青光眼中央暗点型视野损害特点分析  

Characteristics of central scotoma in glaucoma

作　　者：乔荣华[1] 任泽钦[1] 刘丽娜[1] 潘英姿[1] 李梅[1] 

机构地区：[1]北京大学第一医院眼科,北京100034

出　　处：《中国实用眼科杂志》2005年第2期167-170,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的　探讨发生于青光眼的中央暗点所具备的临床特征。方法　回顾性非对照的研究。从青光眼患者的视野资料当中筛选中央暗点 ,分析暗点的形态和分布特点、进展情况、受累眼的视力以及相应的眼底改变 ,计算其在青光眼早期视野改变中所占的比率 ,比较该型视野在正常眼压性青光眼、原发性开角型青光眼、原发性闭角型青光眼的早期阶段发生率的差异。结果　发生于青光眼的中央暗点是以水平径线为界的半侧性中央暗点 ,在进展过程中也不跨越该界线 ,而是在同侧扩大加深 ,水平径线侧边界平直 ;在上方视野的发生多于下方视野 ;对视力无明显影响 ;通过存档的彩色立体眼底相片可查见局限性视网膜神经纤维层损害 ,其位置邻近盘斑束。在青光眼早期视野损害当中 ,中央暗点约占 10 5 %。中央暗点可发生于多种类型的青光眼 ,其中 ,三种原发性青光眼的发生情况为 :正常眼压性青光眼 (NPG) 15 9% ,原发性开角型青光眼 (POAG) 7 5 % ,原发性闭角型青光眼(PACG) 5 2 %。在NPG当中的发生率高于高眼压性青光眼 (POAG或PACG) ,其差异具有统计学意义 (P <0 0 5 ) ,POAG与PACG的发生率则无差异 (P >0 0 5 )。结论　发生于青光眼的中央暗点具有自身特征 ,最突出的特点是不跨越水平径线 ,可与其他疾病所致的中央暗点相鉴别 ;Objective To study the clinical features of central scotoma in glaucoma.Methods A retrospective non-controlled study.Central scotomas were screened from glaucomatous visual field data.Then the shape,the distribution and the progression of central scotoma were analyzed.In addition,visual acuity and fundus of involved eyes were studied.Moreover,we calculated the ratio of central scotomas in early glaucomatous visual field defects.Incidence difference of this kind of scotoma was compared among primary open angle glaucoma(POAG),normal pressure glaucoma(NPG)and primary angle-closure glaucoma(PACG).Results Central scotomas occurred in glaucomatous eyes were semi-central ones limited by the horizontal meridian and seldom crossed this line even in progression.It could be found more in superior field than in the inferior and hadn′t affected visual acuity.Local retinal nerve fiber layer defect were detected in involved eyes and were close to papillo-macular bundles.We found 10 5% of the early glaucomatous visual field damage to be central scotoma and NPG was 15 9%,POAG was 7 5% while PACG was 5 2%.The incidence was statistically higher in NPG than in POAG or PACG( P <0 05).There was no difference between POAG and PACG( P >0 05).Conclusions Central scotoma occurred in glaucoma is different from which in other diseases and we can make differentiations from the clinical features concluded above.There was a higher incidence in NPG than in other glaucomas and further study should be taken to reveal the mechanism.

关 键 词：原发性闭角型青光眼 POAG 视野损害 发生率 原发性开角型青光眼 正常眼压性青光眼 视力 NPG 水平 结论 

分 类 号：R775[医药卫生—眼科] G239.561.2[医药卫生—临床医学]