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目的 探讨合并近视的原发性开角型青光眼 (primary open- angle glaucoma with myopia,M-POAG)视盘形态和视网膜神经纤维层 (retinal nerve fiber layer,RNFL )改变的特点及其临床意义。 方法 对 38例 6 3只合并近视 [(- 6 .92± 3.79) D]、高眼压性 [(32 .0 0± 9.36 ) mm Hg(1mm Hg=0 .133k Pa) ]原发性开角型青光眼 (primary open- angle glaucoma,POAG)作眼底彩色照相 ,利用计算机图像分析设备分析视盘形态及 RNFL 缺损的变化 ,并与单纯原发性开角型青光眼 (simple primary open- angle glaucoma,S- POAG)的相应临床检查资料进行比较。 结果 M- POAG视盘形态和 RNFL萎缩除具有与 S- POAG相同的一般表现外 ,尚有其特征性改变 :视盘呈椭圆形 (垂直或水平 )、斜入及部分缺损形 ,色泽苍白 ;视杯形态各异 ,呈碟形 (2 8.6 % )、垂直形 (2 5 .4% )、倾斜形 (2 3.8% )、锅形 (9.5 % )及局限与同心圆形等 ;盘沿面积及杯 /盘横径比值显著低于 S- POAG组 (P<0 .0 5 ,P<0 .0 0 1)。视盘凹陷偏心多向下方。RNFL 局限性萎缩主要出现在下方视网膜 ;弥漫性 RNFL萎缩与合并高度近视的中后期 POAG视野缺损密切相关 (P<0 .0 0 5 )。 结论 M- POAG的视盘形态特征以及 RNFL改变特点有助于在合并高度近视的 POAG中
Objective To investigate the characteristics and clinical significance of optic disc morphology and retinal nerve fiber layer (RNFL) changes in primary open-angle glaucoma with myopia (M-POAG) combined with myopia. Methods Thirty-eight patients with primary myopia with myopia [(-6.92 ± 3.79) D] and ocular hypertension (32.0 ± 9.36 mm Hg (1 mm Hg = 0.133 kPa) Primary open-angle glaucoma (POAG) was used as fundus fundus photography. The changes of optic disc morphology and RNFL defect were analyzed by computer image analysis equipment, and compared with simple primary open-angle glaucoma (S - POAG) of the corresponding clinical examination data were compared. Results M-POAG optic disc morphology and RNFL atrophy in addition to with the same general performance as S-POAG, there are still its characteristic changes: optic disc was oval (vertical or horizontal), oblique and partial defect shape, pale color; The shapes of the dishes are different from each other in the shape of dish (2 8.6%), vertical shape (2.54%), oblique shape (2 3.8%), pot shape (9.5%) and confinement and concentric circles / Plate diameter ratio was significantly lower than the S-POAG group (P <0. 05, P <0. Dished dent more eccentric to the bottom. The atrophy of RNFL mainly appeared in the retina below. The diffuse RNFL atrophy was closely related to POAG visual field defect in the middle and late stages (P <0.05). Conclusion The morphological characteristics of optic disc and the features of RNFL changes in M-POAG are helpful in the combination of POAG with high myopia