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Am J Ophthalmol ; 190: 34-49, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29559412

RESUMO

PURPOSE: To investigate focal lamina cribrosa (LC) defect that spatially correspond to the nonprogressive glaucomatous visual field defect (VFD) in myopic subjects. DESIGN: Case-control study. SUBJECTS: We included 159 myopic eyes with glaucomatous VFD under treatment and followed up for 7 years. METHODS: Serial enhanced-depth imaging spectral-domain optical coherence tomography B-scans of the optic discs were acquired at the end of the follow-up and reviewed for the LC defect. Nonprogressive VFD was defined as having ≤1 progressing point of Humphrey visual field, with a slope calculated using pointwise linear regression worse than -1.0 dB/year at P < .01. Eyes were classified as having either progressive or nonprogressive VFD, and associating factors were evaluated. RESULTS: Sixty-four subjects (40.3%) exhibited nonprogressive VFD with mean deviation change -0.06 ± 0.22 dB/year. Multivariate logistic regression analysis revealed that presence of LC defect was significantly associated with nonprogressive VFD (odds ratio, 3.96; P = .002). The location of LC defect corresponded spatially to the location of VFD. Nonprogressive eyes with LC defect exhibited lower baseline intraocular pressure (IOP) (16.6 mm Hg vs 21.0 mm Hg, P = .0030) and smaller percentage of IOP change (12.9% vs 30.5%, P < .0001) than those without LC defect, but greater myopic optic disc deformation (10.1 degrees vs 1.2 degrees in torsion angle, P < .0001). When the eyes with LC defect had higher baseline IOP, they exhibited progressive VFD. CONCLUSIONS: In myopic eyes, there are specific patters of LC defect that are suggested to be associated with nonprogressive glaucomatous VFD.


Assuntos
Glaucoma de Baixa Tensão/diagnóstico , Miopia/diagnóstico , Disco Óptico/patologia , Doenças do Nervo Óptico/diagnóstico , Transtornos da Visão/diagnóstico , Campos Visuais/fisiologia , Adulto , Estudos de Casos e Controles , Progressão da Doença , Feminino , Humanos , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Hipertensão Ocular/diagnóstico , Disco Óptico/diagnóstico por imagem , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/métodos , Transtornos da Visão/fisiopatologia , Testes de Campo Visual
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