Association between peripheral visual field defects and focal lamina cribrosa defects in highly myopic eyes
Association between peripheral visual field defects and focal lamina cribrosa defects in highly myopic eyes
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DOI：
10.1007/s10384-022-00909-0
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发表时间：
2022-03-20
影响因子：
2.4
通讯作者：
Ohno-Matsui, Kyoko
中科院分区：
文献类型：
--
作者：
Mochida, Shiho;Yoshida, Takeshi;Ohno-Matsui, Kyoko
目的应用光学相干断层扫描（OCT）和微视野检查（microperimetry）探讨高度近视患者周边视野（VF）缺损的发病机制，并探讨局灶性筛板缺损（fLCD）与高度近视特异性周边视野缺损（HM-pVFDs）的关系。研究设计回顾性病例对照研究。方法对35例高度近视患者（屈光度≥ 8.0 D或眼轴长度> 26.5 mm）进行研究，并与35名年龄和35名性别匹配的对照者进行比较。用OCT分析视神经乳头（ONH）形态，用微视野计测量ONH周围视网膜光敏感度。主要结果指标为最佳矫正视力（BCVA）、眼轴长度（AL）、屈光不正、眼内压（IOP）、OCT结果和微视野检查结果。结果患者组与对照组的最佳矫正视力（BCVA）、平均屈光度（AL）、眼压、屈光度差异无统计学意义。在HM-pVFD的35只眼睛中，24只通过使用OCT检测到fLCD，1只没有显示fLCD的证据，10只由于过度ONH倾斜而图像不足。在35只对照眼中，2只有fLCD，28只没有fLCD的证据，5只图像不足。35只HM-pVFD眼中有29只的视乳头周围视网膜光敏感度降低; 35只对照眼中有30只没有观察到这种降低。微视野检测外周VF异常的敏感性为82.9%，特异性为85.7%。结论HM-pVFDs与fLCD之间存在重要关系，提示fLCD参与了高度近视患者外周VF异常的发病机制。此外，微视野测定法对于评价HM-pVFD是可重现的。
Purpose We aimed to identify peripheral visual field (VF) defect pathogenesis in high myopia using optical coherence tomography (OCT) and microperimetry and to investigate the association between focal lamina cribrosa defects (fLCDs) and high myopia-specific peripheral visual field defects (HM-pVFDs). Study design Retrospective case-control study. Methods Thirty-five highly myopic patients (refractive error >= 8.0 D or axial length > 26.5 mm) with an HM-pVFD, diagnosed using the V-4 isopter in Goldmann perimetry, and 35 age- and 35 sex-matched controls were studied. The optic nerve head (ONH) morphology was analyzed by use of OCT; retinal light sensitivities around the ONH were evaluated by use of microperimetry. The main outcome measures were best-corrected visual acuity (BCVA), axial length (AL), refractive error, intraocular pressure (IOP), the OCT findings, and the microperimetry findings. Results The BCVA, AL, IOP, and refractive error did not differ significantly between the patient and the control groups. Of the 35 eyes with an HM-pVFD, twenty-four had fLCDs detected by use of OCT, one showed no evidence of fLCDs, and ten had inadequate images due to excessive ONH tilting. Of the 35 control eyes, two had fLCDs, twenty-eight showed no evidence of fLCDs, and five had inadequate images. The peripapillary retinal light sensitivity was decreased in 29 of the 35 eyes with an HM-pVFD; no such decrease was noted in 30 of the 35 control eyes. Peripheral VF abnormality detection by use of microperimetry had 82.9% sensitivity and 85.7% specificity. Conclusions Our findings indicate an important relationship between HM-pVFDs and fLCDs, suggesting fLCD involvement in peripheral VF abnormality pathogenesis in highly myopic patients. Furthermore, microperimetry is reproducible for evaluating HM-pVFDs.