正常眼压性青光眼视盘出血与局限性视网膜神经纤维层缺损的关系  

Relationship between optic disc hemorrhage and localized retinal nerve fiber layer defect in normal-tension glaucoma

作　　者：李梅[1] 李美玉[1] 任泽钦[1] 潘英姿[1] 乔荣华[1] 沈亚云[1] 刘丽娜[1] 王捷[1] 

机构地区：[1]北京大学第一医院眼科,100034

出　　处：《中华眼底病杂志》2004年第6期339-342,共4页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的　观察正常眼压性青光眼视盘出血与局限性视网膜神经纤维层缺损 (RNFL D)的关系。　方法　回顾性分析 83例正常眼压性青光眼患者视盘出血的累计发生频度及其在视盘上的分布 ,观察彩色立体眼底像中同一象限内的视盘出血和视盘旁局限性 RNFL D的毗邻关系及视盘出血发生之后视网膜神经纤维层的变化。　结果　 (1)视盘出血在视盘上分布 :83人中 2 9人 (34.94 % ) ,33只眼有出血的记录 ,累计 5 8眼次 ,其中颞下方 39眼次、颞上方 14眼次、其他象限 5眼次。 (2 )立体眼底像中同一象限内视盘出血与视盘旁 RNFL D的毗邻关系 :在可获得的立体眼底像中有 2 3眼次 (15人 16只眼 )视盘出血在同一象限内存在楔形 RNFL D,其中 2 2眼次出血位于视盘旁楔形 RNFL D的边界附近。 (3)视盘出血发生后相对应的视网膜神经纤维层的变化 :2 4眼次出血 (2 0人 2 1只眼 )出血当时及出血 2年以后的眼底像保存完整。随访像中原 19眼次视盘出血 (均位于颞下或颞上 )相对应处视网膜神经纤维层发生变化 ,其中由无缺损到出现宽窄不一的楔形缺损者 7眼次 ,原视盘出血毗邻的局限性 RNFL D扩展者 12眼次。其它 5眼次视盘出血 (颞上、颞下各 1眼次 ,其他象限 3眼次 )随访中相对应处无明显局限性 RNFL D出现。　结论　正常眼压性青光眼患?Objective To investigate the relationship between optic d isc hemorrhage and localized retinal never fiber layer defects (RNFLDs) in norma l-tension glaucoma. Methods In 83 patients with normal-tensi on glaucoma, the cumulative frequency and quadrantal distribution of optic disc hemorrhages were retrospectively analyzed. The neighboring relation between opti c disc hemorrhages and RNFLDs in a same quadrant and the changes of correspondin g retinal never fiber layer (RNFL) after the occurrence of optic disc hemorrhage s were observed by tridimensional photochromy of ocular fundus. Results (1) The occurrences and distribution of optic disc hemorrhages: 29 of 83(34.94%) patients (33 eyes) had totally 58 occurrences, including 39 in infer iotemporal area, 14 in superiotemporal area, and 5 in other area. (2) The relati onship of neighborhood between optic disc hemorrhages and RNFLDs: in the availab le tridimensional photochrome, 23 occurrences in 15 patients (16 eyes) were foun d with cuneiform RNFLDs in the same quadrant, in which 22 was near the border of cuneiform RNFLDs. (3) The changes of corresponding retinal never fiber layer (R NFL) after the occurrence of optic disc hemorrhages: the photochromes of 24 occu rrences in 20 patients (21 eyes) were kept well in the initial and the 2-year f ollow-up periods, while the changes of RNFL were found in each region correspon ding to the 19 occurrences (in inferiotemporal or superiotemporal area) in the i nitial photochrome, including 7 cuneiform defects with various sizes, and 12 dev eloped localized RNFLDs next to the initial hemorrhages in the optic disc. No ob vious localized RNFL corresponding to the other 5 occurrences (1 in inferiotempo ral, 1 in superiotemporal, and 3 in other areas) were found in the follow-up pe riod. Conclusion Optic disc hemorrhages in normal-tension gla ucoma occur mostly in inferiotemporal area, and secondly in superiotemporal area of optic disc, and the appearance of optic disc hemorrhages may suggest that th e localized RNFLD

关 键 词：视盘 出血 视网膜神经纤维层 正常眼压性青光眼 缺损 眼底 患者 象限 局限性 结论 

分 类 号：R775[医药卫生—眼科] R774[医药卫生—临床医学]