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患有青光眼的近视眼多发性颞侧筛板缺损及其与视野缺损的关联 Multiple Temporal Lamina Cribrosa Defects in Myopic Eyes with Glaucoma and Their Association with Visual Field Defects

Sawada, Y., Araie, M., Ishikawa, M., Yoshitomi, T.

期刊名称:Ophthalmology

卷期:2017年第124卷第11期

摘要

摘要:目的:旨在利用光谱域(SD)光学相干断层扫描技术(OCT)研究开角型青光眼(OAG)近视眼的筛板(LC)缺损的特征。设计:横断面研究。研究对象:133OAG眼,83只轴向长度为24mm以上的无OAG 眼。方法:收集视盘增强深度成像SD OCT B扫描,对LC缺损(直径≥100μm)和大孔(直径60-100μm)进行评估。对每只眼的LC缺陷和大孔数量和位置进行评估。在OAG眼中,评估与LC缺陷数目相关的因素,以及LC缺陷的位置与视野(VF)缺陷(例如,旁中央暗点(PCS)和上方或下方缺损)之间的关联。主要观察指标:LC缺损和大孔的数目和位置。结果:在有或没有OAG的近视眼中,LC缺损的平均数分别为3.80.8,大孔数分别为1.91.6。在两组中,LC缺损和大孔主要位于颞侧。在OAG眼中,视盘倾斜角度越大,LC缺损的数量相对较多,VF平均偏差越大(均P <0.001)。颞侧LC缺损和倾斜角度的数量与PCS存在相关,而下方和上方的LC缺损和扭转角的数目与上方和下方VF缺损相关。结论:OAG近视眼的LC缺损及大孔位置与没有OAG眼类似,但数量更多。这提示当眼出现青光眼时,近视眼LC的局灶性变化可能演变成更大的缺损。与视盘倾斜角度相关的LC缺损的数量明显与青光眼VF缺损的严重程度和位置相关。这表明近视可能通过增加颞侧LC缺损数量造成视盘倾斜来影响青光眼VF缺损。

PURPOSE:To investigate characteristics of lamina cribrosa (LC) defects in myopic eyes with open-angle glaucoma (OAG) using spectral-domain (SD) optical coherence tomography (OCT).DESIGN:Cross-sectional study.PARTICIPANTS:One hundred thirty-three eyes with OAG and 83 eyes without OAG, with axial length of 24 mm or more.METHODS:Serial enhanced depth imaging SD OCT B-scans of the optic disc were acquired and reviewed for LC defects (diameter, 100 μm) and large pores (diameter, 60-100 μm). The numbers and locations of LC defects and large pores in each eye were assessed. In eyes with OAG, factors related to the number of LC defects were evaluated, as well as the association between the locations of LC defects and visual field (VF) defects (e.g.,paracentral scotoma [PCS] and superior or inferior hemifield defects).MAIN OUTCOME MEASURES:Numbers and locations of LC defects and large pores.RESULTS:In myopic eyes with and without OAG, the average numbers of LC defects were 3.8 and 0.8 and numbers of large pores were 1.9 and 1.6, respectively. In both groups, LC defects and large pores were located predominantly at the temporal periphery. Among eyes with OAG, the number of LC defects was relatively high in the eyes with greater optic disc tilt angle and worse mean deviation of the VF (both P < 0.001). The number of temporal LC defects and tilt angle were associated with presence of PCS, whereas the number of inferior and superior LC defects and torsion direction were associated with presence of superior and inferior VF defects.CONCLUSIONS:Myopic eyes with OAG exhibited LC defects and large pores at similar locations as those without OAG, but in greater numbers, suggesting that these focal alternations of the LC in myopic eyes may evolve into larger defects when glaucoma develops in the eye. The number of LC defects, which was related to the optic disc tilt angle, was associated significantly with glaucomatous VF defects in both severity and location. This suggests that myopia may influence glaucomatous VF defects through optic disc tilt by way of an increased number of LC defects at the temporal periphery.


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