原发性慢性闭角型青光眼与正常眼HRT-Ⅱ视盘形态结构的对比研究

目的 比较慢性闭角型青光眼（chronic angle-closure glaucoma,CACG）和正常眼视盘形态结构参数之间的差异,评价HRT-Ⅱ在原发性慢性闭角型青光眼早期诊断中的意义方法 用Heidelberg视网膜断层扫描仪（Heidelberg retina tomograph,HRT）对早期、进展期CACG 36例（60只眼）及正常人30例（60只眼）的视盘进行断层扫描,获得视盘平均地形图像和视盘结构诸参数.结果 CACG与正常人视盘结构各参数中视杯面积、杯盘面积比、盘沿面积、视杯容积、盘沿容积、视杯形态测量、平均视神经纤维层厚度及视神经纤维层横截面积存在明显差异.结论 HRT-Ⅱ能够反映慢性闭角型青光眼视盘改变,为临床早期诊断CACG提供依据.     

原发性慢性闭角型青光眼HRT-Ⅱ视盘参数和视野缺损的关系

目的探讨原发性慢性闭角型青光眼视盘参数和视野缺损之间的关系。方法用海德堡视网膜断层扫描仪和Humphrey自动视野计测定30例(44眼)原发性慢性闭角型青光眼患者的视盘参数(视盘面积、视杯面积、盘沿面积、视杯容积、盘沿容积、杯/盘面积、平均杯深、最大杯深、视杯形态测量、平均神经纤维层厚度、平均神经纤维层面积)和视野平均缺损。视盘参数与视野平均缺损作相关分析和多元线性回归分析。结果盘沿面积、视杯容积、杯/盘面积、视杯形态测量、平均神经纤维层厚度与视野平均缺损呈直线相关,并建立回归方程,Y=-13.012 5.064X1(Y表示平均缺损,X1表示盘沿面积),本研究没有发现其他参数与平均缺损相关关系的显著性。结论盘沿面积、视杯容积、杯/盘面积、视杯形态测量、平均神经纤维层厚度在海德堡视网膜断层扫描仪众多参数中最能反映青光眼的视野平均缺损程度。盘沿面积、视杯容积、杯/盘面积、视杯形态测量、平均神经纤维层厚度可用于慢性闭角型青光眼视神经损害监测。     

原发性开角型青光眼 HRT 视盘参数与视野缺损计分的关系

目的探讨原发性开角型青光眼(primary open an-gle glaucoma,POAG)病例的海德堡视网膜断层扫描仪(Hei-delberg retinal tomoscanner,HRT-Ⅱ)视盘参数与视野缺损计分的关系。方法对29例(30眼)POAG患者采用HRT-Ⅱ进行视盘检测;采用Humphrey视野计进行视野检查,运用AGIS计分系统并稍加改动对视野缺损情况进行计分,HRT参数包括视盘面积、视杯面积、盘沿面积、视杯容积、杯盘面积比、线性杯/盘比、平均视杯深度、视盘最大深度、平均视网膜神经纤维层厚度、视杯形态测量,将HRT视盘参数与视野计分进行相关统计学处理。结果HRT视盘参数中盘沿面积、视杯容积、杯盘面积比、平均视网膜神经纤维层厚度、视杯形态测量与视野缺损计分有直线相关关系。对视盘参数与视野计分进行逐步回归筛选变量时盘沿面积被选入,建立回归方程Y=12.351-5.123X(Y表示视野缺损计分,X表示盘沿面积)。结论POAG的视盘参数中盘沿面积与视野缺损计分关系最密切,视野缺损计分能对视野损害程度进行准确量化。     

HRT-Ⅱ在青光眼随访中的应用

目的:应用HRT-Ⅱ检测青光眼视神经乳头的形态改变及视网膜神经纤维的丢失,探讨HRT-Ⅱ在青光眼随访中的意义。方法:已确诊的青光眼患者50例63眼纳入本研究,利用HRT-Ⅱ每6～12mo观察视盘及视神经纤维的变化。结果:盘沿面积、盘沿体积、最大视杯深度、平均视网膜神经纤维层(RNFL)厚度、RNFL截面面积等视盘参数前后2次检查结果差异有显著性意义(P<0.05)。结论:HRT-Ⅱ能够快速、可重复性地测量视盘形态及视神经纤维层的改变,并且可以重复分析视盘参数的变化。     

国际闭角型青光眼新分类中Humphrey视野及HRT-Ⅱ参数的相关性

目的:分析海德堡视网膜断层扫描仪-II(HRT-II)和Hum-phrey视野计检查平均视野缺损(mean defect,MD)间的相关性及其临床价值。方法:闭角型青光眼患者69例117眼,按照国际闭角型青光眼分类法分为可疑原发性房角关闭(primary angle-clo-sure suspect,PACS)38眼,原发性前房角关闭(Primary an-gle-closure,PAC)53眼和原发性闭角型青光眼(primary angle-closure glaucoma,PACG)26眼,利用HRT-Ⅱ和Hum-phrey视野计检查正常人30例60眼和各类闭角型青光眼患者的视盘形态、视网膜神经纤维层(RNFL)厚度和视野,获得视杯面积、视盘面积、盘沿面积、视杯容积、盘沿容积、杯盘面积比、线性杯盘比、平均视杯深度、最大视杯深度、视杯形态测量、视杯高度变异轮廓、平均视网膜神经纤维层厚度、视神经纤维层横截面积和MD等参数,对比分析正常人和各类闭角型青光眼患者之间的各参数的差异。并将各类闭角型青光眼的HRT-Ⅱ的各参数与MD进行相关性分析。结果:HRT-Ⅱ和Humphrey视野计检测对照组与PACS、PAC和PACG4组间各视盘参数和MD差异具有统计学意义(P<0.01)。对照组中LCD和MD呈直线相关,PACS组中DA、CA和MD呈直线相关,PAC中CA,RA,CV,CDAR,HVC和MD呈直线相关。经逐步回归筛选的变量中,CV和HVC是其中2个有意义的参数,PAC组中CV和HVC与MD之间的Pearson相关系数为0.290和0.301,得出CV和HVC与MD之间回归方程:Y=4.475X1+5.338X2-0.480(Y表示MD,X1表示CV,X2表示HVC)。结论:HRT-II和Humphrey视野检查参数在新的闭角型青光眼分类具有一定的临床价值,MD与CV和HVC相互参照分析有助于判断闭角型青光眼的发展。     

大视杯与早期青光眼视盘形态的对比研究

目的了解海德堡视网膜断层扫描(HRT-Ⅱ)视盘参数对青光眼早期视盘变化的灵敏性。设计横断面调查研究。研究对象 21例(36眼)生理性大视杯(C／D≥0．7)和27例(31眼)早期青光眼(C／D≥0.7、MD≤3dB)。方法对所有入选的患者进行视野及HRT-Ⅱ检测,对两组患者的视盘诸参数进行比较。主要指标 HRTⅡ检测的视盘诸参数,包括视盘面积、视杯面积、盘沿面积、视杯容积、盘沿容积、杯盘面积比、平均视杯深度、最大视杯深度、视杯形态测量、视杯高度变异轮廓、平均视网膜神经纤维层(RNFL)厚度和视神经纤维层横断面积。结果 HRTⅡ参数中,生理性大视杯组的盘沿面积、盘沿容积、平均RNFL厚度、RNFL 横断面积的值比早期青光眼组大,差异有显著性(t=2．247-3．714,P=0.000-0．028)。结论在鉴别早期青光眼与生理性大视杯时, 应重点关注上述HRT-Ⅱ参数。     

应用眼底断层扫描仪对青光眼不同时期视盘参数的测定

目的 :应用HRT -Ⅱ对急性闭角性青光眼单眼有过急性发作的处于急性发作或缓解期或慢性期 ,对侧眼处于前驱期患者进行检查 ,比较双眼各指标的差异 ,指导临床随访治疗等。方法 :对于确诊的急性闭角性青光眼进行HRT -Ⅱ检查 ,得到双眼视盘参数 ,对其视盘面积、盘缘面积、杯盘面积比、缘盘面积比、最大杯的深度、平均杯的深度、平均纤维层厚度进行比较分析。结果 :对于每位患者其单眼急性发作期、慢性期、缓解期 ,其视杯的面积、杯盘面积比、缘的面积、平均纤维层厚度、平均杯的深度、最大杯的深度与前驱期比较均有明显差异 ,其P <0 0 1。急性发作期在杯的容积、缘的容积、平均杯的深度、最大杯的深度、神经纤维厚度与慢性期及缓解期比较有差异 ,慢性期与缓解期各个参数比较无显著差异 ,其P >0 0 5。结论 :对于急性闭角型青光眼有过急性发作后其神经损害明显存在 ,应尽量减少急性发作的出现 ,减少神经损害的发生 ,同时提示我们在慢性期、缓解期神经损害并未消失 ,因此在治疗过程中应维持正常眼压水平 ,定期进行视野及HRT -Ⅱ检查 ,追踪其神经改变 ,指导治疗方案的确定。应用HRT -Ⅱ对于确诊的青光眼患者进行检查 ,对于其随访、早期发现对侧眼的病理改变 ,从而指导治疗具有重要意义。     

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。     

青光眼的视网膜神经纤维层缺损及视盘参数改变

青龙眼的主要病理过程是视网膜神经纤维及视乳头盘沿的丢失。青光眼的视网膜神经纤维层缺损可分为局部缺损和弥漫缺损，这两作缺损的存在可能预示着存在两种或多种造成青光眼视神经损害的机制。本文总结分析了75例开角型青光眼及慢性闭角型青光眼病人131只眼的彩色立体眼底象．根据视网膜神经纤维层损害形态的不同，将131只限分为局限性RNFLD；弥漫性RNFLD；混合性RNFLD三组。对各组眼的视盘参数进行定最测量并参照Airaksinen法对视网膜神经纤维层进行半定量评估，根据视杯扩大的形态及盘沿面积的大小将各组中的病眼分为0、Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ几个阶段，采用SYSTAT统计软件对三组病人的c／D、沿盘面积比进行对比分析；且对各级RNFLD的半定量值与盘沿面积进行直线相关及回归分析。结果表明三组间的C／D及沿盘面积比存在着相当显著性差异（P＝0．000），且局部缺损组主要处于青光眼的早期和中期，混合缺损组主要分布于中期，弥漫缺损组主要分布于中晚期。视网膜神经纤维层缺损的半定量值与盘沿面积低度相关。青光眼视网膜纤维层缺损的不同形态表现，不同缺损形态组的视盘参数的差异及视杯扩大形式的差异，可能预示着存在多种造成青光眼视神经损害的机制。     

原发性青光眼早期视盘参数与视野缺损的关系

目的 探讨应用海德堡视网膜断层扫描仪(HRT-Ⅱ)检测原发性青光眼患者视盘参数改变及其与Humphrey 750检测视野改变间的关系.方法 49例原发性青光眼患者和30例对照个体分别行Humphrey 750视野与HRT-Ⅱ检查,每例患者的双眼间视盘损害与视野缺损间的对应关系彼此独立,双眼均被纳入研究.比较对照个体、慢性闭角型青光眼(CACG)、开角型青光眼(POAG)和正常眼压性青光眼(NTC)患者视乳头参数的差异,分析视乳头各项参数分别与各自视野指数(MD)间的相关性.将对照个体与原发性青光眼患者的视盘参数进行逐步判别分析,建立判别函数,筛选出诊断青光眼的敏感参数.结果 HRT-Ⅱ和Humphrey 750检测对照组、CACG组、POAC组和NTG组四组间视野平均缺损(1VID)、视杯面积(CA)、视盘面积(DA)、盘沿面积(RA)、视杯容积(CV)、盘沿容积(RV)、杯盘面积比(CDAR)、线性杯盘比(LCDR)、平均视杯深度(MCD)、最大视杯深度(max CD)、视杯形态(CSM)、视杯高度变异轮廓(HVC)、平均视网膜神经纤维层厚度(MRNFLT)、视神经纤维层横截面积(RCSA)等差异具有显著统计学意义(P<0.01).对照组中LCDR和MD呈直线线性相关,POAG组中DA、CA和MD呈直线线性相关,NTG组中CA、RA、CV、CDAR、HVC和MD呈直线线性相关.经逐步回归筛选的变量中,CV和HVC是其中2个有意义的参数,得出回归方程MD=4.475×CV+5.338×HVC-0.480.诊断敏感的视盘参数为RA、RV、MRNFLT、CSM、HVC,判别函数式为D=2.767+0.312×RA +3.731×RV+4.294×MRNFLT-3.668×CSM-4.024×HVC.结论 临床上应用HRT-Ⅱ检测视盘参数与Humphrey750检测视野结果结合对照分析有助于原发性青光眼的早期诊断.     

Evaluation of glaucomas. Frequently misdiagnosed glaucoma conditions

On the basis of a number of examples the authors describe specific glaucomas which have often reached their final stages by the time the patients are referred to the clinic. They include sub-acute and chronic angle-closure glaucoma, pseudoexfoliation syndrome, and pigmentary glaucoma. An unpleasant feature of these glaucomas is that, somehow or other, treatment comes too late: complete cupping of the optic disk when the ophthalmologist is first consulted, increased intraocular pressure in exfoliation syndrome detected too late, or a tardy decision to perform an iridotomy or a fistulizing operation. The following are some important points: gonioscopy should be performed not only at the initial examination but also at subsequent ones; subacute and chronic pupillary or angle-closure glaucomas are progressive diseases for which the sensible therapy is not miotics but laser iridotomy; because papillary changes usually precede visual field changes (automated perimetry notwithstanding), particular attention must be paid to the former. This can only be accomplished with exact documentation. Therefore, glaucoma follow-up means pressure measurement and gonioscopy and examination of the optic disk and visual field. In conclusion, aids for decision-making and a follow-up schedule are presented.     

Quantification of optic nerve head topography in optic neuritis: a pilot study

AIMS: To investigate optic nerve head topography in patients with optic neuritis compared to controls using the Heidelberg retina tomograph-II (HRT-II) and to determine if detected changes are related to visual function and electrophysiology. METHODS: 25 patients with a previous single episode of unilateral optic neuritis and 15 controls were studied with HRT-II, visual evoked potentials, and pattern electroretinogram. Patients also had testing of visual acuity, visual field, and colour vision. RESULTS: In affected eyes compared to fellow eyes, there was reduction of both the mean retinal nerve fibre layer (RNFL) thickness at the disc edge (p = 0.009) and the neuroretinal rim volume (p = 0.04). In affected eyes compared to control eyes, the three dimensional optic cup shape measure was increased (p = 0.01), indicative of an abnormal cup shape. There were no other significant differences in HRT-II measures. Within patient interocular difference correlation was used to investigate the functional relevance of these changes and demonstrated associations between RNFL thickness change and changes in visual acuity, visual field, and colour vision. Colour vision change was also associated with change in neuroretinal rim volume. CONCLUSIONS: HRT detects functionally relevant changes in RNFL thickness and neuroretinal rim volume between eyes affected by optic neuritis and unaffected fellow eyes.     

HRT视盘参数在原发性开角型青光眼早期诊断中的作用

目的:在众多海德堡视网膜断层扫描仪(heidelberg retina tomogragh,HRT)测定的视盘参数中,筛选出最有助于青光眼早期诊断的视盘参数。方法:用HRT测定23例视野损害较轻的青光眼患者和23例正常人的视盘参数(杯盘面积比、盘沿面积、盘沿容积、视杯容积、视杯形态测量、视杯高度变异轮廓和平均神经纤维层厚度)作逐步判别分析。结果:盘沿面积和杯盘面积比对青光眼早期诊断最有帮助,其诊断敏感度和特异度分别为87%和96%。结论:本组资料盘沿面积和杯盘面积比是区分青光眼和正常眼最好的判别因素。     

Correlation between confocal scanning laser ophthalmoscopy and scanning laser polarimetry in open angle glaucoma

PURPOSE: To correlate the findings of confocal scanning laser ophthalmoscopy and scanning laser polarimetry in diagnosed cases of glaucoma with established visual field defects. METHODS: A total of 53 diagnosed cases of primary open angle glaucoma that had at least two recorded of IOP more than 21 mm Hg on Goldmann applanation tonometry, open angles on gonioscopy and glaucomatous visual field defects on automated perimetry, were examined by confocal scanning laser ophthalmoscopy (HRT-II) and scanning laser polarimetry (GDx-NFA), in random order. RESULTS: The number on GDx advanced analysis had a significant (p < 0.05) correlation with the rim area (r = -0.279; p = 0.043), cup area (r = 0.311; p = 0.023) and the vertical cup: disc ratio (r = 0.376; p = 0.006). The correlation between HRT-II stereometric parameters and GDx advanced analysis parameters was significant (p < 0.05) for more parameters targeting the inferior pole of the disc than the superior pole. Numerically, the worst values of GDx parameters were associated with a worse result on Moorfields regression analysis, but there was poor agreement between the diagnostic labels like within or outside normal limits as obtained on GDx and HRT-II. CONCLUSIONS: Nerve fiber loss as detected on GDx correlates well with topographic optic nerve head changes as measured with the HRT-II. However, automated diagnosis on the two machines showed poor agreement.     

Comparison of disc damage likelihood scale, cup to disc ratio, and Heidelberg retina tomograph in the diagnosis of glaucoma

AIM: To evaluate the relative diagnostic strength of cup to disc (C/D) ratio, clinical disc damage likelihood scale (DDLS), a new clinical method of documenting glaucomatous optic disc changes, and Heidelberg retina tomograph (HRT-II) in patients with glaucoma, glaucoma suspects, and normal controls. METHOD: Consecutive observational case series. 110 eyes from 110 patients categorised as glaucoma, glaucoma suspect, or normal were examined clinically to grade the DDLS score. HRT-II examination was performed by an examiner masked to the clinical examination findings. Optic disc parameters and Moorfields regression analysis findings were recorded. Stereophotographs of the optic disc were examined independently by two glaucoma specialists in masked fashion to determine the C/D ratio. Zeiss SITA Standard 24-2 visual fields were obtained within 3 months of HRT-II and clinical examination. For each patient, the eye with the worse mean deviation of the visual field test was enrolled in the study, and each field was additionally graded by the four level Hodapp-Parrish-II-Anderson staging. Specificity and sensitivity were calculated by receiver operating characteristic (ROC) curves. RESULTS: Mean patient age was 58 years (SD 13.3) with 45 glaucoma patients, 23 glaucoma suspects, and 42 normals. The mean deviation on Humphrey visual field assessment using SITA-Standard was -4.95 D (SD 5 D) Clinical examination using DDLS had the best predictive power with an area under the ROC curve value of 0.95 when glaucoma patients and suspects were separated from borderline or normals. This was followed by clinical examination of C/D ratio (0.84), and HRT-II Moorfields analysis (0.68). The order of diagnostic strength did not change when definite glaucoma was compared to borderline and normals. CONCLUSIONS: The DDLS grading performs well compared to C/D ratio and HRT-II evaluation. Attention to disc diameter and to rim width may increase the value of clinical optic disc examination.     

Effect of glaucomatous damage on repeatability of confocal scanning laser ophthalmoscope, scanning laser polarimetry, and optical coherence tomography

PURPOSE: To determine and compare the effect of the severity of glaucomatous damage on the repeatability of retinal nerve fiber layer (RNFL) thickness with GDx-VCC (variable corneal compensation) and StratusOCT (optical coherence tomography; both produced by Carl Zeiss Meditec, Inc., Dublin, CA), and optic nerve head (ONH) topography with HRT-II (retinal tomograph; Heidelberg Engineering GmbH, Heidelberg, Germany) and StratusOCT. METHODS: With each of these techniques, two measurements were obtained from 41 eyes of 41 control subjects and 98 glaucomatous eyes (37 patients with early, 29 with moderate, and 32 with severe field loss). To evaluate test-retest variability at each stage, limits of agreement (Bland-Altman plots) and repeatability coefficients (RCs) were obtained from pairs of measurements. Comparisons of within-subject variances were used to compare repeatability of GDx-VCC versus StratusOCT for global RNFL and HRT-II versus StratusOCT for global ONH topography. Effects from age, visual acuity, and lens status were also included in the analysis as covariates. RESULTS: Test-retest variability of RNFL using GDx-VCC and StratusOCT were consistent through all stages of disease severity. Repeatability results of GDx-VCC were better than those of StratusOCT, except in severe cases. Test-retest variability of ONH topography using HRT-II and StratusOCT increased with increasing disease severity for rim area, cup area, and cup-to-disc (C/D) area ratio. In contrast, vertical C/D ratio from HRT-II, and horizontal C/D ratio from StratusOCT showed stable test-retest variability through all stages. Regardless of disease severity, repeatability results of HRT-II were better than those of StratusOCT. CONCLUSIONS: GDx-VCC and HRT-II showed better repeatability than StratusOCT. Although test-retest variability increased with disease severity for rim area, the variability for vertical C/D ratio (HRTII) and global RNFL (GDx-VCC) was stable across disease severity. These parameters, rather than rim area, may be more useful in detection of progression in patients with glaucoma who have more advanced field loss.     

The optic disc hemifield test

PURPOSE: To evaluate whether an optic disc hemifield test comparing the superior half of the optic disc with the inferior disc half is useful for glaucoma diagnosis. METHODS: The clinical observational study included 1268 patients with primary or secondary open-angle glaucoma and 649 normal subjects. The glaucoma group was divided into 1118 patients with glaucomatous visual field defects ("perimetric glaucoma"), and 150 patients with optic nerve head changes and normal visual fields ("preperimetric glaucoma"). Color stereo optic disc photographs were morphometrically evaluated. The optic disc area was divided into four sectors: temporal horizontal (60 degrees), superotemporal (90 degrees), inferotemporal (90 degrees), and nasal (120 degrees). Area and width of the neuroretinal rim were measured, and the ratio of superotemporal-to-inferotemporal rim area, the ratio of superior (12 o'clock)-to-inferior (6 o'clock) rim width, the difference of inferotemporal minus superotemporal rim area, and the difference of inferior rim width minus superior rim width were calculated. RESULTS: For the differentiation between the normal group and the whole glaucoma group, and for the differentiation between the normal group and the preperimetric glaucoma group, respectively, areas under the ROC curves were significantly smaller for the parameters of the optic disc hemifield test (superior-to-inferior rim width ratio: 0.448 and 0.412, respectively; and superotemporal-to-inferotemporal rim area ratio: 0.395 and 0.434, respectively) than for any other rim parameter tested such as inferotemporal rim area (0.827 and 0.745, reps.), total rim area (0.814 and 0.741, respectively), and superotemporal rim area (0.781 and 0.705, respectively). DISCUSSION: An optic disc hemifield test with the parameters superior-to-inferior rim width ratio and superotemporal-to-inferotemporal rim area ratio is not markedly helpful for the morphometric diagnosis of glaucomatous optic nerve damage, either in the preperimetric stage or in the perimetric stage of the disease.     

原发性开角型和闭角型青光眼眼压降低前后视盘改变和筛板顺应性的对比研究

目的比较降跟压前后原发性慢性闭角型青光眼（PACG）与原发性开角型青光眼（POAG）的视盘结构改变,了解两者间筛板顺应性是否存在差异。设计前瞻性对比研究。研究对象PACG36例49眼和POAG35例49眼。方法眼压降低前全部患者进行海德堡视网膜断层扫描（HRT—II）及Humphrey静态视野检查。根据病情选择手术、激光或药物治疗,使眼压降至正常范围。眼压降低后1个月重复HRT检查和视野检查。比较POAG和PACG眼压降低前后HRT视盘参数的变化,采用多元线性逐步回归法校正治疗前眼压、眼压降低幅度、年龄、杯盘比等因素影响。主要指标眼压降低前后HRT视杯面积、盘沿面积、视杯容积、平均视杯深度的差值。结果PACG及POAG组的视杯面积、视杯容积、平均视杯深度等指标在眼压降低后均明显降低（P〈0．05）,盘沿面积在眼压降低后均明显增加（P〈0．05）。视杯面积、盘沿面积、视杯容积、平均视杯深度在跟压降低前后的差值两组间无显著性差异（P〉0．05）。眼压降低前后这4个参数的差值与眼压降低幅度及杯盘比有关（P〈0．05）;与年龄及治疗前眼压无关（P〉0．05）。结论眼压降低后青光眼视盘形态结构有一定回复;但在PACG和POAG间,视盘形态结构回复的程度无明显差异,PACG和POAG的筛板顺应性可能无差异。（眼科,2009,18：264—269）     

Morphometric characteristics of optic disk with disk hemorrhage in normal-tension glaucoma.

PURPOSE: To evaluate the morphometric characteristics of the optic disk in eyes with and without disk hemorrhage in normal-tension glaucoma. METHODS: This was a prospective study conducted at Gifu University Hospital of 50 eyes of 50 patients with normal-tension glaucoma (12 men, 38 women; age, 56.5 +/- 14.1 years) who had developed new disk hemorrhage at the time of enrollment and 58 eyes of 58 patients with normal-tension glaucoma (20 men, 38 women; age, 56.7 +/- 12.4 years) with no history of disk hemorrhage during the follow-up period of more than 2 years. Age and global indexes of the visual field were matched. We morphometrically compared the optic disk with and without hemorrhage using a scanning laser tomograph. Global and sector analyses were made of the optic disk structural parameters. RESULTS: There was no significant difference in the global values of the disk parameters between the disk hemorrhage and the nonhemorrhage groups. However, the inferotemporal values for the rim area, rim volume, mean retinal nerve fiber layer thickness, and retinal nerve fiber layer cross-section area in the disk hemorrhage group were significantly smaller than those in the nonhemorrhage group (P <.05). In the disk hemorrhage group, moreover, the values for the rim area, rim volume, and retinal nerve fiber layer cross-section area in the inferotemporal sector with hemorrhage were significantly smaller than those in the same sector without hemorrhage (P <.05). CONCLUSION: Localized damage of the disk rim and retinal nerve fiber layer at the inferotemporal sector was prominent in eyes with disk hemorrhage.