合并高度近视的原发性开角型青光眼视野分析(英文)  

Visual field analysis in primary open angle glaucoma with high myopia

作　　者：李云琴[1] 樊芳[1] 唐罗生[1] 钟华[1] 赵坦泰[1] 田润[1] 

机构地区：[1]中南大学湘雅二医院眼科,中国湖南省长沙市410011

出　　处：《国际眼科杂志》2009年第4期623-626,共4页International Eye Science

摘　　要：目的:探讨合并高度近视和非高度近视的原发性开角型青光眼早期视野改变特点及其与视网膜神经纤维层缺损的关系。方法:利用Humphrey750型计算机自动视野计对17例(21眼)合并高度近视的POAG和16例(17眼)非高度近视的POAG及20例(25眼)单纯高度近视以及17例(19眼)正常组进行静态中心阈值视野检查,利用OCT进行视盘周围RNFL厚度检查。比较正常组、合并高度近视POAG组、非高度近视POAG组、单纯高度近视组视野缺损的总偏差概率图;比较正常组、合并高度近视的POAG组、非高度近视的POAG组以及单纯高度近视组的MD值、PSD值、上方、下方、鼻侧、颞侧平均光敏感度;比较正常组、合并高度近视的POAG组、非高度近视的POAG组以及单纯高度近视组的平均、上方、下方、鼻侧、颞侧RNFL厚度;分别分析合并高度近视的POAG组、非高度近视的POAG组以及单纯高度近视组各组内上方、下方、鼻侧、颞侧各象限RNFL厚度与视野对应部位的缺损之间的关系以及各组视野特点。结果:合并高度近视的早期POAG患者在总偏差概率图中多表现为普遍敏感性降低,而在模式偏差概率图则更多表现出POAG早期视野缺损;平均缺损值显著高于其它各组。合并高度近视的POAG患者无论平均光敏感度还是MD、PSD值均与其他三组有显著差异(P<0.05);单纯高度近视组与非高度近视的POAG组的各象限平均光敏感度的差异均有显著性(P<0.05)。合并高度近视的POAG组较非高度近视的POAG组以及单纯高度近视组RNFL厚度明显变薄;此三组较正常组RNFL厚度变薄;单纯高度近视组与非高度近视的POAG组的平均RNFL厚度及各象限RNFL厚度的差异均有显著性(P<0.05);各组四个象限RNFL厚度与视野对应部位的缺损相关。结论:在进行合并高度近视的POAG视野结果判定时要依靠模式偏差概率图,其特点是伴有生理盲点扩大和外移。OCT能够反映合并高AIM： To evaluate the relationship between damages of visual field and retinal nerve fiber layer （RNFL） thickness in primary open angle glaucoma （POAG）with highly myopia. POAG with highly myopia group （21 eyes of 17 cases）, POAG with non-highly myopia group （17 eyes of 16 cases）, highly myopia without POAG group （25 eyes of 20 cases） and normal control group （19 eyes of 17 cases）. METHODS： The static central visual fields were tested by Humphrey 750 automated perimeter and thickness of RNFL was measured by optical coherent tomography （OCT）. Main outcome mean deviation （MD）, pattern standard deviation （PSD） and mean sensitivity at superior, inferior, nasal and temporal sectors in total deviation probability plots. Thickness of RNFL at superior, inferior, nasal and temporal sector.RESULTS： There were more obvious general depression of sensitivity in total deviation probability plots of the early POAG with highly myopia than that of POAG without highly myopia, and the early visual field defects of glaucoma in pattern deviation probability plots of this group. MD of POAG with highly myopia was more than those of others （P 〈 0.05）. The differences of MD, PSD and mean sensitivity between POAG with highly myopia and others were significant （ P 〈 0.05 ）. Mean sensitivities in each sector of POAG without highly myopia were similar to those of highly myopia（P〉0.05）. The thickness of RNFL of POAG with highly myopia was thinner than that of others and the thickness of RNFL of normality was thicker than that of others. The relationship between mean sensitivity and the thickness of RNFL in each quadrant was significant（ P〈 0.05）.CONCLUSION： Pattern deviation probability plots is an important favor for judgment of the visual field changes in POAG with highly myopia. The relationship between RNFL thickness by OCT and visual field damage may provide clinically relevant information in diagnosis of POAG with highly myopia.

关 键 词：高度近视 原发性开角型青光眼 视野缺损 光学相干断层扫描 

分 类 号：R778.1[医药卫生—眼科] R775[医药卫生—临床医学]