应用海德堡视网膜断层扫描仪检测开角型青光眼的视盘改变

目的探讨海德堡视网膜断层扫描仪(Heidelberg retinal tomography,HRT)检测青光眼性视盘改变是否与视野损害的部位相一致,了解正常眼压性青光眼(normal tension glaucoma,NTG)与原发性开角型青光眼(primary open angle glaucoma,POAG)早或中期视盘形态是否异同.方法对64例(64只眼)仅有半侧视野异常的开角型青光眼(POAG27只眼、NTG37只眼)患者进行HRT检测,将Humphery视野与HRT的检测结果以0°～180°为界,分成上下两部分进行对应分析.结果与正常半侧视野对应的1/2视盘比较,显示异常半侧视野对应的1/2视盘HRT参数中,杯盘面积比、视杯形态测量值显著增大,而盘沿面积、视网膜神经纤维层厚度及视网膜神经纤维层横断面积值显著减少 (t=-2.625～3.025,P=0.003～0.05);NTG眼和POAG眼对应与异常半侧视野的HRT视盘参数差异无显著性(t=-0.98～1.511,P=0.14～0.97).结论 HRT参数能较准确反映与视野损害相一致的视盘变化,其中尤以杯盘面积比、盘沿面积、视杯形态测量、平均视网膜神经纤维厚度及视网膜神经纤维层横断面积测量值较为准确.NTG和POAG眼的视盘形态相似,可能具备某些相似的视神经损害发生机制.     

A comparison of optic disc topographic parameters in patients with primary open angle glaucoma,normal tension glaucoma,and ocular hypertension

Background Heidelberg Retina Tomograph (HRT) findings have been employed to quantitatively assess the topography of optic discs. We measured topographic parameters of optic discs in patients with primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), and ocular hypertension (OH) using an HRT in order to determine whether HRT topographic parameters can be used to differentiate those conditions.Methods Seventeen eyes in 17 patients with POAG, 23 eyes in 23 patients with NTG, and 15 eyes in 15 patients with OH were examined using an HRT, and the results were analyzed by age, refractive error, and topographic parameters.Results Among the HRT parameters, the mean values for rim area, rim volume, cup disk area ratio, and classification showed significant differences among POAG, NTG, and OH eyes. The mean values for cup area, cup volume, mean RNFL thickness, and RNFL cross section area showed significant differences between POAG and NTG eyes, and NTG and OH eyes, however, not between POAG and OH eyes. Cup shape measure showed significant differences between POAG and OH, and NTG and OH eyes, but not between POAG and NTG eyes.Conclusions Our results suggest that POAG is distinguishable from NTG and OH based on evaluations of rim area and rim volume. Patients with NTG tend to have larger cupping, smaller rims, and thinner retinal nerve fiber layers as compared to POAG and OH patients. Thus, HRT topographic parameters are useful to differentiate patients with POAG, NTG, and OH.     

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）     

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。     

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。     

Papillary blood flow and morphological parameters of the optic nerve head in patients with normal tension glaucoma, primary open angle glaucoma and in healthy volunteers

The aim of the present study was to compare selected morphological parameters of the optic nerve head and papillary blood flow in patients with NTG, POAG and in healthy volunteers, as well as to find any possible correlation between selected morphological parameters and papillary blood flow. 21 glaucomatous and 31 normal eyes were diagnosed using HRT and HRF. Statistically significant differences within many morphological parameters like cup area, cup to disc, cup shape measure, rim volume, RFNL thickness, RFNL cross section and neuroretinal rim blood flow appeared. Nevertheless, in glaucoma patients no statistically significant differences between morphology and flow were found. The conclusion is that blood flow impairment within the neuroretinal rim is connected with glaucoma neuropathy development, nevertheless it is affected by other factors.     

视网膜断层扫描仪在青光眼性视神经病变中的诊断价值

目的　评价视网膜断层扫描仪在青光眼性视神经病变中的诊断价值。方法　应用海德堡视网膜断层扫描仪 (HRT)检测 116例 (116只眼 )正常人和 6 3例 (99只眼 )原发性开角型青光眼(POAG)患者的视乳头地形图参数 ,比较两者间各参数的差异 ;将正常人与POAG患者的视乳头地形图参数进行逐步判别分析 ,建立判别函数 ,筛选出诊断POAG的敏感参数并进行回代分析。结果POAG患者的视盘面积 (DA)、视杯面积 (CA)、杯 /盘面积 (C/DAR)、盘沿面积 (RA)、视乳头轮廓线高度变化值 (HVC)、视杯容积 (CV)、盘沿容积 (RV)、平均视杯深度 (MCD)、最大视杯深度 (MxCD)、视杯形态测量 (CSM)、平均视网膜神经纤维层厚度 (mRNFLT)、视网膜神经纤维层截面面积 (RNFLA)与正常人比较差异有显著意义 (P <0 0 0 1) ;对POAG诊断敏感的视盘地形图参数为C/DAR、RA、CSM、CV和MxCD ;判别函数式为Y =- 2 0 83- 4 833×C/DAR - 2 0 379×CSM 2 0 35×RA 3 95 5×CV - 3 70 1×MxCD ;对POAG诊断的敏感性、特异性及诊断符合率分别为 81 8%、86 2 %及 84 2 % ,与HRT自动分析程序相当。结论　POAG患者视乳头地形图与正常人差异较大 ;利用我国人的数据资料建立的判别函数对POAG诊断效能与HRT自动分析程序相当 ,说明HRT自动分析程序在一定程     

原发性开角型青光眼HRT视盘参数和视野缺损的关系

目的 :探讨原发性开角型青光眼视盘参数和视野平均缺损之间的关系。方法 :用海德堡视网膜断层扫描仪和自动视野计测定 5 5名原发性开角型青光眼患者的视盘参数 (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 )和静态光阈值。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 :盘沿面积与平均缺损显著相关 (r =0 3 5 0 ,P <0 0 5 )。盘沿面积每减少 1mm2 ,视野缺损绝对值增加 8 0 81dB。本研究没有发现其它 6个参数与平均缺损相关关系的显著性。结论 :盘沿面积在HRT众多参数中最能反映青光眼的视野平均缺损程度。     

Detection of optic disc change with the Heidelberg retina tomograph before confirmed visual field change in ocular hypertensives converting to early glaucoma

AIM: To determine whether analysis of sequential optic disc images obtained with the Heidelberg retina tomograph (HRT) is able to demonstrate optic disc change before the development of reproducible field defects in a group of ocular hypertensive (OHT) patients converting to early glaucoma. METHODS: Two groups were analysed: (1) 13 eyes of 13 OHT patients who subsequently developed reproducible field defects (converters); and (2) 13 eyes of 11 normal control subjects. Two sequential optic disc images were obtained using the HRT (median separation between images was 12 months for the converters and 13 months for the normals). The second image in the converter group was obtained before confirmed visual field loss. The optic disc variables were analysed both globally and segmentally using HRT software version 1.11. The Wilcoxon signed rank test was used to determine if there were any significant differences between the variables of the two image sets. RESULTS: Significant optic disc change was demonstrated in the group of converters: (1) global variables: the cup area increased by 9.7%, the C/D area ratio increased by 10.5%, and the rim area decreased by 6.9%; (2) segmental variables: the superonasal cup area increased by 11.0%, the superonasal C/D area ratio increased 11.7%, and the inferonasal cup volume increased by 28.4%. The temporal rim volume decreased by 15.6%, the inferotemporal rim volume decreased by 23.6%, and the rim area in the superonasal and superotemporal segments decreased by 6.6% and 6.9% respectively. CONCLUSION: Analysis of sequential optic disc images on the HRT allowed the detection of glaucomatous change before confirmed visual field change in a group of OHT patients converting to early glaucoma.     

高眼压性和正常眼压性原发性开角型青光眼视神经损害特征的比较

目的探讨高眼压性原发性开角型青光眼(POAG)和正常眼压性青光眼(NTG)患者视神经损害的不同特点。方法应用德国Heidelberg公司生产的视网膜断层扫描仪对高眼压性POAG39例(47只眼)和NTG32例(38只眼)进行定量视盘参数和神经纤维层检查,并行眼底立体照相观察视网膜神经纤维层(RNFL)缺损类型,检测静态定量视野,并对检查结果进行比较。结果(1)NTG组视盘总体参数和分区(除颞侧外)盘沿面积、沿/盘面积小于高眼压性POAG组,而C/D大于高眼压性POAG组;平均RNFL厚度和RNFL面积在颞下和颞上小于高眼压性POAG组;总体盘沿容积小于高眼压性POAG组,总体平均视杯深度和颞下视杯面积大于高眼压性POAG组,两组差异均有统计学意义(P<005)。两组颞侧视盘各参数比较,差异无统计学意义(P>005)。(2)RNFL缺损类型高眼压性POAG组RNFL弥漫性缺损占5319%,局限性缺损占426%;NTG组弥漫性缺损占2105%,局限性缺损占5526%。两组RNFL缺损类型构成比比较,差异有统计学意义(P<001)。结论NTG较高眼压性POAG具有较大的C/D值、C/D面积比和窄盘沿面积,RNFL丢失严重。高眼压性POAG患者的RNFL以弥漫性缺损为主,NTG患者的RNFL以局限性缺损为主。两者视神经损害具有不同特点,其损害机制可能不同。(中华眼科杂志,2005,41136140)     

Effect of topical glaucoma medications on optic disc topography in normal tension glaucoma

PURPOSE: To investigate the effects of topical glaucoma medications on optic disc topography in patients with normal tension glaucoma (NTG) using confocal scanning laser ophthalmoscopy. SUBJECTS AND METHODS: We enrolled 39 NTG patients (39 eyes) who had not been treated for glaucoma. A combined medication of 0.005% latanoprost and 0.5% timolol gel was administered. Optic disc parameters were measured before and after the treatment using the Heidelberg Retina Tomograph (HRT). The treatment period was 20.2 +/- 6.4 days (mean +/- SD). RESULTS: Administration of these two drugs significantly decreased the intraocular pressure (IOP) from 16.7 +/- 1.9 mmHg to 12.3 +/- 1.9 mmHg (26.7 +/- 8.7% decrease). Cup area, cup/disk area ratio and cup volume decreased significantly, while the rim area increased significantly. Linear progression analysis showed a significant correlation between the percent decrease in the IOP and the topographic changes in the cup area, cup/disk area ratio, rim area, cup volume, rim volume, and height variation contour. When the subjects were divided into two groups: patients with high baseline IOP of more than 16 mmHg (HNTG group) and those with low baseline IOP below 15 mmHg (LNTG group), significant changes in several parameters were observed only in the HNTG group. CONCLUSIONS: These results suggest that the topographic changes in the optic disc were induced by the short-term topical glaucoma medications prescribed for the NTG patients, and the changes in several HRT parameters correlated with the percent decrease in the IOP.     

Relationship between optic nerve head microcirculation and visual field loss in glaucoma

PURPOSE: To study the relationship between optic nerve head blood flow velocity and visual field loss in patients with primary open-angle glaucoma (POAG) and normal tension glaucoma (NTG). METHODS: This study included 44 eyes of 44 patients with POAG and 44 eyes of 44 patients with NTG. To evaluate optic nerve head blood flow velocity, the square blur rate (SBR) was measured by means of laser speckle flowgraphy. The correlation between SBR and Humphrey visual field indices was evaluated with linear regression analysis. RESULTS: In the NTG group, the average SBR at the superior and inferior temporal neuroretinal rim was positively correlated with mean deviation (MD) (r = 0.349, p = 0.020). The SBR at the superior or inferior temporal neuroretinal rim was positively correlated with the sum of the total deviations in the corresponding hemifields (r = 0.299, p = 0.049; r = 0.354, p = 0.019, respectively). The correlations between SBR and MD did not differ statistically between the NTG and POAG groups; however, no significant correlation between SBR and visual field indices was observed in the POAG group. CONCLUSION: These results suggested that the change in the circulation of the optic nerve head may be related to visual field damage in the NTG group but may be less involved in visual field damage in the POAG group.     

开角型青光眼与正常大陷凹眼中视乳头旁萎缩区的比较研究

目的研究原发性开角型青光眼(POAG)、正常眼压性青光眼(NTG)与正常大陷凹眼的视乳头旁脉络膜萎缩区(PPA)的差异及其与视野的关系。方法利用计算机图像分析系统对拍摄的视乳头立体图像进行测量,比较42例(42只眼)POAG、40例(40只眼)NTG与45例(45只眼)正常大陷凹眼之间PPA的发生率及大小差异,分析PPA的有关参数与视乳头结构指标、视野分级之间的相关性。所有入选患者的屈光度(等效球镜度数)均在+3.00~-3.00D之间。结果正常大陷凹组、POAG组及NTG组α区的出现率分别为85.4%、100.0%、95.0%,β区的出现率分别为19.1%、48.9%、37.5%,POAG组和NTG组的α区和β区的出现率均大于正常大陷凹组,差异均有统计学意义(P<0.05)。正常大陷凹组、POAG组及NTG组β区面积分别为(0.08±0.25)、(0.24±0.36)、(0.14±0.21)mm2,POAG组的β区面积大于正常大陷凹组,差异有统计学意义(P<0.05)。三组的α区面积差异无统计学意义(Chi-Square=4.534,P=0.104)。而POAG组与NTG组间上述各指标及α区和β区出现率的差异均无统计学意义(P>0.05)。青光眼患者视乳头结构指标与视野相关分析结果表明,杯/盘比值与视野受损分级之间有较强相关性(r=0.5624,P<0.01)。而α区面积、β区面积与视野受损分级之间均为低相关性(α区:r=0.246,P<0.01;β区:r=0.2302,P<0.01)。有无青光眼性视野缺损相关因素的Logistic回归分析结果显示,在包括年龄、性别、屈光度、杯/盘比值分级指标及α区面积和β区有无的多个因素中,仅年龄和杯/盘比值分级指标被证实为两个可能的影响因素。结论排除了-3.00D以上的中高度近视人群后,POAG和NTG患者的α区和β区出现率及β区面积虽与正常大陷凹者有所不同,但其与视野缺损程度的相关性较传统的视乳头结构指标低,在两组青光眼患者间也未见明显差异。由此认为PPA不能作为诊断POAG的独立指标,也不能作为POAG与NTG的鉴别诊断指标。     

中国正常人眼眼底断层扫描HRT-Ⅱ测量值

摘要目的应用海德堡视网膜断层扫描仪Ⅱ（HRT-Ⅱ）系统测定中国正常人眼的视盘结构参数。方法随机筛选出不同年龄的正常观察对象200例（400眼）。分为男、女2组进行HRT-Ⅱ检查,得出不同性别、不同眼别视盘参数的正常值。结果得出HRT—Ⅱ系统提供的部分重要视盘参数：盘面积、杯面积、盘缘面积、杯／盘面积比、盘沿／盘面积比、杯容积、盘缘容积、最大杯深、高度变异曲线、平均神经纤维层的厚度、神经纤维层截面积,不同性别及不同眼别问各参数比较差异均无统计学意义（P〉0．05）。结论所得测量值与以往国外所提供的数据有一定差异,较以往国内参考值亦有一定的差异,HRT-Ⅱ在国内应用时的参考值需进行矫正。     

Absolute filling defects of the optic disc in fluorescein angiograms in glaucoma--a retrospective clinical study

BACKGROUND: Analysis of clinical importance of the size of filling defects in fluorescein angiograms in primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), ocular hypertension and subjects with physiological excavations in comparison to visual field loss, optic nerve head morphology and hemodynamics. PATIENTS AND METHODS: 75 patients (POAG, NTG, ocular hypertension) and 10 healthy subjects with physiological excavations were included in this study. In digitized video fluorescein angiograms (Scanning Laser Ophthalmoscope) the size of absolute filling defects of the optic disc was quantified in the early venous phase and expressed by percentage of the optic disc. Visual fields were obtained by conventional static perimetry (Humphrey 24-2) and graded in stages of glaucoma visual field defects (Aulhorn I-V). Optic disc excavations were evaluated as cup-to-disc-area-ratios. RESULTS: The filling defects correlated with the visual-field loss stages of Aulhorn and the visual field indices MD (mean deviation), PSD (pattern standard deviation) and CPSD (corrected pattern standard deviation). There was no correlation with the index SF (short-term fluctuation) and with systemic hemodynamics (blood pressure, perfusion pressure) or the IOP. Absolute filling defects correlated with the cup-to-disc-area-ratio in NTG. The absolute filling defects were larger in patients with glaucoma (POAG, NTG) in comparison to patients without glaucomatous visual field loss (ocular hypertension, glaucoma-like discs). No difference of filling defects was found in the glaucoma group (POAG, NTG). Patients with NTG had larger excavations and lower systolic blood pressures than patients with POAG. CONCLUSION: The size of fluorescein filling defects may be useful as a parameter for the evaluation of an ischemic lesion of the optic nerve head. Absolute filling defects may differentiate POAG from ocular hypertension and NTG from glaucoma-like discs without field defects. The results support the hypothesis that in POAG and NTG disturbances of the circulation result in similar filling defects of the optic disc and visual field loss.     

Correlation analysis of visual field thresholds and scanning laser ophthalmoscopic optic nerve head measurements in glaucoma

In a cross-sectional study of 50 consecutive primary open-angle glaucoma cases, full threshold 30-2 visual fields on Humphrey Visual Field Analyser were correlated to stereometric parameters obtained using a scanning laser ophthalmoscope (HRT II). The strength of linear correlation between the stereometric parameters and visual thresholds was used to generate a correspondence map between the optic disc and the visual field. Rim/disc area ratio and cup/disc area ratio correlated with the visual thresholds at the highest number of points in the visual fields. Thresholds at superior hemifield locations correlated best with the rim/disc area ratio and cup/disc area ratio in the inferonasal sector and the ones in the inferior hemifield correlated best with the rim/disc area ratio and cup/disc area ratio in the superotemporal sector. Optic disc parameters correlated better with inferior field locations and non-edge points than superior field locations and edge points. The data indicate that rim/disc area ratio and cup/disc area ratio measurements on HRT II have a good correlation with visual field damage seen on automated visual fields.     

海德堡视网膜断层扫描仪测量正常人视盘参数

目的 :建立正常人群海德堡视网膜断层扫描仪 (Heidelbergretinatomograph ,HRT)视盘参数的正常值 ,明确哪些因素对正常人HRT视盘参数有影响。方法 :选用 10 2例 (13 2只眼 )正常人 ,用HRT进行视盘扫描 ,视盘参数包括视盘面积、视杯面积和容积、盘沿面积和容积、视杯形态、视杯平均深度和最大深度、杯 /盘面积比、沿 /盘面积比、平均视网膜神经纤维层(retinalnervefiberlayer,RNFL)厚度和横截面积、水平C/D和垂直C/D。计算正常人视盘参数范围 ,用直线回归的方法判断视盘大小和年龄对视盘参数的影响。结果 :正常人左右眼和男女间视盘各参数差异无显著意义 (P >0 0 5)。年龄与RNFL厚度及横截面积呈负相关 ,相关系数分别为 -0 2 3 4和 -0 2 3 5,其余各参数与年龄无关。盘沿容积和视杯最大深度不受视盘大小的影响 ,其余各参数均与视盘大小呈线性相关。结论 :HRT可定量检测正常人视盘参数 ;正常人视盘参数变异很大 ,盘沿容积不受视盘大小的影响 ,是一个区分正常与早期青光眼的很好的参数     

Scanning laser ophthalmoscopy of the optic nerve head in exfoliation glaucoma and ocular hypertension with exfoliation syndrome

AIMS: To study the relation between optic nerve head topography (Heidelberg retina tomograph, HRT) and disc area, visual field index mean defect (MD), and intraocular pressure (IOP), and to see whether change in HRT parameters is associated with change in MD in a prospective follow up. METHODS: 80 consecutive patients (69 patients with exfoliation glaucoma and 11 with ocular hypertension combined with exfoliation syndrome) were examined before IOP reducing intervention and prospectively followed every 6 months for 2 years. RESULTS: At the entry point, multiple regression analysis showed significant linear association between MD and all HRT parameters, when controlling for disc area. Disc area showed significant association with cup area, cup/disc area ratio, rim area, cup volume, and mean RNFL thickness. Six months after intervention IOP had decreased significantly. Reversible changes in cup area, cup/disc area ratio, rim area, cup volume, rim volume, mean cup depth, and maximum cup depth were associated with decrease in IOP. During the follow up period from 6 month to 2 years, IOP did not change significantly, and MD was used as a measure of progression of glaucoma. During this period, only cup shape measure among HRT parameters showed significant association with subsequent change in MD. CONCLUSION: Disc area should be taken into account when using HRT to compare patients. Any effect of change in IOP should be also taken into account when using HRT in follow up. Cup shape measure is a promising indicator of progression of glaucomatous damage.     

The Heidelberg retina tomograph ancillary study to the European glaucoma prevention study: study design and baseline factors

Purpose: To describe the study design and baseline factors of the Heidelberg Retina Tomograph ancillary study within the EGPS. Furthermore, to examine the relationship between HRT optic disc topographic measurements and baseline demographic and ocular factors. Methods: Four hundred and eighty‐nine ocular hypertensive participants were included. Each participant completed HRT imaging at least annually. The associations between HRT measurements and IOP, central corneal thickness (CCT), baseline photographic estimates of vertical CDR ratio (CDR), asymmetry between the two eyes in CDR ratio and baseline visual field indices were assessed using regression analysis. Results: Associations between HRT measurements and vertical CDR by photographs were found for almost all stereometric optic disc parameters in both univariate and multivariate analysis. The strongest association was found between vertical CDR measurements and disc, cup and rim area; cup and rim volume, CDR area, linear CDR, mean and maximum cup depth and cup shape measure (all p < 0.0001). In multivariate analysis, pattern standard deviation (PSD) and HRT disc area had significant associations with several HRT optic disc measurements. Furthermore, CCT was significantly associated with reference height and the glaucoma probability score (GPS, outside normal limits). Conclusions: The EGPS is the first multicentre, placebo‐controlled randomized clinical trial to use HRT for monitoring optic disc changes in participants with ocular hypertension. We found strong associations between stereophotographic vertical CDR estimates, HRT disc area, PSD and several HRT parameters. We found, furthermore, that the parameters reference height and GPS were significantly related to central corneal thickness.     

正常眼压性青光眼患者视盘区血管密度与视野指数和视野损伤形态的关系

目的：研究正常眼压性青光眼(NTG)视盘区血管密度变化与青光眼视野指数(VFI)和视野损伤形态分期的关系。

方法：选取我院2018-12/2020-12 NTG患者106例106眼和原发性开角型青光眼(POAG)患者79例79眼进行横断面研究,其中双眼病变者采用随机数字表选取1眼为样本,同时选取我院健康体检者92名为对照组,三组均完成视盘血管密度、VFI检测和视野缺损形态分期,然后分析视盘血管密度与VFI和视野缺损形态分期的关系。

结果：POAG组眼压明显高于NTG组和对照组(P<0.05); NTG组和POAG组视盘区全区域血管密度、大血管密度和毛细血管密度均明显低于对照组(P<0.05),无血管区密度均明显高于对照组(P<0.05),且NTG组和POAG组各项指标比较有差异(P<0.05); NTG组和POAG组VFI均明显低于对照组(P<0.05),视野平均缺损(MD)明显高于对照组(P<0.05),且NTG组和POAG组VFI和MD比较无差异(P>0.05); 随着视野缺损形态分期增加,NTG患者视盘全区域血管密度和毛细血管密度呈明显降低趋势(P<0.05); NTG患者视盘全区域血管密度和毛细血管密度与VFI呈正相关性,与视野缺损形态分期呈负相关性,无血管区密度与VFI呈负相关性,与视野缺损形态分期呈正相关性(均P<0.05)。

结论：NTG患者视盘血管密度较POAG患者和正常人群明显降低,且与VFI和视野缺损形态分期存在明显相关性,其中以毛细血管密度相关程度最高,可见OCTA对NTG诊断、治疗和随访均具有重要临床意义。