Objective To observe the relationship between shallow optic cup,small disc and occurrence in patients with nonarteritic anterior ischemic optic neuropathy (NAION).Methods Ninetysix patients(96 diseased eyes)who accorded with the diagnosis criteria for NAION,with duration ge; three months and optic disc edema in paracmasis were selected. The fellow eyes of 96 NAION patients and 80 normal eyes were selected in our study. The horizontal and vertical disc and cup diameters,optic cup depth, and peripapillary retinal nerve fiber layer (RNFL) thickness were measured by quot;cross quot; and quot;ring quot; scan of optical coherence tomography (OCT,Humphrey 2000,German Carl Zeiss Company) inspection system. The cup depth were classified four grades by cup shape according to OCT images:GradeⅠ,bottom of optic cup above the anterior plane of peripapillary neuroepithelial layer(PNL);GradeⅡ,bottom of optic cup above the plane of PNL;Grade Ⅲ,bottom of optic cup between the plane of PNL and choroidal pigment epithelium;Grade Ⅳ,bottom of optic cup under the plane of choroidal pigment epithelium connection. The grades of optic cup and value in three groups were statistically analyzed. The follow up ranged from six months to three years.Results The disc diameter in horizontal scanning of diseased eyes,fellow eyes and normal eyes were (1.29 plusmn;0.19), (1.32 plusmn;0.17), (1.40 plusmn;0.15) mm,and diameters in vertical scanning were (1.52 plusmn;0.14), (1.49 plusmn;0.17), (1.60 plusmn;0.22) mm, respectively. Compared the diseased eyes and fellow eyes with normal eyes,the difference were statistically significant in horizontal scanning (t=4.291,3.315; P<0.05) and in vertical scanning (t=2.812, 3.654; P<0.05). Compared the diseased eyes with fellow eyes,the difference of average diameter were not statistically significant in horizontal and vertical scanning (t=1.153,1.335; P>0.05). Of the diseased eyes,GradeⅠoptic cup in 36 eyes(37.50),Grade Ⅱ-Ⅲoptic cup in 52 eyes(54.17%),Grade Ⅳoptic cup in eight eyes(8.33%),and GradeⅠ-Ⅲ optic cup in 88 eyes(91.67%)were found. Of the fellow eyes,GradeⅠoptic cup in 18 eyes(18.75%),Grade Ⅱ-Ⅲoptic cup in 69 eyes(71.88%),Grade Ⅳoptic cup in nine eyes(9.34%),and GradeⅠ-Ⅲ optic cup in 87 eyes(9066%)were found. Compared the average RNFL thickness of diseased eyes with the fellow eyes and normal eyes,the differences were statistically significant in temporal, upper, nasal, lower quadrant(t=12.862,10.147,15.046,8.180,12.859,9.562,12.174,8.632;P<0.001). Compared the average RNFL thickness of the fellow eyes and normal eyes,the differences were not statistically significant in all quadrants(t=1.040,1.576,1.062,1.192;P>0.05). During the followup,eight eyes with recurrence which optic cup were GradeⅠand Ⅱin diseased eyes;44 eyes(45.8%)occurred NAION. Correlation analysis showed that there was negative correlation between incidence of fellow eye and optic cup depth(t=-0.757, P=0.000). Conclusion Optic cup and disk in NAION patients are smaller than that in the normal,the anatomical characteristics of shallow cup and small disc was one of the NAION pathogenesis.
Citation: 王润生,吕沛霖,常倩,李沛,杜善双,雷晓琴,俞江. Relationship of shallow optic cup and small disc with nonarteritic anterior ischemic optic nerupathy. Chinese Journal of Ocular Fundus Diseases, 2010, 26(4): 319-323. doi: Copy