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목적 : To investigate whether the configuration of the peripapillary sclera (PPS) differed between the eye with unilateral primary angle closure glaucoma (PACG) and the contralateral healthy eye in the same patient.
방법 : Both ONH of 48 patients with unilateral PACG were scanned by EDI SD-OCT. Anterior PPS configuration was assessed by measuring two (a central and a mid-inferior) reference points on horizontal B-scan images: (1) the end point of the choroidal tissue and (2) anterior scleral canal opening. The horizontal (X), vertical (Y) and oblique (Z) lengths of the line connecting the two reference points were measured. The surface area, and the median, and maximal lengths of the peripapillary atrophy (PPA) were determined using optic disc photograph.
결과 : : The X, Y, Z lengths of the anterior PPS were significantly greater in the PACG eyes than in the healthy eyes (all P<0.001), whereas the PPA surface area determined by optic disc photography showed no significant intereye difference (P=0.101). The largest intereye difference was for the Z length on the mid-inferior scans (PACG eyes vs. healthy eyes = 185±83 vs. 95±86 μm). On multivariate regression analysis, the Z length and lamina depth were negatively correlated with the mean deviation of visual field defect (P<0.001, and P=0.005, respectively).
결론 : Alteration of the PPS configuration in the posterolateral direction was observed on OCT images; this feature was indistinct on the optic disc photograph of patients with unilateral PACG. PPS strain in the posterolateral direction was significantly associated with the mean deviation of the visual field. This finding suggests that the posterolaterally strained PPS is a component of glaucomatous axonal damage.
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