视野检查在先天性青光眼疗效评价中的应用  

Application of peripheric examination to congenital glaucoma.

作　　者：刘丽娜[1] 李美玉[1] 任泽软[1] 才瑜[1] 

机构地区：[1]北京大学第一医院眼科,100034

出　　处：《中国斜视与小儿眼科杂志》2004年第1期16-19,共4页Chinese Journal of Strabismus & Pediatric Ophthalmology

摘　　要：目的 探讨视野在原发性先天性青光眼疗效观察中的价值。方法 对17例28眼先天性青光眼的视野资料进行回顾性分析,并就视力、眼压、杯盘比值、手术次数、手术年龄等因素与视野的关系进行探讨。结果 初次检查视野的年龄4～16岁,平均11.52±3.47岁,视野检查距手术的时间1～14年,平均6.7年。矫正视力≥0.4者占78.57％,其中>0.8者占46.43％。22眼具有青光眼性视野缺损,占78.57％,其中旁中心暗点5眼,鼻侧阶梯9眼。弓形缺损6眼,管视和/或颞岛7眼。早、中、晚三期视野损害所占比例分别为:32.14％、21.43％、25.00％。8例13眼有视野随访,随访时间3～13年,平均6.6年,6眼有视野进展。手术次数≥2次组的视野损害较≤1次手术组重(P<0.05)。杯盘比值≥0.6组的视野损害明显重于C/D<0.6组(P<0.05)。结论 视野是评价先天性青光眼疗效的一个重要指标,先天性青光眼患者经训练后能够完成视野检查。Objective To assess the application of visual field examination during the treatment of primary congenital glaucoma. Methods The perimetric data were retrospectively analyzed and the relationships between visual fields and visual acuity, intraocular pressure, cup-disk diameter ratios, times of operations, and ages at operations were investigated in 17 patients (28 eyes) with congenital glaucoma. Results Ages at the initial visual field tests were 4 - 16 years (11.52 ± 3.27), and the periods from visual field tests to surgeries were 1-14 years (mean, 6.7). 78.57% of the 28 eyes presented best corrected visual acuity (BCVA) more than or equal to 0.4, in which 46.43% over 0.8. Glaucoma-tous visual field damages occurred in 22 eyes ( 78.57 % ), among which 32.14 % with early damages including paracentral scotomas in 5 eyes, and nasal steps in 9 eyes, 21.43% with advanced arcuate defects in 6 eyes, and 25% with late pipe vision and/or temporal island in 7 eyes. 8 patients (13 eyes) were followed up for 3 -13 years (mean, 6.6), and visual fields were worsened in 6 eyes. The visual fields were more damaged in the group of operation times≥2 than in the group of operation times ≤1, and more damaged in the group of cup/disc ≥0.6 than in the group of cup/disc <0.6. Conclusion Peripherie examination was an important criterion in assessing the effectiveness of CG management. The children with CG could fulfill the visual field tests after they were previously trained.

关 键 词：视野检查 先天性青光眼 疗效评价 儿童 视功能 

分 类 号：R775[医药卫生—眼科]