倍频视野检查对单眼视野异常开角型青光眼患者视野正常眼临床诊断价值的8年随访分析  

The 8-year follow-up study for clinical diagnostic potentials of frequency-doubling technology perimetry for perimetrically normal eyes of open-angle glaucoma patients with unilateral visual field loss

作　　者：范翔[1] 吴玲玲[1] 肖格格[1] 马志中[1] 刘峰[1] 

机构地区：[1]北京大学第三医院眼科眼部神经损伤的重建保护与康复北京市重点实验室,100191

出　　处：《中华眼科杂志》2018年第3期177-183,共7页Chinese Journal of Ophthalmology

摘　　要：目的 分析倍频视野检查（FDP）对标准自动视野检查（SAP）视野正常的开角型青光眼（OAG）患者的诊断潜力以及FDP结果异常转化为未来SAP视野异常的相关因素.方法 前瞻性队列研究.对2003年11月至2007年10月在北京大学第三医院眼科就诊的68例单眼SAP（Octopus101 tG2程序）视野异常OAG患者[原发性开角型青光眼32例,正常眼压性青光眼36例;男性32例,女性36例;平均年龄（59±13）岁]的68只视野正常眼进行基线FDP N-30程序检测.根据结果分为FDP阳性与阴性两组,并连续8年随访SAP视野,分别计算两组8年后的SAP视野转化为异常的比例;比较在FDP阳性组中8年后SAP视野转化眼与未转化眼在基线杯盘比、青光眼视神经病变眼数比例等相关因素之间的差异.连续变量的比较采用独立样本t检验或Wilcoxon秩和检验,分类变量的比较采用χ2检验或Fisher精确检验.结果 48例患者完成了8年随访.基线FDP阳性组33例（33只眼）,FDP阴性组15例（15只眼）;FDP阳性组中22只眼在14.5个月（4.0~90.0个月）SAP视野转化为异常,而FDP阴性组8年后SAP视野转化为异常的眼数为0.在FDP阳性组中,SAP视野转化眼比SAP视野未转化眼在基线具有较大的杯盘比（0.73±0.09比0.63±0.14,Wilcoxon秩和检验,P=0.011）、较高的青光眼视神经病变眼数比例（19/22比4/11,Fisher精确检验,P=0.006）.结论 对于单眼视野异常的OAG患者SAP视野正常眼,FDP不仅能提前检测出视野异常,而且可在一定程度上预测未来SAP视野的异常;视神经病变程度是FDP结果异常转化为SAP视野异常的相关因素.（中华眼科杂志,2018,54：177-183）Objective To analyze potentials of frequency-doubling technology perimetry（FDP）for diagnosing open-angle glaucoma （OAG） in perimetrically normal eyes of OAG patients diagnosed with standard automated perimetry （SAP） and relating factors from abnormalities on FDP to visual field loss on SAP. Methods A prospective cohort study. Sixty-eight eyes of 68 OAG patients visiting the ophthalmic clinic of Peking University Third Hospital during November 2003 and October 2007[32 primary open-angle glaucoma patients and 36 normal tension glaucoma patients,32 males and 36 females,with an average age of （59±13）years]with unilateral field loss detected by SAP（Octopus101 tG2 program）were examined with the FDP N-30 threshold program（Humphrey Instruments）at baseline.Two groups,FDP positive group and FDP negative group, were divided based on the FDP results, and visual field examinations were followed by a series of SAP examinations for the perimetrically normal eyes over 8 years. During the follow-up, the difference of the converting rate of SAP tests between the two groups was analyzed. Differences between＂convertors＂and＂non-convertors＂of SAP tests in the FDP positive group,such as the cup-to-disk ratio and glaucomatous optic neuropathy rate, were also compared with the independent-sample t test or Wilcoxon two-sample test for continuous variable data and the χ2test or Fisher exact test for classified variable data and rates. Results Forty-eight perimetrically normal eyes of 48 participants had complete data and a qualifying follow-up.Baseline FDP results were positive in 33 eyes and negative in 15 eyes.Of the eyes with positive FDP results, 22 eyes developed abnormal SAP results after 4.0 to 90.0 months（median 14.5 months）, whereas none of the eyes with negative FDP results developed abnormal SAP results. For perimetrically normal eyes in the FDP positive group,＂converters＂showed a greater cup-to-disk ratio（0.73± 0.09 vs.0.63 ± 0.14,Wilcoxon two-sample test,P=0.011）and more eyes wit

关 键 词：青光眼 开角型 视觉 单眼 视野测试 视神经疾病 随访研究法 

分 类 号：R775.2[医药卫生—眼科]