研究目的
To investigate the relationship between the morphologic features of myopic optic nerve head (ONH) and visual field (VF) defects in myopic subjects with primary open-angle glaucoma (POAG) by intraindividual comparison.
研究成果
Among the ONH deformation features in myopic eyes, only greater optic disc rotation is significantly associated with the presence of VF defects in POAG subjects. This suggests that ONH deformation, rather than refractive error or axial length, is a key factor in glaucoma susceptibility in myopia.
研究不足
Cross-sectional design limits causal inferences; long-term follow-up is needed. IOP was not measured by Goldmann applanation tonometry. Small sample size from a single hospital. Two-dimensional fundus photographs may not accurately reflect three-dimensional ONH structure.
1:Experimental Design and Method Selection:
A retrospective cross-sectional study design was used. Intraindividual paired eye comparisons were performed to minimize confounding factors. Morphologic features (optic disc tilt, optic disc rotation, β-zone PPA) were measured from color fundus photographs using ImageJ software. Logistic regression analysis was employed to assess associations with VF defects.
2:Sample Selection and Data Sources:
100 eyes of 50 myopic POAG subjects with unilateral VF defects were recruited from medical records at Cathay General Hospital from January to December 2012. Inclusion criteria included BCVA ≥20/30, SE ≤ -0.5 D, AL ≥24.0 mm, asymmetric AL between eyes, open angles, glaucomatous optic disc appearance, and corresponding VF defects in one eye. Exclusion criteria included previous ocular surgery, trauma, corneal opacity, vitreoretinal diseases, pathologic myopic fundus changes, other optic nerve diseases, horizontally oval disc, tilted disc syndrome, and systemic/neurologic diseases affecting VF.
3:Inclusion criteria included BCVA ≥20/30, SE ≤ -5 D, AL ≥0 mm, asymmetric AL between eyes, open angles, glaucomatous optic disc appearance, and corresponding VF defects in one eye. Exclusion criteria included previous ocular surgery, trauma, corneal opacity, vitreoretinal diseases, pathologic myopic fundus changes, other optic nerve diseases, horizontally oval disc, tilted disc syndrome, and systemic/neurologic diseases affecting VF. List of Experimental Equipment and Materials:
3. List of Experimental Equipment and Materials: Equipment included KR-3000 Auto Refractometer (Topcon), Air-puff tonometry (Topcon CT-80), Canon CR-6 Non-Mydriatic Fundus Camera, Orbscan corneal topography system, ophthalmic ultrasound biometer (PacScan 300), Octopus 101 perimeter, Cirrus HD SD-OCT device, and ImageJ software for image analysis.
4:Experimental Procedures and Operational Workflow:
Subjects underwent comprehensive ophthalmic exams including BCVA, refraction, slit-lamp biomicroscopy, IOP measurement, gonioscopy, dilated fundus exam, color fundus photography, CCT measurement, AL measurement, automated perimetry, and SD-OCT imaging. VF defects were defined based on specific criteria. Morphologic parameters were measured by masked examiners using ImageJ, with average values used for analysis.
5:Data Analysis Methods:
Descriptive statistics, paired t-tests, univariate and multivariate logistic regression analyses, ICCs for reproducibility, and Kappa values for agreement were performed using SPSS version 18.0.
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Non-Mydriatic Fundus Camera
CR-6
Canon
Acquisition of color fundus photographs
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Spectral-domain optical coherence tomography device
Cirrus HD version 5.01
Carl Zeiss Meditec
Measurement of RNFL thickness and ONH parameters
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Auto Refractometer
KR-3000
Topcon
Measurement of refraction
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Air-puff tonometry
CT-80
Topcon
Measurement of intraocular pressure
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Corneal topography system
Orbscan version 3.00
Orbtek
Measurement of central corneal thickness
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Ophthalmic ultrasound biometer
PacScan 300
Measurement of axial length
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Perimeter
Octopus 101
Interzeag
Automated perimetry for visual field testing
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Image analysis software
ImageJ version 1.40
National Institutes of Health
Analysis of fundus photographs for morphologic measurements
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