境界明瞭な網膜神経線維層欠損を有する正常眼圧緑内障における乳頭出血出現や網膜神経線維層欠損拡大と視野障害進行との関連

• 新田, 耕治

• 杉山, 和久

• 棚橋, 俊郎

書誌事項

タイトル別名

• キョウカイ メイリョウ ナ モウマク シンケイ センイソウ ケッソン オ ユウスル セイジョウガンアツ リョクナイショウ ニ オケル ニュウトウ シュッケツ シュツゲン ヤ モウマク シンケイ センイソウ ケッソン カクダイ ト シヤ ショウガイ シンコウ ト ノ カンレン
• Relationship between the Frequency of Disc Hemorrhage and the Enlargement of Nerve Fiber Layer Defects and the Deterioration Speed of Visual Field Loss in Normal-tension Glaucoma with Wedge-shaped Nerve Fiber Layer Defects

抄録

目的:正常眼圧緑内障(NTG)について乳頭出血(DH)出現および網膜神経線維層欠損(NFLD)拡大と視野障害進行との関連を検討すること. 対象と方法:3年以上(平均9.1年)経過観察した境界明瞭なNFLDを認めるNTG106例106眼を視野障害進行速度(MD slope, 半視野TD slope)やNFLD角度拡大速度について検討した. NFLD角度はカラー眼底写真を青成分のみを抽出した白黒写真に加工し, 乳頭中心と黄斑の中点を求め, 乳頭を中心とし中点までの距離を半径とした円がNFLDと交差する2点と乳頭中心とのなす角とした. 結果:DH出現頻度は51/106(48.1%)であり, DH回数は1.28±1.99(平均値±標準偏差)回であった. MD slopeがDH群は-0.30dB/yearで非DH群:-0.13dB/yearより有意に急峻で, NFLD拡大速度がDH群は1.90度/yearで非DH群:O.64度/yearより有意に急速だった. DH回数が増加するにつれTD slope(r=-0.263,p=0.0056)とNFLD拡大速度(r=0.410, p<0.0001)は有意に加速した. 結論:境界明瞭なNFLDを有するNTGにおいて, DH眼は非DH眼よりもNFLD拡大速度と視野障害進行速度が速く, かつ頻回にDHが出現した症例ほどその両者が加速した. 　　Purpose : To examine progressive visual field loss in relation to disc hemorrhage (DH) and enlarged nerve fiber layer defects (NFLDs) in normal-tension glaucoma (NTG) . Subjects and Methods : There were 106 eyes of 106 NTG patients (mean follow-up : 9.1 years) with well-defined NFLD borders and at least 3 years of follow-up. Examination was performed on their rate of visual field loss (MD slope and hemifield TD slope) and their rate of NFLD angle enlargement. For the NFLD angle, we took color fundus photographs and converted color photos into black-white photos extracted the blue ingredient. The midpoint between the fovea and the disc center was determined. The center was established as the disc, and the distance to the midpoint was established as the radius of a circle. The NFLD angle was defined as the angle formed by the two points where this circle intersected the NFLD and a third point which was the disc center. Results : DH was seen in 51/106 (48.1%) cases and it occurred 1.28 ± 1.99 times. In the DH group, the MD slope was -0.30 dB/year, indicating a significantly faster rate of visual field loss than that of the non-DH group (-0.13 dB/year) ; the rate of NFLD enlargement was 1.90 degrees/year, indicating a significantly faster rate than that of the non-DH group at 0.64 degrees/year. As the occurrence of DH increased, the TD slope (r = -0.263, p = 0.0056) and the rate of NFLD enlargement (r = 0.410, p <0.0001) increased significantly. Conclusion : Examination was performed on NTG eyes with well-defined NFLD borders which were divided into the groups of with and without DH. The DH eyes had a faster rate of NFLD enlargement and faster progression of visual field loss compared with the non-DH eyes. In addition, the rate of NFLD enlargement and progression of visual field loss increased in the cases with frequent DHs.

収録刊行物

• 日本眼科學会雜誌 = Journal of Japanese Ophthalmological Society

  日本眼科學会雜誌 = Journal of Japanese Ophthalmological Society 115 (9), 839-847, 2011-09-10

  日本眼科学会 = Japanese Ophthalmological Society

キーワード

• 正常眼圧緑内障
• 乳頭出血
• 視野障害進行
• 網膜神経線維層欠損
• 長期観察
• Normal-tension glaucoma
• Disc hemorrhage
• Visual field loss
• Retinal nerve fiber layer defect
• Long-term follow up

詳細情報

• CRID: 1050564285904268672
• NII論文ID: 120005345675
• NII論文ID: 10029528644
• NII書誌ID: AN00187157
• ISSN: 00290203
• NDL書誌ID: 11233125
• Web Site: http://hdl.handle.net/2297/36189
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I11233125
• Web Site: https://search.jamas.or.jp/link/ui/2011350979
• 本文言語コード: ja
• 資料種別: journal article
• データソース種別:
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  • NDL
  • CiNii Articles
  • KAKEN