The Optic Nerve Head in Primary Open-Angle Glaucoma Eyes With High Myopia: Characteristics and Association With Visual Field Defects
The Optic Nerve Head in Primary Open-Angle Glaucoma Eyes With High Myopia: Characteristics and Association With Visual Field Defects
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DOI：
10.1097/ijg.0000000000000395
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发表时间：
2016-06-01
影响因子：
2
通讯作者：
Hsieh, Jui-Wen
中科院分区：
文献类型：
--
作者：
Chen, Li-Wei;Lan, Yu-Wen;Hsieh, Jui-Wen
目的：探讨原发性开角型青光眼（POAG）伴高度近视眼视神经病变的形态学特征及其与视野缺损的关系。方法：在本横断面研究中，我们回顾了375位台湾患者（375只眼）的资料，年龄在20至60岁之间。视盘照片用于形态学变量的平面测量。近视屈光度分为高度近视（< -6.0 D）和非高度近视（中度近视至远视）。视盘面积分为中等（1.59 ~ 2.85 mm(2)）、大、小。确定各组之间的特征差异，与椎间盘面积的相关性以及与VF缺陷相关的因素。结果：142只高度近视眼中，大视盘33只（23%），小视盘26只（18%），倾斜视盘55只（39%）。大椎间盘的杯盘面积比和倾斜比较高；小椎间盘边缘面积小，倾斜比低（P < 0.05）。与高度近视相关的特征包括边缘面积较小，C/D面积比较高，倾斜比较低（均P < 0.001）。经logistic回归分析，屈光、C/D面积比、边缘面积、倾斜比与VF缺损相关（P均< 0.05）。结论：在台湾的POAG患者中，我们的研究发现倾斜、大或小的椎间盘普遍存在于高度近视的眼睛中。在这些特征中，只有椎间盘倾斜和高度近视本身与青光眼视神经病变的严重程度有关。
Purpose: To evaluate the morphologic characteristics of optic neuropathy and its association with visual field (VF) defects in primary open-angle glaucoma (POAG) eyes with high myopia.Methods: In this cross-sectional study, we reviewed data from 375 Taiwanese patients (375 eyes) of POAG, ages 20 to 60 years. Optic disc photographs were used for planimetric measurements of morphologic variables. The myopic refraction was divided into high myopia (< -6.0 D) and nonhigh myopia (moderate myopia to hyperopia). The optic disc area was classified as moderate (1.59 to 2.85 mm(2)), large, and small. Differences in characteristics between groups, correlations with the disc area, and factors associated with VF defects were determined.Results: Of the 142 highly myopic eyes, 33 (23%) had a large disc, 26 (18%) had a small disc, and 55 (39%) had a tilted disc. Large discs had a higher cup-to-disc (C/D) area ratio and a higher tilt ratio; small discs had a smaller rim area and a lower tilt ratio (all P < 0.05). Characteristics associated with high myopia included a smaller rim area, a higher C/D area ratio, and a lower tilt ratio (all P < 0.001). In logistic regression, the refraction, the C/D area ratio, the rim area, and the tilt ratio (all P < 0.05) were associated with VF defects.Conclusions: In Taiwanese individuals with POAG, our study found that tilted, large, or small discs were prevalent in highly myopic eyes. Of these characteristics, only the disc tilt and high myopia by itself were associated with the severity of glaucomatous optic neuropathy.