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목적 : To categorize of peripapillary atrophy (PPA) with respect to the extent of existing Bruch’s membrane (BM) on the bed and to determine factors associated with each PPA type. This study analyzed 162 eyes from 162 patients who had a temporal PPA of which the width is greater than 200 μm on at least one horizontal scan image within the mid-horizontal 1/3 of the optic nerve.
방법 : Based on the extent of BM within PPA area, eyes were categorized as Group A (with intact BM, 61eyes), B (with discontinuous BM, 80eyes), and C (with lacking BM, 21eyes). Differences in the demographic, clinical and ocular characteristics were compared using ANOVA and chi-square tests between the 3 groups. The distance from the temporal optic disc margin to the temporal margin of PPA (PPA width) and to the edge of the BM/RPE complex (width of PPA devoid of BM (PPAdBM) were measured on the horizontal scan.The configuration of the border tissue of Elschnig at the temporal disc margin was assessed
결과 : The mean age of group A was significantly higher than that of groups of B and C (P < 0.001). The average axial length was greatest in group C, then group B and least in group A (P < 0.001). In group A, the border tissue mainly had a non-oblique configuration (44/61 eyes, 72.1%), whereas majority of the eyes in group B (77/80 eyes, 96.3%) and all eyes in group C (21 eyes) had an externally oblique configuration (P < 0.001). A longer axial length was significantly correlated with a larger PPAdBM width (partial correlation coefficient adjusted by age = 0.410, P < 0.001).
결론 : A new morphologic classification of PPA, which may reflect the differing pathogenesis, has been proposed. It appears that PPA with intact BM is likely an age-related atrophic change, while PPA with lacking BM may result from scleral stretching derived from eyeball elongation.
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