早期青光眼的盘沿形态学研究

青光眼早期损害的特征是颞下、颞上的视网膜神经纤维层缺损(RNFLD),并于相应区的视野弓形缺损。为了探讨青光眼视神经损害的发生规律,本研究利用计算机图象分析技术,测定一周(每(?)度)的盘沿宽度,以此形态指标分析早期青光眼与正常眼的盘沿形态差异以指导临床诊断,检查对象分两组:①正常对照组183只眼。②早期青光眼组175只眼。结果:正常组盘沿形态特征是下方盘沿宽度较上方宽,颞侧盘沿最窄,鼻侧盘沿最宽;早期青光眼组盘沿形态特征是下方盘沿宽度较上方更窄。用多因素逐步判别法对早期青光眼与正常眼进行判别分类,单纯用盘沿面积为指标,正确判断率为78％;用系列盘沿宽度为指标,经逐步判别筛选,以颞下及上方盘沿宽度最为相关,其正确判断率为94％。因后者除了与盘沿面积大小有关外,还与盘沿形态有关,依据盘沿形态特征有助于鉴别生理性大视杯(①大视盘,②视杯大,但下方盘沿宽于上方),发及发现小视盘青光眼(①小视盘及扩大不明显的视杯,②下方盘沿宽度比上方窄)     

早期青光眼视神经损害进展的随诊研究

目的 探讨早期青光眼视神经损害随诊进展的情况.设计回顾性病例系列.研究对象初诊为早期青光眼视神经改变、随诊3年以上发生了视神经进展者164例197眼.方法 早期青光眼视神经损害者的初诊眼底照片与末次随诊照片在计算机图像配准软件处理下进行闪烁对比,发现有盘沿及神经纤维层缺损进展者,记录视神经进展的指标.应用Pearson相关性分析,评价盘沿进展程度与神经纤维层进展程度的相关性,盘沿进展部位与神经纤维层进展部位的相关性.主要指标视盘盘沿丢失进展程度、盘沿丢失进展部位、神经纤维层缺损进展的程度和部位.结果 随诊时间3～19年,平均随诊时间7年.早期青光眼盘沿丢失进展多数从下方开始,进而发展到上方盘沿、上下方盘沿均受损,晚期累及视盘颞侧、鼻侧,直至视杯呈同心圆状扩大盘沿弥漫性丢失,神经纤维层受损顺序与盘沿进展相对应.盘沿进展程度与神经纤维层缺损进展程度有相关性,相关系数r=0.44.P＜0.001,盘沿进展程度与神经纤维层进展程度有显著相关性,r=0.93,P＜0.001.结论 青光眼视神经进展多从下方或上方盘沿进展开始,晚期波及视盘鼻颞侧,盘沿进展多与相应神经纤维层缺损进展一致.眼底立体照相联合图像闪烁对比方法对于监测青光眼视神经进展是一种较理想的手段.     

正常眼压性青光眼视神经损害的临床观察

目的　探讨正常眼压性青光眼 (NPG)患者视神经损害的临床表现 ,综合性医院眼科从临床角度对NPG进行早期诊断。方法　对 2 6例NPG患者视神经损害所致眼底和视野改变的临床特点作回顾性系统分析。结果　视神经损害眼底表现为视盘盘沿形态改变和视网膜神经纤维层 (RN FL)缺损。引入盘沿宽度比概念 :以自身鼻侧盘沿宽度N为标准和下方盘沿宽度I作比较 ,N≥I为阳性指标 ,检出N≥I者 42眼 (占 80 77% ) ;对照以颞侧盘沿宽度T和下方宽度I比较 ,T≥I者 2 2眼 (占 42 3 1% )。两种方法经统计学处理 ,差异有非常显著性 (χ2 =14 5 6,P <0 0 1)。检出RNFL缺损 44眼 (占 84 62 % ) ,其中局限性缺损 3 5眼 ,弥漫性缺损 9眼。视野情况 :平均缺损MD为10 87dB± 2 41dB ,平均视野敏感度MS为 15 5 8dB± 3 0 8dB。检出不同程度视野形态缺损 3 7眼 ,阳性率为 71 15 %。结论　正常眼压性青光眼视神经损害主要表现为眼底视盘盘沿形态改变和RNFL缺损。盘沿形态改变以自身鼻侧盘沿宽度N为标准与下方盘沿宽度I相比较较合理 ,N≥I有诊断意义。视野改变为其提供重要诊断依据。     

正常人不同视盘类型和早期青光眼盘沿形态学研究

目的 :探讨正常人 (本文所称正常人为非青光眼者 ,下同 )不同视盘类型和早期青光眼盘沿形态学特征 ,以指导各种视盘类型青光眼的早期诊断。方法 :检查对象分五组 :①正常人小视盘 4 1只眼 ;②正常人大视盘 4 0只眼 ;③视盘斜入 4 2只眼 ;④正常人正常大小视盘 4 2只眼 ;⑤早期开角型青光眼 4 5只眼。利用计算机图像分析技术 ,测量视盘面积、盘沿面积、视杯面积和一周 (每 10°)的盘沿宽度 ,以此形态指标分析正常人不同视盘类型和早期青光眼的盘沿形态差异。结果 :①正常人不同视盘类型盘沿形态共同特点是盘沿从鼻侧到下 /上方逐渐变宽 ,在下 /上方偏鼻侧有一宽带区 ;而早期青光眼盘沿从鼻侧到下 /上方逐渐变窄 ,无变宽区。②视盘斜入上下方盘沿宽度基本相同 ,而大视盘下方盘沿最宽 ,小视盘上方盘沿最宽 ;鼻侧次之 ,颞侧最窄。大视盘C/D较大而盘沿宽度较窄 ,小视盘C/D较小而盘沿宽度较宽 ,视盘斜入也具有较大的C/D和较窄的盘沿宽度。③经多因素逐步判别分析 ,盘沿面积加C/D的正确判别率为 88 4 % ,以系列盘沿宽度为指标 ,下方偏颞侧 (6∶2 0 )和上方偏鼻侧 (1∶0 0 )两个盘沿宽度最为相关 ,其正确判断率为 90 6 %。结论 :正常人不同视盘类型和早期青光眼各具有不同的盘沿形态特征 ,计算机图像测量系列盘     

原发性开角型青光眼不同发展阶段盘沿缺失的形态特征及其临床意义

目的:探讨青光眼病情发展阶段盘沿缺失的形态特征。方法:对青光眼92眼和正常人124眼进行立体彩色视盘照像,侧重分析盘沿的形态。结果:与视力正常眼比较,青光眼不同病情阶段盘沿缺失有其好发区域。早期青光眼盘沿缺失在视盘颞下极明显,中期青光眼盘沿缺失在颞上极较为明显,极晚期青光眼盘沿仅保留视盘鼻侧区域,并且鼻上区大于鼻下区。结论:青光眼盘沿缺失的形态特征与青光眼性视野缺损的发展及筛板的形态密切相关。     

生理性大视杯及早期青光眼的盘沿形态研究

目的探讨生理性大视杯与早期青光眼的差异。方法侧重分析、研究盘沿的形态。研究对象分两组：（１）生理性大视杯：Ｃ／Ｄ＞０．６，视盘面积大于２．８ｍｍ２，随诊３～６年盘沿无改变，眼压及视野均正常，共５４例（８８只眼）。（２）早期青光眼：在随诊中有盘沿丢失或视野缺损，但Ｃ／Ｄ＜０．８者共６８例（８９只眼）。反映形态的指标有：（１）系列盘沿宽度；（２）视杯形态参数，即垂直Ｃ／Ｄ与水平Ｃ／Ｄ的比值。结果生理性大视杯与早期青光眼在形态上的差异：（１）前者视盘大；（２）前者的视杯为横椭圆形，后者视杯呈竖椭圆形；（３）前者的盘沿以下方最宽，上方次之，鼻侧、颞侧盘沿宽度较窄；后者因早期以下方盘沿丢失最常见，所以下方盘沿宽度较上方者窄或相同。结论视杯形态＋盘沿面积＋视盘面积的组合，在多因素判别分析的回代中符合率最高。     

青光眼盘沿缺失的分析

进行性青光眼患者的视神经损伤，其盘沿面积会逐渐缩小，盘沿形态不断改变。此横向研究在于建立一个青光眼盘沿缺失的模式。作者评价了８０１只青光眼及４９６只视力正常眼的立体彩色视盘照像。结果：与视力正常眼比较，青光眼盘沿缺失可发生于视盘任何部位，并根据青光眼病程的不同阶段而有好发区域。轻度青光眼损伤眼，盘沿缺失通常在视盘颞下区最明显；中度进行性青光眼损伤，盘沿减少在颞上部最明显。在很晚期青光眼，盘沿残留通常仅见于视盘鼻侧区，而且鼻上区明显大于鼻下区。结论：与弥散方式不同，青光眼盘沿缺失的发生，在各部分有一顺序。一般说，其开始于视盘颞下区，然后逐渐出现于颞上、颞侧水平，鼻下，最终是鼻上区。这与视野缺损的进展及筛板的形态学有关。这一发现对青光眼的早期诊断可能是重要的。     

视盘血管主干位置在青光眼视神经损害诊断中的作用

目的观察视盘血管主干位置对上、下方盘沿宽度的影响，探讨视盘血管主干位置在青光眼视神经损害诊断中的作用。方法评价眼底照片清晰、视盘血管主干位置明确的视盘459例，其中大视盘131例，中视盘145例，横椭圆形视盘75例，小视盘108例。应用两组独立样本t检验，比较各类视盘的血管偏上组、血管偏下组的上、下方盘沿宽度的差异；比较上方盘沿窄组和下方盘沿窄组的血管位置的差异。结果总体及大视盘、小视盘的血管偏上组的盘沿比（0.467±0.051，0.445±0.040，0.508±0.056）较血管偏下组的盘沿比（0.500±0.066，0.474±0.062，0.546±0.048）小，差异有统计学意义（P=0.000，P=0.045，P=0.018，P值均<0.05）；总体及大视盘、小视盘的上方盘沿窄组的血管比（0.510±0.051，0.508±0.055，0.512±0.036）较下方盘沿窄组的血管比（0.528±0.045，0.533±0.048，0.534±0.045）小，差异有统计学意义（P=0.000，P=0.046，P=0.022，P值均<0.05）。结论视盘血管主干位置偏向侧的盘沿较窄，视盘血管主干位置远离侧的盘沿较宽。大视盘、中视盘、横视盘出现盘沿下方窄、上方宽，血管主干位置偏上，小视盘盘沿上方窄、下方宽，血管主干位置偏下，提示青光眼视神经改变。（中华眼底病杂志，2007，23：118-121）     

正常人不同类型视乳头及早期青光眼患者视乳头形态学研究

目的：探讨正常人不同类型视乳头及早期青光眼患者视乳头形态学特征,以指导青光眼的早期诊断。方法：将收集到的眼底照片分为4组：正常人小视乳头组41只眼,正常人大视乳头组40只眼,正常人大或小视乳头组42只眼,早期开角形青光眼组45只眼。利用计算机图像分析技术,测量视乳头、盘沿、视杯面积向周围（每10^0）盘沿宽度。结果：（1）正常人不同类型视乳头组的盘沿宽度曲线均在下或上方形成双峰,在鼻、颞侧形成谷底。大视乳头组下方盘沿最宽,小视乳头组上方盘沿最宽,鼻侧次之,颞侧最窄。（2）早期青光眼盘沿宽度典线下或上方双峰消失,其曲线低于鼻侧象限、高于颞侧象限。（3）经多因素逐步判别分析,盘沿面积加杯／盘比值的正确判断率为85．7％,以系列盘沿宽度为指标,下方偏颞侧（6：20）和上方偏鼻侧（1：00）两个盘沿宽度最为相关,其正确判断率为90．6％。结论：评价盘沿形态时应以其自身的鼻侧盘沿宽度作为标准,比较其上、下方盘沿宽度是否变窄,有利于生理性大视杯与早期青光眼的鉴别。     

鞍结节脑膜瘤患者视盘及视网膜神经纤维层的形态研究

目的 分析鞍结节脑膜瘤患者的视盘参数特征及视盘周围视网膜神经纤维层（pRNFL）厚度的变化。设计 回顾性病例系列。 研究对象 2010年7月至2011年12月北京天坛医院鞍结节脑膜瘤患者40例（80眼）、正常对照40例（80眼）和青光眼患者40例（80眼）。方法 采用眼底照相和相干光断层扫描（OCT）测量视盘及不同象限pRNFL厚度,比较鞍结节脑膜瘤患者与正常对照组和青光眼组的视盘参数及pRNFL厚度,分析视盘参数改变与肿瘤大小的相关性。主要指标 视盘形态、视盘面积、杯盘面积比、水平杯盘比、垂直杯盘比、盘沿面积、视杯面积,视杯体积和不同象限pRNFL厚度。结果 鞍结节脑膜瘤组的杯盘面积比、水平杯盘比、垂直杯盘比、视杯面积和视杯体积与正常对照组相比均明显增大,而盘沿面积明显减小（P均=0.000）;且杯盘面积比、水平杯盘比、盘沿面积和盘沿体积与青光眼组相比均较大,而垂直杯盘比、视杯面积和视杯体积较青光眼组明显减小（P均=0.000）。肿瘤组视盘周围不同象限pRNFL厚度分别为上方颞侧（124.022±26.100）μm,上方鼻侧（105.856±23.410）μm,鼻侧上方（75.784±19.260）μm,鼻侧下方（65.983±15.708）μm,下方鼻侧（105.915±25.526）μm,下方颞侧（133.591±24.429）μm,颞侧下方（76.592±19.679）μm,颞侧上方（77.352±26.100）μm,与正常对照组相比差异均具有统计学意义（P均<0.05）;与青光眼组相比上方鼻侧象限不具有统计学意义（P=1.114）,其余象限均具有统计学意义（P均<0.05）。鞍结节脑膜瘤盘沿体积与肿瘤大小相关（r=0.492,P=0.011）。结论 鞍结节脑膜瘤视盘形态表现为颞侧变窄、颜色变淡,pRNFL厚度与正常人群比较下方鼻侧变薄最明显,与青光眼组相比除上方鼻侧外其他各象限均变薄,下方颞侧最明显。     

合并近视的原发性开角型青光眼视盘形态和视网膜神经纤维层改变

目的 探讨合并近视的原发性开角型青光眼(primary open-angle glaucoma with myopia,M-POAG)视盘形态和视网膜神经纤维层(retinal nerve fiber layer,RNFL)改变的特点及其临床意义。 方法 对38例63只合并近视[(－6.92±3.79)D]、高眼压性[(32.00±9.36) mm　Hg(1 mmHg=0.133 kPa)原发性开角型青光眼(primary open-angle glaucoma,POAG)作眼底彩色照相,利用计算机图像分析设备分析视盘形态及RNFL 缺损的变化,并与单纯原发性开角型青光眼(simple primary open-angle glaucoma,S-POAG)的相应临床检查资料进行比较。 结果 M-POAG视盘形态和RNFL萎缩除具有与S-POAG相同的一般表现外,尚有其特征性改变：视盘呈椭圆形(垂直或水平)、斜入及部分缺损形,色泽苍白;视杯形态各异,呈碟形(28.6%)、垂直形(25.4%)、倾斜形(23.8%)、锅形(9.5%)及局限与同心圆形等;盘沿面积及杯/盘横径比值显著低于S-POAG组(P<0.05,P＜0.001)。视盘凹陷偏心 多向下方。RNFL局限性萎缩主要出现在下方视网膜;弥漫性RNFL萎缩与合并高度近视的中后期POAG视野缺损密切相关(P<0.005)。 结论 M-POAG的视盘形态特征以及RNFL改变特点有助于在合并高度近视的POAG中的临床诊断。(中华眼底病杂志,2000,16:81-84)     

Is the ISNT rule violated in early primary open-angle glaucoma--a scanning laser tomography study

AIMS: To evaluate the relevance of the ISNT rule with reference to the optic nerve head, in differentiating normal and early glaucoma eyes and neuroretinal rim (NRR) area ratios as measures of glaucomatous optic neuropathy by confocal scanning laser ophthalmoscopy (Heidelberg retina tomography (HRT) II). METHODS: The study included 136 control eyes and 63 eyes of early primary open-angle glaucoma. Each patient underwent a complete ophthalmic examination, HRT II (software 2.01) and achromatic automated perimetry using the Humphrey field analyzer Full threshold program 30-2 or 24-2. Topographic HRT parameters (disc area and rim area) were compared between the groups. To assess the statistical significance of differences between the study groups, the Student's t-test was used. RESULTS: The ISNT rule was applicable in 71% of normal eyes and 68% of early glaucoma eyes. The superior to inferior area ratio was 0.96+/-0.01 in the normal group and 0.90+/-0.02 in the glaucoma group. There was a loss of approximately a quarter of the NRR in the inferotemporal and superotemporal quadrants. The inferonasal sector showed the least loss of NRR (4.34%). CONCLUSION: The inferior NRR is marginally wider than the superior NRR in about 2/3 of normal eyes, but could not be clinically appreciated in many of these. The characteristic configuration of a normal optic disc with the rim width being greatest in the inferior disc region followed by the superior disc region was maintained even in most patients with early glaucoma.     

海德堡视网膜断层扫描仪在开角型青光眼视盘检测中的意义

目的 探讨海德堡视网膜断层扫描仪(HRT)检测开角型青光眼视盘参数与视野损害的关系。评价HRT在早期诊断青光眼中的意义。方法 正常人26例(41只眼)，高眼压11例(16只眼)、原发性开角型青光眼28例(38只眼)。采用Humphrey全自动视野计、HRT分别进行视野、视盘形态检测。比较正常组、高眼压组、青光眼组HRT视盘检测参数．分析青光眼组视野检测的平均缺损(MD)与HRT视盘检测参数的关系。结果 正常组、高眼压组、青光眼组视杯面积、杯／盘面积比、盘沿面积、视杯形态测量指数、视网膜神经纤维层厚度差异有显著性。青光眼组的盘沿面积、杯／盘面积比、视杯形成测量指数、视网膜神经纤维层厚度与视野检测的平均缺损有显著相关。结论 HRT能够反映青光眼视盘改变，为临床早期诊断青光眼提供更多的信息。     

The retinal nerve fiber layer in normal and glaucomatous eyes. II. Correlations

The retinal nerve fiber layer is different in normal and glaucomatous eyes. We correlated semi-quantitative data of the retinal nerve fiber layer of 398 eyes with chronic primary open-angle glaucoma and of 234 normal eyes with the intra- and parapapillary morphometric signs and with the perimetric indices. The three parameters "sequence of the fundus sectors concerning the best visibility of the retinal nerve fiber bundles", "visibility of the nerve fiber bundles", and "localized defects" were significantly (p less than 0.001) correlated to 1) area of the neuroretinal rim as a whole and in four different optic disc sectors, 2) neuroretinal rim width determined every 30 degrees, 3) optic cup area, diameters and form, 4) horizontal and vertical cup/disc ratios and the quotient of the horizontal to vertical cup/disc ratio, 5) area and width of zone "Alpha", zone "Beta", and the total parapapillary chorio-retinal atrophy, 6) diameter of the retinal vessels, 7) grade of a "tesselated fundus", and 8) the visual field loss. If only the inferior temporal and the superior temporal sectors were considered, the retinal nerve fiber bundles were less visible in that sector with the largest notch in the neuroretinal rim, the smaller neuroretinal rim area and width, the thinner retinal vessels, and the larger zone "Alpha", zone "Beta", and total parapapillary chorio-retinal atrophy. The glaucomatous changes in the retinal nerve fiber layer are correlated in time and location with the intra- and parapapillary and the perimetric alterations. Evaluation of the retinal nerve fiber layer is a useful method to detect a glaucomatous optic nerve damage.(ABSTRACT TRUNCATED AT 250 WORDS)     

Shape of the neuroretinal rim and position of the central retinal vessels in glaucoma.

Glaucomatous neuroretinal rim loss can occur in a sequence of sectors with the temporal inferior disc sector as the first and the nasal superior disc sector as the last to be affected. This study evaluated whether the position of the central retinal vessel trunk is correlated with this pattern of glaucomatous rim loss. Morphometrically stereo colour optic disc photographs of 157 glaucomatous eyes and 67 normal eyes were checked. In the normal and glaucomatous eyes, the central retinal vessel trunk was located eccentrically in the upper nasal quadrant of the optic disc. Taking into account the vertically oval disc shape, the distance to the central vessel trunk was largest for the temporal inferior disc region and shortest for the nasal superior disc area. An abnormal form of the glaucomatous neuroretinal rim was found in eyes with an atypical location of the retinal vessel trunk. Also in these glaucomatous eyes, the rim loss was usually most and least marked in that sector with the longest and shortest distance, respectively, to the central retinal vessel trunk. One could infer that the sequence of rim loss in glaucoma is dependent upon the distance of the region to the central retinal vessel trunk; the further away the region from the retinal vessel trunk, the more likely it is to be affected by rim loss. This suggest that the distance from the central retinal vessels is one factor among others that is correlated with the regional vulnerability of the neuroretinal rim to the glaucomatous process.     

Monitoring of morphometric changes of optic discs with morphologic progression of glaucomatous optic atrophy by means of laser scanner tomography

AIM: Aim of this study was to measure morphometric changes in optic discs with laser-scanning tomography (HRT, Heidelberg-Retina-Tomograph, Heidelberg) in eyes with early glaucomatous morphologic progression. PATIENTS AND METHODS: 61 eyes of 36 patients with marked neuroretinal rim loss or its early morphologic signs (1. optic disc hemorrhages, 2. reduced visibility of the retinal nerve fiber layer (RNF), 3. appearance of narrowing of retinal vessels, 4. enlargement of the choroidal, parapapillary atrophy) were compared to 74 normal eyes of 39 probands. 15 degrees stereographs of the optic discs were evaluated for morphologic changes. The morphometric variables of the neuroretinal rim and excavation measured by the HRT were examined in the course of the disease. RESULTS: In the group of normals no significant changes of the neuroretinal rim in the course of 2.0 +/- 1.2 years were found. In the group of glaucomatous eyes (3.0 +/- 1.5 years follow-up) 34 eyes showed marked neuroretinal rim loss, 17 disc hemorrhages, 4 vessel narrowing, 3 an increased chorioidal atrophy, 3 a decreased visibility of the retinal nerve fiber layer. In these eyes a significant loss of rim area (p = 0.01) and an increase of excavation area (p = 0.0001) and volume (p = 0.003) was measured by the HRT. Only three eyes showed a perimetric loss of sensitivity (0.8-3.4 db) in Octopus static perimetry. CONCLUSIONS: Laser-scanning tomography of the optic disc seems to be able to measure morphometric changes in eyes with morphologic progression of glaucomatous optic atrophy, even before perimetric changes occur.     

Comparison of glaucomatous optic nerve damage in primary angle-closure glaucoma with and without acute attack

PURPOSE: To compare the glaucomatous optic nerve damage in primary angle-closure glaucoma (PACG) with acute attack (acute PACG; AACG) and PACG without acute attack (chronic PACG; CACG). METHODS: The study subjects were 84 normal individuals, 130 AACG patients, and 86 CACG patients. Color optic disc photographs were evaluated for the presence or absence of 10 qualitative signs to differentiate between normal and glaucomatous optic discs. RESULTS: Abnormally shaped rim width (alteration of ISN'T rule), bared circumlinear vessel, vessel bayonetting, rim width narrower than the temporal sector, and zone beta (nasal and superotemporal sectors) were detected more frequently in the CACG group than in the AACG group (P<0.05). The most accurate qualitative sign was abnormally shaped rim width in both groups. The specificity and sensitivity of abnormally shaped rim width were 71.4% and 60.8% for AACG, and 71.4% and 81.4% for CACG, respectively. CONCLUSIONS: The optic disc damage is greater in CACG than in AACG.     

生理性大视杯视盘形态结构参数的研究

目的 观察生理性大视杯视盘的结构参数特征。 方法 海德堡断层扫描仪对100 只生理性大视杯眼和74只正常视杯眼的视盘进行断层扫描，对比分析两组之间视盘面积、视杯面积、杯盘面积比、盘沿面积、视杯容积、盘沿容积、平均杯深、最大杯深、杯形测量、 轮廓线高度变化、平均视网膜神经纤维层厚度、视网膜神经纤维层横截面积等视盘结构参数差异，分析生理性大视杯眼视盘上方、下方、鼻侧、颞侧4个象限的特征。 结果 生理性大视杯眼视盘面积、视杯面积、杯盘面积比、视杯容积、平均视杯深度、杯形测量、最大视杯深度测量值均显著大于正常视杯眼；轮廓线高度变化、平均视网膜神经纤维层厚度、视网膜神经纤维层横截面积测量值显著小于正常视杯眼。盘沿面积鼻侧大于上方，盘沿容积颞侧显 著小；视网膜神经纤维层横截面积测量值按上、下、鼻、颞侧递减。 结论 生理性大视杯视盘结构参数特征表现为视盘面积显著大于正常视杯眼，盘沿面积鼻侧大于上方；平均 视网膜神经纤维层厚度较正常视杯眼薄。 （中华眼底病杂志，2008，24：213-216）