Tenner A
Adv Ophthalmol. 1976;32:35-51.
The results of fluorescent angiography show that the main blood supply to the papilla comes from the ciliary circulation in the region of the lamina cribrosa, generally from the posterior ciliary arteries and less frequently from Zinn's corona, in the prelaminar region, to a considerable extent from the peripapillary choroid membrane and in the retrolaminar part also from the recurrent branches of the peripapillary choroid membrane. It also emerges that the vascular supply of the papilla in this region is arranged by segments, which explains, for example, the formation of nerve-fibre bundle defects in glaucoma. Papillary irrigation and the peripapillary choroid membrane are extremely sensitive to an increase in intra-ocular pressure. All these results provide a good basis for the assumption that, in glaucoma, the main factor producing restriction of the field of vision and excavations of the papilla is defective irrigation of the papillary vessels, originating in the choroid membrane, with chronic ischemia of the papilla. Our own studies lead us to suspect that disturbances of irrigation can precede functional disorders. For several reasons, fluorescence angiography is ill-suited to routine diagnosis. In general, however, this method does underline the significance of disturbances of papillary irrigation in the origin of glaucoma damage.
荧光血管造影结果显示，视乳头的主要血液供应来自筛板区域的睫状循环，通常来自睫状后动脉，较少来自Zinn氏血管环，在板前区域，很大程度上来自视乳头周围脉络膜，在板后部分也来自视乳头周围脉络膜的折返分支。还发现该区域视乳头的血管供应是分段排列的，这例如解释了青光眼患者神经纤维束缺损的形成。视乳头灌注和视乳头周围脉络膜对眼内压升高极为敏感。所有这些结果为以下假设提供了良好依据：在青光眼中，导致视野受限和视乳头凹陷的主要因素是源于脉络膜的视乳头血管灌注不足，伴有视乳头慢性缺血。我们自己的研究使我们怀疑灌注紊乱可能先于功能障碍出现。由于多种原因，荧光血管造影不适用于常规诊断。然而，总体而言，该方法确实强调了视乳头灌注紊乱在青光眼损害起源中的重要性。
