Comparison of Structural and Functional Features in Primary Angle Closure and Open Angle Glaucomas.
Comparison of Structural and Functional Features in Primary Angle Closure and Open Angle Glaucomas.
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原发性闭角型青光眼和开角型青光眼的结构和功能特征的比较。
DOI：
10.1097/ijg.0000000000002341
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发表时间：
2024
影响因子：
2
通讯作者：
Wang,Mengyu
中科院分区：
文献类型：
--
作者：
Sun,JessicaA;Yuan,Melissa;Johnson,GraceE;Pasquale,LouisR;Boland,MichaelV;Friedman,DavidS;Elze,Tobias;Shen,LucyQ;Wang,Mengyu
目的：探讨PACG和POAG在结构和功能上的差异。材料和方法：在这项大型横断面研究中，通过光学相干断层扫描和可靠的视野测试来评估POAG和PACG患者在结构和功能损伤方面的差异。结果：共纳入PACG患者283例，POAG患者4110例。尽管类似的平均偏差在视觉领域(平均(SD) -7.73 - 7.53元(7.92)和(6.90)dB, P = 0.72), PACG患者厚全球视网膜神经纤维层(RNFL),小杯体积,cup-to-disc比例较小,较大的边缘面积比青光眼(71年77[20]和[14]µm, 0.32(0.28)和0.40(0.29)3毫米,0.6(0.2)和0.7(0.1),1.07(0.40)和0.89(0.30)毫米2,P < 0.001),而青光眼患者有更明显不如RNFL变薄(82[24]与[35]95µm, P < 0.001)。在多变量分析中，远视[比值比（OR）： 1.24，可信区间（CI）： 1.13-1.37]、杯盘比较小（OR: 0.69, CI: 0.61-0.78）、较厚的下RNFL （OR: 1.15, CI: 1.06-1.26）和较差的平均偏差（OR: 0.95, CI: 0.92-0.98）与PACG相关。功能上，POAG与上位中央旁功能丧失有关，PACG与上位场功能丧失有关。在调整平均RNFL厚度后，PACG比POAG的弥散损失更大（总偏差差1.26-3.2 dB）。结论：PACG患者的结构损伤小于POAG患者，尽管功能损失程度相似。POAG和PACG之间功能和结构损失模式的区域差异可能改善对这些青光眼亚型的疾病监测。
Purpose:To identify structural and functional differences in PACG and POAG.Materials and Methods:In this large cross-sectional study, differences in structural and functional damage were assessed among patients with POAG and PACG with optical coherence tomography and reliable visual field testing.Results:In all, 283 patients with PACG and 4110 patients with POAG were included. Despite similar mean deviation on visual fields (mean [SD]–7.73 [7.92] vs.–7.53 [6.90] dB, P= 0.72), patients with PACG had thicker global retinal nerve fiber layer (RNFL), smaller cup volume, smaller cup-to-disc ratio, and larger rim area than POAG (77 [20] vs. 71 [14] µm, 0.32 [0.28] vs. 0.40 [0.29] mm 3, 0.6 [0.2] vs. 0.7 [0.1], 1.07 [0.40] vs. 0.89 [0.30] mm 2, P< 0.001 for all), while patients with POAG had more pronounced inferior RNFL thinning (82 [24] vs. 95 [35] µm, P< 0.001). In a multivariable analysis, hyperopia [odds ratio (OR): 1.24, confidence interval (CI): 1.13–1.37], smaller cup-to-disc ratio (OR: 0.69, CI: 0.61–0.78), thicker inferior RNFL (OR: 1.15, CI: 1.06–1.26) and worse mean deviation (OR: 0.95, CI: 0.92–0.98) were associated with PACG. Functionally, POAG was associated with superior paracentral loss and PACG with inferior field loss. After adjusting for average RNFL thickness, PACG was associated with more diffuse loss than POAG (total deviation differences 1.26–3.2 dB).Conclusions:Patients with PACG had less structural damage than patients with POAG despite similar degrees of functional loss. Regional differences in patterns of functional and structural loss between POAG and PACG may improve disease monitoring for these glaucoma subtypes.