科研之友
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摘要
ImportanceThe data may support the notion that the intra-ocular pressure (IOP)-related factors and vascular factors were implicated concurrently in glaucomatous optic nerve damage. @@@ BackgroundTo study the association of intraocular pressure (IOP)-related factors, IOP, trans-lamina cribrosa pressure difference (TLCPD), cerebrospinal fluid pressure (CSFP) and retinal vessel diameters (RVD), central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE) with neuro-retinal rim area (RA). @@@ DesignA population-based, cross-sectional study. @@@ ParticipantsA total of 6830 people aged 30years and over. @@@ MethodsAll participants underwent a comprehensive eye examination, fundus photograph-based measurements of RVD and Heidelberg retinal tomogram (HRT) measurement of optic disc. @@@ Main Outcome MeasuresRA, CRAE, CRVE, IOP, body mass index (BMI), CSFP and TLCPD. @@@ ResultsPrimary open-angle glaucoma (POAG) was diagnosed using two separate methods: 67 from expert consensus, and 125 from the International Society of Geographical and Epidemiologic Ophthalmology (ISGEO) classification. After excluding of those with high myopia or without gradable HRT images, 4194 non-glaucoma and 40 POAG were analysed for determinants of RA. On multivariable analysis determinants of reduced RA were POAG (P<0.001), higher IOP (P=0.03), higher refractive error (P<0.01), longer axial length (P=0.01), CRVE (P<0.001), lower BMI (P=0.015), older age (P<0.001) smaller disc area (P<0.001) and higher TLCPD (P=0.03). When age and/or BMI were omitted from the model, reduced RA was also associated with lower CSFP (P<0.001). @@@ Conclusions and RelevanceReduced RA is associated with narrow CRVE and higher IOP or lower CSFP. The data supports the concurrent role of IOP-related and vascular factors in glaucomatous optic nerve damage.
