophthalmol. 1997 May;25(2):137-44. doi: 10.1111/j.1442-9071.1997.tb01295.x.
To retrospectively examine the optic disc photographs of a glaucoma population for optic disc haemorrhages, vascular occlusions and vascular abnormalities.
The optic disc photographs of 906 eyes of glaucoma and suspect glaucoma patients were examined. Optic disc photographs were taken annually, where possible, with the follow-up period varying between 1 and 14 years duration (mean, 2.89). Glaucoma patients are regularly reviewed every 4-6 months and glaucoma suspects every 1-2 years, depending on the ophthalmologist. Low-tension glaucoma patients were reviewed more frequently (mean, every 2.6 months). The results of the findings were compared to a control group of 39 subjects with a mean follow-up period of 7 years, using Fisher's exact test.
It was found that during the period under review, 7.4% (n = 67) of eyes had optic disc haemorrhages. The highest frequency of optic disc haemorrhages (37.5%) was found in the low tension glaucoma group (P = 0.0001) followed by 11% of primary open-angle glaucoma eyes (P = 0.03). In the normal group there were three eyes with optic disc haemorrhages and one with a disc collateral, which constitutes 5.1% vascular changes in this sub-group. Of the study eyes 2.8% had central retinal vein occlusions, 1.3% branch vein occlusion, 1.2% disc vessel abnormalities (loops) and 1.1% disc collaterals. Discrete nerve fibre layer haemorrhages and microaneurysms were found in 0.8% and 1.8% of eyes, respectively.
A total of 16.8% of the eyes observed in this study had either disc haemorrhages or vascular changes. The underlying trend of vascular and haemorrhagic changes in glaucoma are demonstrated in this sample, which is in general agreement with previous studies. The high percentage of optic disc haemorrhages in low tension glaucoma is highlighted. The presence of microaneurysms and nerve fibre layer haemorrhages is interesting but of unknown significance.
回顾性检查青光眼患者的视盘照片，以观察视盘出血、血管阻塞和血管异常情况。
检查了906只青光眼及疑似青光眼患者眼睛的视盘照片。视盘照片尽可能每年拍摄一次，随访期为1至14年（平均2.89年）。青光眼患者每4 - 6个月定期复查一次，疑似青光眼患者则根据眼科医生的安排每1 - 2年复查一次。低眼压性青光眼患者复查更为频繁（平均每2.6个月一次）。使用Fisher精确检验将检查结果与39名平均随访期为7年的对照组受试者进行比较。
发现在观察期内，7.4%（n = 67）的眼睛出现视盘出血。低眼压性青光眼组视盘出血频率最高（37.5%）（P = 0.0001），其次是原发性开角型青光眼患者的眼睛，为11%（P = 0.03）。在正常组中，有3只眼睛出现视盘出血，1只眼睛有视盘侧支血管，该亚组血管变化占5.1%。在研究的眼睛中，2.8%出现视网膜中央静脉阻塞，1.3%出现分支静脉阻塞，1.2%出现视盘血管异常（环），1.1%出现视盘侧支血管。分别有0.8%和1.8%的眼睛发现离散的神经纤维层出血和微动脉瘤。
本研究中观察到的眼睛共有16.8%出现视盘出血或血管变化。该样本显示了青光眼患者血管和出血性变化的潜在趋势，这与先前的研究总体一致。突出显示了低眼压性青光眼视盘出血的高比例。微动脉瘤和神经纤维层出血的存在很有意思，但意义不明。
