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Optic nerve head anatomy in myopia and glaucoma, including parapapillary zones alpha, beta, gamma and delta: Histology and clinical features
Progress in Retinal and Eye Research ( IF 18.6 ) Pub Date : 2020-12-09 , DOI: 10.1016/j.preteyeres.2020.100933
Ya Xing Wang 1 , Songhomitra Panda-Jonas 2 , Jost B Jonas 3
Affiliation  

The optic nerve head can morphologically be differentiated into the optic disc with the lamina cribrosa as its basis, and the parapapillary region with zones alpha (irregular pigmentation due to irregularities of the retinal pigment epithelium (RPE) and peripheral location), beta zone (complete RPE loss while Bruch's membrane (BM) is present), gamma zone (absence of BM), and delta zone (elongated and thinned peripapillary scleral flange) within gamma zone and located at the peripapillary ring. Alpha zone is present in almost all eyes. Beta zone is associated with glaucoma and may develop due to a IOP rise-dependent parapapillary up-piling of RPE. Gamma zone may develop due to a shift of the non-enlarged BM opening (BMO) in moderate myopia, while in highly myopic eyes, the BMO enlarges and a circular gamma zone and delta zone develop. The ophthalmoscopic shape and size of the optic disc is markedly influenced by a myopic shift of BMO, usually into the temporal direction, leading to a BM overhanging into the intrapapillary compartment at the nasal disc border, a secondary lack of BM in the temporal parapapillary region (leading to gamma zone in non-highly myopic eyes), and an ocular optic nerve canal running obliquely from centrally posteriorly to nasally anteriorly. In highly myopic eyes (cut-off for high myopia at approximately −8 diopters or an axial length of 26.5 mm), the optic disc area enlarges, the lamina cribrosa thus enlarges in area and decreases in thickness, and the BMO increases, leading to a circular gamma zone and delta zone in highly myopic eyes.



中文翻译:

近视和青光眼中的视神经乳头解剖,包括 α、β、γ 和 δ 视乳头旁区:组织学和临床特征

视神经乳头在形态上可分为以筛板为基础的视盘,以及具有α区(由于视网膜色素上皮(RPE)和周边位置不规则导致的不规则色素沉着)、β区(完全存在 Bruch 膜 (BM) 时的 RPE 损失)、γ 区(无 BM)和 δ 区(延长和变薄的视乳头周围巩膜法兰)位于 γ 区内并位于视乳头周围环处。几乎所有的眼睛都存在阿尔法区。Beta 区与青光眼有关,并且可能由于 RPE 的眼压升高依赖的视乳头旁堆积而发展。由于中度近视眼中非扩大 BM 开口 (BMO) 的移动,伽马区可能会发展,而在高度近视眼中,BMO 会扩大并形成圆形伽马区和三角区。视盘的检眼镜形状和大小受 BMO 近视移位的显着影响,通常是向颞方向,导致 BM 悬垂到鼻间盘边缘的乳头内隔室,颞侧乳头旁区域继发性缺乏 BM (导致非高度近视眼的伽马区),以及从中央后部到鼻前部倾斜延伸的眼视神经管。在高度近视眼中(高度近视的截止值约为 -8 屈光度或轴长 26.5 毫米),视盘面积扩大,筛板面积扩大,厚度减少,BMO 增加,导致高度近视眼中的圆形伽马区和三角区。通常在颞方向,导致 BM 悬垂到鼻盘边缘的乳头内隔室,颞侧乳头旁区域继发性缺乏 BM(导致非高度近视眼的伽马区)和眼视神经管从中央后部向鼻部前部倾斜延伸。在高度近视眼中(高度近视的截止值约为 -8 屈光度或轴长 26.5 毫米),视盘面积扩大,筛板面积扩大,厚度减少,BMO 增加,导致高度近视眼中的圆形伽马区和三角区。通常在颞方向,导致 BM 悬垂到鼻盘边缘的乳头内隔室,颞侧乳头旁区域继发性缺乏 BM(导致非高度近视眼的伽马区)和眼视神经管从中央后部向鼻部前部倾斜延伸。在高度近视眼中(高度近视的截止值约为 -8 屈光度或轴长 26.5 毫米),视盘面积扩大,筛板面积扩大,厚度减少,BMO 增加,导致高度近视眼中的圆形伽马区和三角区。以及从中央后部到鼻部前部倾斜延伸的眼视神经管。在高度近视眼中(高度近视的截止值约为 -8 屈光度或轴长 26.5 毫米),视盘面积扩大,筛板面积扩大,厚度减少,BMO 增加,导致高度近视眼中的圆形伽马区和三角区。以及从中央后部到鼻部前部倾斜延伸的眼视神经管。在高度近视眼中(高度近视的截止值约为 -8 屈光度或轴长 26.5 毫米),视盘面积扩大,筛板面积扩大,厚度减少,BMO 增加,导致高度近视眼中的圆形伽马区和三角区。

更新日期:2020-12-09
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