Sugiyama K, Tomita G, Kitazawa Y, Onda E, Shinohara H, Park K H
Department of Ophthalmology, Gifu University School of Medicine, Japan.
Ophthalmology. 1997 Nov;104(11):1926-33. doi: 10.1016/s0161-6420(97)30005-0.
The purpose of the study is to elucidate a topographic correlation between optic disc hemorrhages and retinal nerve fiber layer defects as well as peripapillary atrophy in normal-tension glaucoma (NTG).
The authors prospectively studied the relation between the precise locations of disc hemorrhages and retinal nerve fiber layer defects in the first part of the study. The authors also compared morphometrically the peripapillary atrophy and the optic disc in eyes with disc hemorrhage with eyes without a history of disc hemorrhage in age-matched patients in the second part of the study.
In part 1, 42 patients with NTG (male/female = 11/31; age, 56.8 +/- 14.2 years) in whom new disc hemorrhages developed were enrolled. In part 2, 51 randomly selected age-matched patients with NTG without a history of disc hemorrhage (male/female = 16/35; age, 55.7 +/- 12.5) were examined.
In part 1, retinal nerve fiber layer defects were observed by scanning laser ophthalmoscopy using an argon-blue laser. In part 2, the area, angular extent, and radial extent of zone beta of peripapillary atrophy and the structural parameters of optic disc were measured by scanning laser tomography using a diode laser.
In part 1, the authors detected 64 disc hemorrhages in 48 eyes of 42 patients; retinal nerve fiber layer defects were shown in 47 (97.9%) of 48 eyes by scanning laser ophthalmoscopy. Of 64 disc hemorrhages, 51 (79.7%) coincided with retinal nerve fiber layer defects in location. These 51 hemorrhages were present on the border (41.2%) or adjacent to the border (58.8%) between the retinal nerve fiber layer defect and the apparently healthy-looking retinal nerve fiber layer. In part 2, the prevalence, area, angular extent of zone beta, and ratio of zone beta area to disc area were significantly greater in the disc hemorrhage group than in the nonhemorrhage group, even though there were no significant differences in disc parameters between the two groups.
Disc hemorrhage is associated closely with retinal nerve fiber layer defect in location and the size of peripapillary atrophy in NTG.
本研究旨在阐明正常眼压性青光眼（NTG）中视盘出血与视网膜神经纤维层缺损以及视盘周围萎缩之间的地形学相关性。
在研究的第一部分，作者前瞻性地研究了视盘出血的精确位置与视网膜神经纤维层缺损之间的关系。在研究的第二部分，作者还对年龄匹配的有视盘出血的患者与无视盘出血病史的患者的视盘周围萎缩和视盘进行了形态学比较。
在第一部分，纳入了42例出现新的视盘出血的NTG患者（男/女 = 11/31；年龄，56.8±14.2岁）。在第二部分，检查了51例随机选择的年龄匹配的无视盘出血病史的NTG患者（男/女 = 16/35；年龄，55.7±12.5）。
在第一部分，使用氩蓝激光通过扫描激光眼底镜观察视网膜神经纤维层缺损。在第二部分，使用二极管激光通过扫描激光断层扫描测量视盘周围萎缩β区的面积、角度范围和径向范围以及视盘的结构参数。
在第一部分，作者在42例患者的48只眼中检测到64处视盘出血；通过扫描激光眼底镜在48只眼中的47只（97.9%）显示有视网膜神经纤维层缺损。在64处视盘出血中，51处（79.7%）在位置上与视网膜神经纤维层缺损重合。这51处出血位于视网膜神经纤维层缺损与外观看似健康的视网膜神经纤维层之间的边界处（41.2%）或边界附近（58.8%）。在第二部分，视盘出血组中β区的患病率、面积、角度范围以及β区面积与视盘面积的比值均显著高于无出血组，尽管两组之间的视盘参数无显著差异。
在NTG中，视盘出血在位置上与视网膜神经纤维层缺损以及视盘周围萎缩的大小密切相关。
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