Uchida H, Ugurlu S, Caprioli J
Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut, USA.
Ophthalmology. 1998 Aug;105(8):1541-5. doi: 10.1016/S0161-6420(98)98044-7.
This study aimed to determine the incidence and degree of progression of peripapillary atrophy in progressive and nonprogressive glaucoma.
A retrospective cohort study.
A total of 75 eyes of 75 patients were examined.
Qualitative assessment of optic disc, peripapillary atrophy,and visual field change was performed by three experienced, masked, independent observers.
Rim-disc area ratio and peripapillary atrophy-disc area ratio were measured at baseline and follow-up with computer-aided planimetry.
Among 75 eyes studied with an average duration of follow-up of 8 years (range, 4-19 years), 33 (44%) showed progressive optic disc damage. Twenty-one (64%) of 33 eyes with progressive disc damage showed peripapillary atrophy progression, and 7 (17%) of 42 eyes without progressive disc damage showed peripapillary atrophy progression; this difference was significant (P < 0.01). In groups with and without peripapillary atrophy, no statistically significant differences were found for mean intraocular pressure, baseline rim-disc area ratio, or baseline peripapillary atrophy-disc area ratio. However, optic disc progression and visual field progression were statistically more frequent in the group with peripapillary atrophy progression (75% and 54%, respectively) than in the group without peripapillary atrophy progression (26% and 11%, respectively) (P < 0.01). There was a statistically significant correlation between measurements of peripapillary atrophy area increase and disc rim loss over time (r = -0.35, P = 0.002).
Progression of peripapillary atrophy is associated with progressive optic disc damage and progressive visual field loss in glaucoma and may be used as a marker for progressive glaucomatous damage.
本研究旨在确定进展性和非进展性青光眼患者视盘周围萎缩的发生率及进展程度。
一项回顾性队列研究。
共检查了75例患者的75只眼。
由三名经验丰富、不知情的独立观察者对视盘、视盘周围萎缩和视野变化进行定性评估。
在基线期和随访期采用计算机辅助平面测量法测量视盘边缘面积比和视盘周围萎缩面积与视盘面积比。
在平均随访8年（范围4 - 19年）的75只眼中，33只眼（44%）出现了进展性视盘损害。33只出现进展性视盘损害的眼中，21只（64%）出现了视盘周围萎缩进展，42只未出现进展性视盘损害的眼中，7只（17%）出现了视盘周围萎缩进展；差异具有统计学意义（P < 0.01）。在有和无视盘周围萎缩的组中，平均眼压、基线视盘边缘面积比或基线视盘周围萎缩面积与视盘面积比均无统计学显著差异。然而，视盘周围萎缩进展组的视盘进展和视野进展在统计学上比无视盘周围萎缩进展组更频繁（分别为75%和54% 对比 26%和11%）（P < 0.01）。视盘周围萎缩面积增加的测量值与随时间的视盘边缘丢失之间存在统计学显著相关性（r = -0.35，P = 0.002）。
视盘周围萎缩进展与青光眼患者的进展性视盘损害和进展性视野缺损相关，可作为进展性青光眼损害的一个标志物。
