Central retinal vessel trunk exit and location of glaucomatous parapapillary atrophy in glaucoma
Central retinal vessel trunk exit and location of glaucomatous parapapillary atrophy in glaucoma
复制标题
DOI：
10.1016/s0161-6420(01)00571-1
复制
发表时间：
2001-06-01
期刊：
影响因子：
13.7
通讯作者：
Hayler, JK
中科院分区：
文献类型：
--
作者：
Jonas, JB;Budde, WM;Hayler, JK
目的：探讨视网膜中央血管干出口在筛板上的位置与青光眼视乳头旁萎缩的位置是否存在空间相关性。设计：基于临床、观察性、横断面研究。乳头状区和乳头状区分为四个象限。测定视网膜中央血管主干出口在筛板表面的位置，并测量四个象限的视网膜区和视网膜缘的面积，主要观察指标：视网膜区和视网膜区萎缩的面积以及视盘中央血管主干出口的位置。结果：对侧视盘象限的测量结果显示，视网膜区和视网膜缘与血管主干出口所在的视盘象限相比，视网膜区和视网膜缘明显扩大(P<；0.05)，视网膜区和视网膜缘明显缩小。比较不同位置的视网膜中央血管主干出口的视盘象限的测量结果发现，在各自的视盘象限中，血管主干出口位于对侧视盘象限的眼β区明显大于血管主干出口位于相应视盘象限的视盘象限，而神经视网膜边缘明显小于血管主干出口位于视盘象限的视盘象限。结论：青光眼视网膜中央血管主干出口在筛板上的位置影响视乳头旁萎缩的位置。距视网膜中央血管主干出口的距离越长，毛细血管旁萎缩越大，神经视网膜缘越小。这种关系与青光眼神经视网膜缘缺失和青光眼扩大的毛细血管旁萎缩之间的空间关系是一致的。在诊断上，它可能表明，在毛细血管旁萎缩的异常构型或视网膜中央血管主干出口位置异常的情况下，青光眼早期边缘改变应在距离视网膜中央血管主干出口最远且毛细血管旁萎缩可能相对较大的盘区寻找。眼科2001；美国眼科学会108：1059-1064(C)2001。
Objective: To evaluate whether the position of the central retinal vessel trunk exit on the lamina cribrosa spatially correlates with the location of parapapillary atrophy in glaucoma.Design: Clinic-based, observational, cross-sectional study.Patients: Color stereo optic disc photographs of 95 patients with primary or secondary open-angle glaucoma and 65 healthy persons were morphometrically evaluated. The intrapapillary and parapapillary region was divided into four quadrants. We determined the position of the central retinal vessel trunk exit on the lamina cribrosa surface and measured the area of parapapillary atrophy and neuroretinal rim in the four quadrants,Main Outcome Measures: The area of neuroretinal rim and parapapillary atrophy and the position of the central retinal vessel trunk exit.Results: Comparing measurements between opposite disc quadrants showed that beta zone of parapapillary atrophy was significantly (P < 0.05) larger and that the neuroretinal rim was significantly smaller when beta zone and neuroretinal rim were measured in the disc quadrant most distant to the central retinal vessel trunk exit, than if the beta zone and neuroretinal rim were measured in the quadrant containing the vessel trunk exit. Comparing measurements in the disc quadrants between eyes with different positions of the central retinal vessel trunk exit revealed that, in the respective disc quadrant, the beta zone was significantly larger and the neuroretinal rim was smaller in eyes with the vessel trunk exiting in the opposite disc quadrant than in eyes with the vessel trunk exit located in the respective disc quadrant where the measurements were obtained.Conclusions: Position of the central retinal vessel trunk exit on the lamina cribrosa influences the location of parapapillary atrophy in glaucoma. The longer the distance to the central retinal vessel trunk exit, the more enlarged is parapapillary atrophy and the smaller is the neuroretinal rim. This relationship agrees with the spatial relationship between glaucomatous neuroretinal rim loss and enlarged parapapillary atrophy in glaucoma. Diagnostically, it may indicate that, in eyes with an abnormal configuration of parapapillary atrophy or with an abnormal position of the central retinal vessel trunk exit, early glaucomatous rim changes should be looked for in the disc sector that is most distant to the central retinal vessel trunk exit and where parapapillary atrophy may be relatively large. Ophthalmology 2001;108:1059-1064 (C) 2001 by the American Academy of Ophthalmology.