Various glaucomatous optic nerve appearances - Clinical correlations
Various glaucomatous optic nerve appearances - Clinical correlations
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DOI：
10.1016/s0161-6420(96)30640-4
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发表时间：
1996-04-01
期刊：
影响因子：
13.7
通讯作者：
Drance, SM
中科院分区：
文献类型：
--
作者：
Nicolela, MT;Drance, SM
目的：探讨不同视神经形态的开角型青光眼患者青光眼的危险因素、视野缺损的形态及进展情况。方法：对青光眼合并高眼压患者及疑似青光眼患者的视盘立体照片11711张进行回顾性分析，以确定具有四种不同视盘外观的纯视盘。本文回顾了所选患者的临床图表，重点分析了预定的眼部和全身危险因素的存在，并对其自动视野进行了分析。选择局灶性缺血性椎间盘34例，近视青光眼椎间盘38例，老年性硬化椎间盘22例，广泛性视杯椎间盘扩大23例。近视性青光眼和视杯盘广泛性扩大的患者明显比局灶性缺血性和老年性硬化的患者年轻。局灶性缺血组女性较多，老年性椎间盘硬化患者缺血性心脏病患病率明显增高；他们也有更高的全身性高血压患病率，但没有达到统计学意义。偏头痛在局灶性缺血组的发生率是其他组的2.5倍。全身性增大组眼压明显增高。四组的视野缺损模式也有明显差异。结论：不同椎间盘外观的患者，仅从其椎间盘照片中选择，其人口学特征，某些系统性危险因素的患病率，眼压水平和视野损害模式存在差异，这些发现表明，这些不同的椎间盘外观可能代表了不同人群的青光眼患者，可能具有不同的致病机制。
Purpose: To study the prevalence of risk factors for glaucoma as well as the pattern of visual field defects and their progression in patients with open angle glaucoma with different and distinct optic nerve appearances.Methods: One thousand seven hundred eleven optic disc stereo photographs of patients with glaucoma and ocular hypertension and of those suspected of having glaucoma were reviewed to identify pure examples of discs with four different optic disc appearances: focal ischemic discs, myopic glaucomatous discs, senile sclerotic discs, and generalized enlargement of the optic cup discs, The clinical charts of the selected patients were reviewed, with emphasis on the presence of predetermined ocular and systemic risk factors, Their automated visual fields also were analyzed,Results: Thirty-four patients with focal ischemic discs, 38 with myopic glaucomatous discs, 22 with senile sclerotic discs, and 23 with generalized enlargement of the optic cup discs were selected. Patients with myopic glaucoma and generalized enlargement of the optic cup discs were significantly younger than patients with focal ischemic and senile sclerotic discs. There were more women in the focal ischemic group, Patients with senile sclerotic discs had a significantly higher prevalence of ischemic heart disease; they also had a higher prevalence of systemic hypertension, which did not reach statistical significance, Migraine was 2.5 times more frequent in the focal ischemic group than in the other groups. Intraocular pressure was significantly higher in the generalized enlargement group. The pattern of visual field defect in the four groups also was distinctly different.Conclusions: Patients with different disc appearances, selected only from their disc photographs, showed differences in their demographic characteristics, prevalence of certain systemic risk factors, intraocular pressure levels, and the pattern of their visual field damage, These findings suggest that these various disc appearances probably represent different populations of patients with glaucoma with, possibly, different pathogenic mechanisms.