色觉对比敏感度阈值检测在原发性开角型青光眼早期诊断中的应用  

Color contrast sensitivity test as an aid to the diagnosis of early-stage primary open angle glaucoma： a pilot Study

作　　者：海鸥[1] 安洁[1] 杨国庆[2] 李冰[1] 高丹宇[1] 

机构地区：[1]解放军第四五一医院眼科,西安710030 [2]第四军医大学航空航天医学院航临教研室,西安710032

出　　处：《中华眼视光学与视觉科学杂志》2012年第11期670-673,共4页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的探讨色觉对比敏感度阈值测试在原发性开角型青光眼早期诊断中的应用价值。方法前瞻性病例对照研究。选取82只可疑开角型青光眼作为可疑青光眼（SOAG）组，80只已确诊为原发性开角型青光眼作为青光眼（POAG）组，75只正常眼作为对照组。3组均采用计算机图像辅助系统检测双眼红一绿色轴和蓝一黄色轴上四个象限的色觉对比度阈值，6个月后对SOAG组进行随访。组间及组内象限间采用单因素方差分析，SOAG组随访前后采用配对t检验，视野随访检查阳性率与色觉对比敏感度检查一致性检验采用Kappa评价方法。结果①3组红．绿色轴和蓝-黄色轴上色觉对比敏感度阈值为POAG组〉SOAG组〉对照组。红．绿色轴上仅POAG组与对照组在四个象限间差异有统计学意义（F=4．16、3．57、4．58、5．10，P〈0．01）；蓝-黄色轴上POAG组与对照组的四个象限间，POAG组与SOAG组的颞下象限间与鼻下象限间，SOAG组与对照组的颞上象限间，颞下象限间和鼻上象限间差异无统计学意义（F=16．58、15．32、9．76、10．86，P〈0．05）。（2）SOAG组6个月随访红．绿色轴和蓝．黄色轴各个象限阈值均高于初次阈值。蓝．黄色轴在颞上和颞下象限差异有统计学意义（t=2．12、2．03，P〈0．05）；视野检查与色觉对比敏感度检查方法一致性较好（Kappa=0．47）。结论色觉对比敏感度阈值能较好的反映病情变化．6个月随访其视野变化与色觉对比敏感度检出异常变化有较好的一致性，可作为青光眼早期筛选与监测的一项辅助手段。Objective To evaluate a color contrast sensitivity test as a tool for the diagnosis of primary open angle glaucoma. Methods In a prospective case control study, 82 eyes suspected of having primary open angle glaucoma served as the SOAG group; 80 primary open angle glaucoma eyes served as the POAG group; 75 normal eyes served as the control group. Color contrast sensitivity was measured with a Chroma Test. The SOAG group was followed up in 6 months. The thresholds of color contrast sensitivity were compared and the differences between and within the groups were statistically analyzed with a one-way ANOVA. In the SOAG group, the thresholds before and after six months were statistically analyzed with a paired t test. The consistency between the two methods was statistically analyzed with Kappa. Results （1）The thresholds from high to low were compared for the POAG group, SOAG group and control group. There were significant differences between the POAG group and the control group （P〈0.01） in the protan and tritan axes. There was a significant difference in the lower temporal field and lower nasal field between the POAG group and the SOAG group. There were also significant differences in the upper temporal field, lower temporal field and upper nasal field between the SOAG group and the control group （P〈0.05）. （2）During the 6 months of follow-up for the SOAG group, the threshold was higher comparing to the initial follow-up and there was a significant difference between the upper and lower temporal fields in the tritan axis （P〈0.05）. The consistency between the two methods was good （Kappa=0.47）. Conclusion Color contrast tests reveal a sensitivity to color change in the early stages of glaucoma. There was a good consistency between the visual field test and the chromatic test. Color contrast can be used in a screening program and to monitor patients who develop glaucoma.

关 键 词：对比敏感度 色觉 青光眼 诊断 

分 类 号：R775[医药卫生—眼科]