晚期青光眼患者视野检查的可靠性分析  

Comparison of the reliability of visual field test in early,moderate and advanced glaucoma

作　　者：黄萍[1] 张纯[1] 

机构地区：[1]北京大学第三医院眼科,北京北京大学眼科中心100083

出　　处：《中国实用眼科杂志》2006年第2期132-134,共3页Chinese Journal of Practical Ophthalmology

基　　金：国家自然科学基金(30371504)资助~~

摘　　要：目的本文探讨晚期青光眼与早中期青光眼患者视野检测的可靠性是否存在显著性差异。方法以2002年4月至2003年12月随诊于我科的临床确诊为青光眼的患者作为研究对象,应用OCTOPUS101型视野计中G2/TOP程序对双眼进行视野检测。以每位患者有一次以上视野检查经历及裸眼视力≥0.5,瞳孔直径大于2.5mm作为入选标准。共157只眼(90位患者)入选;年龄25岁到79岁,男性29人、女性61人。结果以平均缺损指数(MD,meandefect)分组:MD≥15dB为晚期青光眼组;MD<15dB为早中期青光眼组。MD≥15dB组RF值35.73±3.69,显著高于MD<15dB组5.14±0.73(P<0.01);根据RF值进行分组:RF>15%为RF异常组;RF≤15%为RF正常组,RF异常组的MD值8.64±1.08显著高于RF正常组4.38±0.38(P<0.01)。晚期青光眼组患者假阴性率远高于早中期青光眼组。结论晚期青光眼患者视野检查的可靠性因子(RF)与早中期患者相比有显著差异,在视野损伤严重的患者,高RF值并不一定代表患者视野检查的可靠性差,相反,当青光眼损伤到一定程度,RF值随之增大,可能与损伤程度有关。高RF值来源于高的假阴性率,青光眼的加重导致假阴性率的增高。Objective To compare the reliable factor （RF） of visual field investigation between advanced and early moderate glaucoma. Methods 157 eyes of 90 glaucoma patients followed - up from 2002. 4 to 2003. 12 were reviewed retrospectively. Their visual fields were investigated by using program TOP/NOR- MAL of the Octopus 101 perimeter. All of them had one more experiences of visual field examination, visual acuity /〉0. 5 and pupil diameter 〉 2. 5mm. The differences of MD value between the above groups were compared. The frequencies of false negative responses in eyes with advanced glaucoma were analyses. Results The eyes were divided into two groups based on the MD value. Advanced glaucoma group： MD≥15dB; early and moderate glaucoma group： MD 〈 15dB. The difference of RF between the two groups was analyzed by t-test. RF value in MD≥15dB group showed higher value than that in MD 〈 15dB group （P 〈0. 01 ） ; Then the eyes were divided again according to the RF value. Normal RF value group： RF≤15% ; Abnormal RF value group： RF〉 15%. There was significant difference between RF 〉 15% group and RF≤15% group on MD value, （P 〈 0. 01 ）. False negative responses were higher in the eye with advanced glaucoma. Conclusions The RF value of visual field test in advanced glaucoma patients is significantly higher than that of visual field in patients with early, moderate glaucoma. According to our results, even if the RF in advanced glaucoma patients showed higher level, the clinical visual field appeared to be still valuable.

关 键 词：青光眼 视野检查法 视野缺损 

分 类 号：R775[医药卫生—眼科] R169.41[医药卫生—临床医学]