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목적 : To investigate quantitative neuroretinal rim (NRR) characteristics in eyes with pallor and glaucomatous cupping.
방법 : We recruited patients with unilateral glaucoma and non-arteritic ischemic optic neuropathy, respectively. We matched pairs of five eyes by disc area; pallor affected (PL-AE) and unaffected fellow eye (PL-FE), glaucoma affected (GL-AE) and unaffected fellow eye (GL-FE), and control eye. Three rim width parameters against Bruch’s membrane opening (BMO), the minimum (BMO-MRW), vertical (BMO-VRW), and horizontal rim width (BMO-HRW) were measured. The ratio between BMO-HRW and BMO-VRW (HV ratio) was calculated. We compared in affected-unaffected, pallor-glaucoma, and disease-control matches.
결과 : We had 12 pairs of eyes. Under similar disc area, PL-AE had significantly thinner BMO-MRW, BMO-VRW, and BMO-HRW than PL-FE (all p<0.001), and thicker values than GL-AE with mean values of 136.9 um, 166.7 um, and 263.4 um vs 84.8 um, 121.5 um, and 103.8 um, respectively (p=0.004, 0.015, and <0.001). Against control eyes, all rim parameters except BMO-HRW of PL-AE significantly decreased. We observed relative NRR tissue preservation in horizontal direction in PL-AE, as HRW being 64% of fellow eye value contrasting that of glaucoma being 38% where rim thinning occured in all directions.
결론 : We compared quantitatively the NRR structures between pallor and glaucomatous cupping, and controls. Relative horizontal NRR preservation of prelaminar tissue was marked in pallor compared to consistent thinning in glaucomatous cupping. Prelaminar area is composed mostly of glial cells, and preservation of glial columns under ischemic axonal loss might be the reason. Histopathologic examination should follow for confirmation.
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