初期緑内障における長期予後と初診時乳頭所見

Prognosis of visual function related with optic disc cupping in early primary open-angle glaucoma

　3年以上薬物にて治療した原発性開放隅角緑内障の初期例48眼を対象に，長期予後と初診時乳頭所見との関係を検討した．

　初診時垂直C／D比0.3以下の群と0.4以上の群での予後を比較すると，前者の視野改善頻度は高く（38％対21％），悪化頻度は低かった（4％対50％）．C／D比と予後との間には有意の相関がみられ，初診時垂直C／D比の程度から初期緑内障の予後の異なることが明らかにされた．

　視神経の眼圧に対する抵抗性には個体差があり，それは生理的乳頭陥凹の大きさに起因すると推測された．

We evaluated the prognosis of visual function in48 eyes with primary open-angle glaucoma (POAG) as correlated with the initial size of the cup of the optic disc. All the eyes were in the early stage of POAG, with the intraocular pressure controlled below 24mmHg without surgery. The follow-up period ranged from 3 to 5 years, average 4 years. Localized depression in the central visual field was present in 36 eyes. Paracentral scotoma was present in the other 12 eyes.

The patients were divided into 2 groups of 24 eyes each. Eyes with disc cupping with 0.3 or less in the vertical meridian were assigned to 'small C/ D group',while eyes with disc cupping between 0.4 and 0.6 were assigned to 'medium C/D group'.