Nduaguba C, Ugurlu S, Caprioli J
Yale University School of Medicine, Department of Ophthalmology and Visual Science, New Haven, CT 06520, USA.
Acta Ophthalmol Scand. 1998 Jun;76(3):273-7. doi: 10.1034/j.1600-0420.1998.760304.x.
This study was performed to determine the prevalence of acquired pits of the optic nerve (APON) in glaucoma and the characteristics of associated visual field loss.
Stereoscopic optic disc photos from 235 patients with a low-tension variety of primary open-angle glaucoma (LTG) and 251 primary open-angle glaucoma patients with intraocular pressures higher than 21 mmHg (HTG) were examined for the presence of typical APON as defined by a standard photograph (Fig 1). Associated visual field loss was evaluated with automated perimetry and patterns of field loss were identified.
Out of a total of 486 patients, 63 APON were found in 51 eyes of 44 glaucoma patients. APONs were more prevalent in women. Acquired pits were more frequently (p<0.001) located inferiorly (70%) than superiorly (30%). There was a significantly higher prevalence (p<0.001) of APON in LTG patients (12.7%) than in HTG patients (5.6%). Dense visual field defects within five degrees of fixation occurred in 96% of patients with APON.
Acquired pits of the optic nerve are more often located at the inferior optic disc than at the superior disc and are nearly always associated with visual field loss close to fixation. In a glaucoma referral center setting, APON are more prevalent in lower pressure glaucoma than in higher pressure glaucoma.
本研究旨在确定青光眼患者中获得性视神经凹陷（APON）的患病率以及相关视野缺损的特征。
对235例低眼压性原发性开角型青光眼（LTG）患者和251例眼压高于21 mmHg的原发性开角型青光眼患者（HTG）的立体视盘照片进行检查，以确定标准照片所定义的典型APON（图1）。采用自动视野计评估相关视野缺损情况，并确定视野缺损模式。
在总共486例患者中，44例青光眼患者的51只眼中发现了63个APON。APON在女性中更为常见。获得性凹陷位于下方（70%）的频率高于上方（30%）（p<0.001）。LTG患者中APON的患病率（12.7%）显著高于HTG患者（5.6%）（p<0.001）。96%的APON患者在注视点5度范围内出现密集的视野缺损。
获得性视神经凹陷更多位于视盘下方而非上方，且几乎总是与靠近注视点的视野缺损相关。在青光眼转诊中心环境中，APON在低压性青光眼患者中比在高压性青光眼患者中更为普遍。
