Optic Disc Torsion Direction Predicts the Location of Glaucomatous Damage in Normal-Tension Glaucoma Patients with Myopia
Optic Disc Torsion Direction Predicts the Location of Glaucomatous Damage in Normal-Tension Glaucoma Patients with Myopia
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DOI：
10.1016/j.ophtha.2012.03.006
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发表时间：
2012-09-01
期刊：
影响因子：
13.7
通讯作者：
Park, Chan Kee
中科院分区：
文献类型：
--
作者：
Park, Hae-Young L.;Lee, Kook;Park, Chan Kee
目的：目的探讨伴有近视的正常眼压性青光眼（NTG）患者的视盘倾斜和扭转的特征，并评价视盘倾斜和扭转与视野缺损（VF）位置的关系。设计：回顾性病例对照设计。参与者：225例NTG患者。方法：将患者分为近视NTG组（球镜当量大于-2.00屈光度[D]或轴长大于24.0 mm;非近视NTG组（等效球镜小于-0.50D或眼轴长度小于24.0mm; n = 59）。椎间盘倾斜，这是确定的倾斜率，光盘扭转，和面积的乳头周围萎缩（PPA），从光盘照片测量。根据模式偏差图中VF缺损的位置，将患者进一步分为上级和下级缺损组。结果：225只NTG眼中，近视眼166只（73.8%），近视眼166只（73.8%）。近视NTG组明显年轻（42.85岁）比非近视NTG组（60.73岁）。近视NTG组的视盘倾斜（45.8%）和扭转（75.9%）明显高于非近视NTG组。虽然没有统计学意义（P = 0.057），但近视NTG组的PPA面积更大。VF缺损的位置在两组之间存在显著差异，近视NTG组中上级缺损更常见（69.9%; P < 0.001）。上级缺损组的扭转程度（18.45度）与下层缺损组（-3.81度; P = 0.001）存在显著差异。扭转程度是唯一的因素与VF缺陷的位置在单变量（P = 0.001）和多变量（P = 0.014）logistic回归analysis.Conclusions：韩国NTG患者有很高的患病率近视和年轻。在韩国NTG近视患者中，视盘倾斜和扭转非常普遍。视盘扭转的方向可以预测损伤的位置。财务披露：作者对本文中讨论的任何材料没有任何专有或商业利益。Ophthalmology 2012; 119：1844-1851（C）2012，美国眼科学会。
Objective: To characterize optic disc tilt and torsion in normal-tension glaucoma (NTG) patients with myopia and to evaluate the relationship between optic disc tilt and torsion with the location of visual field (VF) defect.Design: Retrospective, case-control design.Participants: Two hundred twenty-five NTG patients.Methods: Patients were divided into a myopic NTG group (spherical equivalent more than -2.00 diopters [D] or axial length more than 24.0 mm; n = 166) and nonmyopic NTG group (spherical equivalent less than -0.50 D or axial length less than 24.0 mm; n = 59). Disc tilt, which was identified by the tilt ratio, disc torsion, and area of peripapillary atrophy (PPA), was measured from disc photographs. Patients were divided further into superior and inferior defect groups according to the location of the VF defect in the pattern deviation map. Logistic regression analysis was used to determine the relationship between ocular factors, including tilt ratio, torsion degree, and the VF defect location.Main Outcome Measures: Tilt ratio, torsion degree, PPA area, and location of VF defect.Results: Among 225 NTG eyes, 166 (73.8%) were myopic eyes. The myopic NTG group was significantly younger (42.85 years) than the nonmyopic NTG group (60.73 years). Disc tilt (45.8%) and torsion (75.9%) were significantly more prevalent in the myopic NTG group than in the nonmyopic NTG group. Although just short of statistical significance (P = 0.057), PPA area was larger in the myopic NTG group. The VF defect location was significantly different between the 2 groups, with superior defects more prevalent in the myopic NTG group (69.9%; P < 0.001). Torsion degree was significantly different in the superior defect group (18.45 degrees) compared with the inferior defect group (-3.81 degrees; P = 0.001). Torsion degree was the only factor related to VF defect location in both univariate (P = 0.001) and multivariate (P = 0.014) logistic regression analyses.Conclusions: Korean NTG patients had a high prevalence of myopia and young age. Optic disc tilt and torsion were highly prevalent in Korean NTG patients with myopia. The direction of the optic disc torsion may predict the location of damage.Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. Ophthalmology 2012; 119: 1844-1851 (C) 2012 by the American Academy of Ophthalmology.