原发性开角型青光眼患者确诊时视野损害程度的相关因素分析  

Relative factor analysis of visual field defect degree when diagnosing primary open-angle glaucoma

作　　者：刘川[1] 张文强[2] 周和政[1,2] 

机构地区：[1]南方医科大学附属武汉临床医学院,湖北省武汉市430070 [2]广州军区武汉总医院眼科,湖北省武汉市430070

出　　处：《眼科新进展》2016年第4期356-358,共3页Recent Advances in Ophthalmology

摘　　要：目的分析原发性开角型青光眼（primary open-angle glaucoma,POAG）患者确诊时的视野损害程度及其相关因素。方法收集2014年5月至2015年10月在我院门诊就诊的POAG患者113例113眼。根据视野损害分级将患者分为早期视野损害组（视野损害0~1级）和中晚期视野损害组（视野损害2~5级）。对两组患者的确诊年龄、性别、身体质量指数、青光眼相关症状、家族史、高度近视、中央角膜厚度、眼压等相关因素进行统计分析。结果早期视野损害组31眼（27.43%）,中晚期视野损害组82眼（72.57%）。早期视野损害组的确诊年龄为（52.81±16.57）岁,眼压为（23.67±11.44）mm Hg（1 kPa=7.5 mmHg）,与中晚期视野损害组的（45.62±17.12）岁和（30.58±12.13）mm Hg相比,差异均有统计学意义（P=0.047、0.007）;早期视野损害组合并高度近视的患者比例（9.68%）及有青光眼相关症状的患者比例（29.03%）均小于中晚期视野损害组（29.27%、53.66%）,差异均有统计学意义（P=0.029、0.019）。早期视野损害组的性别比例、身体质量指数、家族史、中央角膜厚度与中晚期视野损害组相比,差异均无统计学意义（均为P〉0.05）。眼压与患者确诊时的视野损害严重程度呈正相关（r=0.411,P=0.000）。结论大多数POAG患者确诊时已发生较严重的视野损害,高眼压、青光眼相关症状、合并高度近视、确诊时年龄偏低可能是POAG患者确诊时发生较严重视野损害的危险因素。Objective To analyze the defect degree of visual field when diagnosing primary open-angle glaucoma（ POAG） and its relative factors. Methods A total of 113 outpatients with POAG were collected from May 2014 to October 2015. Patients were divided into early stage group（ stage 0- 1） and moderate-advanced stage group（ stage 2- 5） according to the stage of visual field defect. Clinical data including age at diagnosis,gender,body mass index（ BMI）,symptom related to POAG,family history of POAG,high myopia,central corneal thickness and intraocular pressure（ IOP） were analyzed between two groups. Results There were 31 eyes（ 27. 43 %） in early stage group and 82 eyes（ 72. 57 %） in moderateadvanced stage group. The age at diagnosis was（ 52. 81 ± 16. 57） years in early stage group and（ 45. 62 ± 17. 12） years in moderate-advanced stage group,while IOP was（ 23. 67 ±11. 44） mm Hg（ 1 kPa = 7. 5 mm Hg） in early stage group and（ 30. 58 ± 12. 13） mm Hg in moderate-advanced stage group,and the differences were statistically significant（ P = 0. 047,0. 007）. The incidence of high myopia（ 9. 68 %） and symptom related to POAG（ 29.03 %） in early stage group were significantly lower than those in moderate-advanced stage group（ 29. 27 %,53. 66 %,P = 0. 029,0. 019）. There was no statistically significant difference in gender,BMI,family history of POAG and central corneal thickness between two groups（ all P〈 0. 05）. IOP was positively related to visual field defect at the time of diagnosis（ r = 0. 411,P = 0. 000）. Conclusion The majority of patients with POAG have serious visual field defect at the time of diagnosis. High IOP,high myopia,symptom related to POAG and younger age at the time of diagnosis may be risk factors for serious visual field defect when diagnosing POAG.

关 键 词：原发性开角型青光眼 视野 相关因素 

分 类 号：R775.2[医药卫生—眼科]