非青光眼性大视杯临床分析

目的 探讨非青光眼性疾病引起视杯扩大的病因以及鉴别要点，为临床识别非青光眼性大视杯提供依据。设计 回顾性病例系列。研究对象 12例（19眼）非青光眼大视杯患者。方法 分析比较这些患者的病因、视盘形态学特征以及相关影像资料。主要指标 病因、视盘形态特征以及视功能改变。结果 12例患者中，4例为视神经炎，1例视神经脊髓炎，1例Leber遗传性视神经病变，2例垂体瘤，1例基底节脑出血，1例睫状视网膜动脉阻塞合并视网膜中央静脉阻塞，1例视网膜中央动脉阻塞，1例视神经损伤。所有患者视杯呈弥漫性或局限性扩大，盘沿苍白。视野表现为与原发病相应的缺损。结论 各种视神经疾病和视网膜疾病均有可能导致大视杯，它与青光眼性大视杯的鉴别点在于盘沿色泽、有无盘沿局限性缺失以及视功能异常和视盘改变的相关性。（眼科, 2012, 21: 306-309）

Clinical characteristics of nonglaucomatous optic disc cupping

Objective To analyze the etiology of nonglaucomatous optic disc cupping and the differentiation with glaucomatous optic disc cupping. Design Retrospective case series. Participants Twelve cases with 19 eyes of nonglaucomatous optic disc cupping. Methods The morphology of optic disc and clinical data of these cases were analyzed. Main Outcome Measures Etiology, morphologi- cal characteristics of optic disc and visual function. Results Of the 12 cases, four were with optic neuritis, one with Devic disease, one with Leber hereditary optic neuropathy, two with pituitary adenoma, one with cerebral hemorrhage in basal ganglia, one with ciliary artery obstruction and central retinal vein occlusion, one with central retinal artery occlusion, and one with optic nerve injuries. In all patients the optic cupping shows diffuse excavation or focal notch with pale rim. The visual field defect was corresponding to the primary diseases. Conclusions Both optic nerve diseases and retinal diseases can cause nonglaucomatous optic disc cupping. The key points to differentiate nonglaucomatous optic disc cupping with glaucomatous lie in the color of optic disc rim, notched disc and the correlation between visual field defect and disc appearance.