Clinical implications of peripapillary atrophy in glaucoma.
Clinical implications of peripapillary atrophy in glaucoma.
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DOI：
10.1097/01.icu.0000156135.20570.30
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发表时间：
2005-04-01
影响因子：
3.7
通讯作者：
Jonas, Jost B
中科院分区：
文献类型：
--
作者：
Jonas, Jost B
综述目的：阐明青光眼视神经病变的乳头周围萎缩；其在青光眼的形态学诊断中的排名，以及对各种类型的慢性开角型青光眼的鉴别、青光眼与非青光眼的分离、青光眼进展的检测等方面的价值。最近的发现：最近的研究表明，乳头状周围萎缩与青光眼有关，最终发展为青光眼盘出血，独立于小的神经视网膜边缘区域，乳头状周围萎缩增加与进行性青光眼有关。一项视盘参数检测青光眼损伤的排序显示，与神经视网膜边缘参数相比，乳头周围萎缩的α和β区用处不大。没有青光眼的假性脱落综合征不是乳头周围萎缩的危险因素。动脉前缺血性视神经病变，乳头周围萎缩不扩大。乳突周围萎缩在欧洲人和南印度人之间没有显著差异。与视网膜中央血管干的位置相反，纤毛视网膜动脉的存在和位置对青光眼乳头周围萎缩的进展没有显著影响。摘要：乳头周围绒毛膜视网膜萎缩是检测青光眼异常的几个形态学变量之一。在青光眼视神经损伤检测的视盘变量排名中，乳头周围萎缩是第二级变量。对不同类型的慢性开角型青光眼有一定的鉴别价值。与青光眼相比，非青光眼视神经萎缩的眼睛，包括前动脉缺血性视神经病变后的眼睛，没有显示出扩大的乳头周围萎缩。
PURPOSE OF REVIEW: To elucidate peripapillary atrophy in glaucomatous optic neuropathy; its ranking in the morphologic diagnosis of the glaucoma, and its value for the differentiation of various types of chronic open-angle glaucoma, for the separation of glaucomatous eyes from nonglaucomatous eyes, and for the detection of progression of glaucoma.RECENT FINDINGS: Recent studies showed an association of peripapillary atrophy with glaucoma and the eventual development of glaucomatous disc hemorrhages independent of a small neuroretinal rim area, and an association between increasing peripapillary atrophy and progressive glaucoma. A ranking of optic disc parameters to detect glaucomatous damage revealed that the alpha and beta zones of peripapillary atrophy, compared with neuroretinal rim parameters, are less useful. Pseudoexfoliation syndrome without glaucoma is not a risk factor for peripapillary atrophy. In arteritic anterior ischemic optic neuropathy, peripapillary atrophy does not enlarge. Peripapillary atrophy does not differ markedly between Europeans and South Indians. In contrast to the position of the central retinal vessel trunk, the presence and position of cilioretinal arteries do not markedly influence the progression of peripapillary atrophy in glaucoma.SUMMARY: Peripapillary chorioretinal atrophy is one among several morphologic variables to detect glaucomatous abnormalities. Ranking optic disc variables for the detection of glaucomatous optic nerve damage, peripapillary atrophy is a variable of second order. It is useful for the differentiation of various types of chronic open-angle glaucomas. In contrast to glaucomatous eyes, eyes with nonglaucomatous optic nerve atrophy, including eyes after arteritic anterior ischemic optic neuropathy, do not show an enlarged peripapillary atrophy.