Initial Arcuate Defects within the Central 10 Degrees in Glaucoma
Initial Arcuate Defects within the Central 10 Degrees in Glaucoma
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DOI：
10.1167/iovs.10-5803
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发表时间：
2011-02-01
影响因子：
4.4
通讯作者：
Ritch, Robert
中科院分区：
文献类型：
--
作者：
Hood, Donald C.;Raza, Ali S.;Ritch, Robert
目的.为了更好地了解在无彩色视野上主要局限于中央10度的昏迷性弓形缺陷患者的功能（视野[VF]损失）和结构（轴突损失）异常的空间模式之间的关系。11只眼（9例患者）的弧形青光眼VF缺陷主要局限于黄斑，从一个更大的患者组中选择10-2和24-2 VF测试。如果眼睛的10-2 VF有弓形缺陷，并且如果24-2测试在中心10度之外正常（即，在半场内没有三个连续点的群集）。对于结构分析，使用频域光学相干断层扫描（fdOCT）获得黄斑的视网膜神经纤维层（RNFL）厚度图。视乳头周围fdOCT扫描确定RNFL缺损的视盘位置。10-2测试时VF弧形缺损延伸至1个注视点内，11只眼中有10只出现在上级半视野。11只患眼黄斑部fdOCT扫描均可见弧形RNFL损伤，在视乳头周围扫描上累及视盘颞侧和颞下部分。青光眼性黄斑RNFL的弓形缺陷与主弓形束的峰值的盘颞部相遇，并产生一系列黄斑VF缺陷，从清晰的弓形暗点到视乳头中央凹水平台阶（“手枪筒暗点”）。如果考虑RGC位移，RNFL和VF缺陷可以直接进行比较。（Invest Ophthalmol维斯科学。2011;52：940-946）DOI：10.1167/iovs.10-5803
PURPOSE. To better understand the relationship between the spatial patterns of functional (visual field [VF] loss) and structural (axon loss) abnormalities in patients with glaucomatous arcuate defects largely confined to the central 10 degrees on achromatic perimetry.METHODS. Eleven eyes (9 patients) with arcuate glaucomatous VF defects largely confined to the macula were selected from a larger group of patients with both 10-2 and 24-2 VF tests. Eyes were included if their 10-2 VF had an arcuate defect and if the 24-2 test was normal outside the central 10 degrees (i.e., did not have a cluster of three contiguous points within a hemifield). For the structural analysis, plots of retinal nerve fiber layer (RNFL) thickness of the macula were obtained with frequency-domain optical coherence tomography (fdOCT). The optic disc locations of the RNFL defects were identified on peripapillary fdOCT scans.RESULTS. The VF arcuate defects extended to within 1 of fixation on the 10-2 test and were present in the superior hemifield in 10 of the 11 eyes. The arcuate RNFL damage, seen in the macular fdOCT scans of all 11 eyes, involved the temporal and inferior temporal portions of the disc on the peripapillary scans.CONCLUSIONS. Glaucomatous arcuate defects of the macula's RNFL meet the disc temporal to the peak of the main arcuate bundles and produce a range of macular VF defects from clear arcuate scotomas to a papillofoveal horizontal step ("pistol barrel scotoma"). If RGC displacement is taken into consideration, the RNFL and VF defects can be compared directly. (Invest Ophthalmol Vis Sci. 2011;52:940-946) DOI:10.1167/iovs.10-5803