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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(RNFLD)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RNFLD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29人(34.94%),33只眼有出血的记录,累计58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RNFLD的毗邻关系:在可获得的立体眼底像中有23眼次(15人16只眼)视盘出血在同一象限内存介楔形RNFLD,其中22眼次出血位于视盘旁楔形RNFLD的边界附近。③视盘出血发生相对应的视网膜神经纤维层的变化:24眼次出血(20人21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RNFLD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)随防中相对应处无明显局限性RNFLD出现。结论正常眼压青光眼患者的视盘出血多分布于颞下,其次为颞上,视盘出血的出现常预示着其邻近部位局限性。
Objective To observe the relationship between optic disc hemorrhage and localized retinal nerve fiber layer defect (RNFLD) in normal tension glaucoma. Methods The cumulative frequency of ocular hemorrhage and its distribution on optic disc in 83 patients with normal tension glaucoma were retrospectively analyzed. The adjacent disc relationship between disc hemorrhage and disc-limited RNFLD in the same quadrant of color stereopsis was observed. Changes in retinal nerve fiber layer after bleeding occurred. Results ① The optic disc hemorrhage was distributed on the optic disc: 29 of 83 (34.94%) and 33 eyes had hemorrhage recorded in 58 eyes, of which 39 were inferior temporal, 14 were superior temporal, 5 were observed in other quadrants . (2) Adjacent relationship between optic disc hemorrhage and disc-RNFLD in the same quadrant of stereoscopic fundus images: In the available stereoscopic fundus images, 23 eyes (16 eyes of 15) had discival wedge-shaped RNFLD in the same quadrant, of which 22 eyes Bleeding is located near the border of optic disc wedge-shaped RNFLD. Â’¡ optic disc hemorrhage occurred corresponding retinal nerve fiber layer changes: 24 times the bleeding (20 21 eyes) bleeding and bleeding 2 years after the fundus image is intact. Follow-up like Central Plains 19 times the optic disc hemorrhage (all located in the temporal or superior temporal) at the corresponding retinal nerve fiber layer changes, which from no defect to the width of wedge-shaped defects were 7 times, the original disc bleeding adjacent to the limitations 12 cases of sexual RNFLD expander. The other 5 cases of secondary disc hemorrhage (one in temporal superior temporalis and three in other quadrants) showed no obvious limitations with RNFLD. Conclusion In patients with normal intraocular pressure glaucoma, optic disc hemorrhage is mostly distributed in the inferior temporal region, followed by the superior temporal and optic disc hemorrhage often indicates the limitations of the adjacent parts.