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目的了解青光眼患者视乳头旁萎缩(peripapillaryatrophy,PPA)即脉络膜和视网膜萎缩的发生频率及脉络膜血供情况。方法选择原发性青光眼患者43例(43只眼),其中慢性闭角型青光眼16例(16只眼),开角型青光眼27例(27只眼),正常对照组33例(33只眼)。采用海德堡视网膜血管造影仪(HRA)对患者进行荧光素眼底血管造影和吲哚氰绿眼底血管造影(ICGA)同步检查,通过荧光素眼底血管造影进行PPAα带和β带的判定,观察其ICGA特点。结果PPAα带的ICGA表现为充盈正常和充盈减弱两种表现,PPAβ带的ICGA显示无脉络膜血管充盈,或仅见大脉络膜血管充盈。PPAα带的发生频率慢性闭角型青光眼组为87.5%,开角型青光眼组为100.0%,对照组为84.8%,差异无统计学意义(χ2=4.339,P=0.114)。PPAβ带的发生频率慢性闭角型青光眼组为31.3%,开角型青光眼组为77.8%,对照组为21.9%,差异有统计学意义(χ2=19.915,P=0.000)。PPAα带ICGA充盈减弱的发生频率开角型青光眼组为66.7%,慢性闭角型青光眼组为53.8%,对照组为32.1%,差异有统计学意义(χ2=6.648,P=0.036)。结论PPAβ带脉络膜血供缺乏,其发生频率以开角型青光眼组最高,慢性闭角型青光眼组次之。PPAα带的发生频率各组间差异无统计学意义,但开角型和慢性闭角型青光眼组的PPAα带较多表现为脉络膜血管充盈减弱,推测可能是PPAβ带扩大的前兆。(中华眼科杂志,2006,42967-971)
Objective To investigate the incidence of peripapillary atrophy (PPA), the choroidal and retinal atrophy, and the choroidal blood supply in patients with glaucoma. Methods Forty-three patients (43 eyes) with primary glaucoma were selected, including 16 cases of chronic angle closure glaucoma (27 eyes), 27 cases of open angle glaucoma (27 eyes) and 33 cases (33 eyes) of normal control group ). Heidelberg retinal angiography (HRA) patients with fluorescein fundus angiography and indocyanine green fundus angiography (ICGA) simultaneous examination by fluorescein angiography PPAα and β-band determination of the ICGA to observe its characteristics . Results The ICGA of PPAα band showed normal filling and weakened filling. The ICGA of PPAβ band showed no choroidal blood vessel filling, or only the filling of choroidal blood vessels. The incidence of PPAα band was 87.5% in chronic angle-closure glaucoma group, 100.0% in open-angle glaucoma group and 84.8% in control group, with no significant difference (χ2 = 4.339, P = 0.114). The frequency of PPAβ band was 31.3% in chronic angle-closure glaucoma group, 77.8% in open-angle glaucoma group and 21.9% in control group, with significant difference (χ2 = 19.915, P = 0.000). The occurrence frequency of PPAα band ICGA filling was 66.7% in open-angle glaucoma group, 53.8% in chronic angle-closure glaucoma group and 32.1% in control group (χ2 = 6.648, P = 0.036). Conclusions PPAβ with choroidal blood supply deficiency, its frequency of occurrence is highest in open angle glaucoma group, followed by chronic angle closure glaucoma group. There was no significant difference in the frequency of PPAα band between the groups. However, the PPAα band in the open angle and chronic angle closure glaucoma group showed a more decreased choroidal blood vessel filling, presumably the precursor of PPAβ band expansion. (Chinese Journal of Ophthalmology, 2006,42967-971)