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正常眼压性青光眼和高眼压性青光眼的视野缺损模式

Pattern of visual field defects in normal-tension and high-tension glaucoma.

作者信息

Araie M

机构信息

Department of Ophthalmology, University of Tokyo School of Medicine, Japan.

出版信息

Curr Opin Ophthalmol. 1995 Apr;6(2):36-45. doi: 10.1097/00055735-199504000-00007.

Abstract

There are probably two major types of causative factors in open-angle glaucoma: pressure-dependent and pressure-independent. If clinical features such as the pattern of visual field defects differ between normal-tension and high-tension glaucoma, the differences may provide an insight for discriminating between the pressure-dependent and the pressure-independent damage in open-angle glaucoma. This article gives a brief review of the most recent studies including reports wherein progression or pattern of visual field defects in normal-tension and high-tension glaucoma or primary open-angle glaucoma are addressed. Further deterioration of the visual field in 5 years is expected in about 50% of eyes with normal-tension glaucoma in which intraocular pressure is one of the contributing factors. This figure may be greater than that seen in eyes with primary open-angle glaucoma where intraocular pressure is controlled with surgery in the middle teens. When eyes with normal-tension glaucoma and high-tension glaucoma or primary open-angle glaucoma were matched for extent of overall visual field loss, many studies noted a difference in the pattern of visual field defects between the two groups. Visual field defects in normal-tension glaucoma are relatively more localized and closer to fixation, especially in the nasal superior quadrant and may be more predominant in the lower hemifield. Results of other psychophysical tests also appear to support the above findings.

摘要

开角型青光眼可能主要有两种致病因素

眼压依赖性和眼压非依赖性。如果正常眼压性青光眼和高眼压性青光眼之间的临床特征(如视野缺损模式)存在差异,那么这些差异可能为区分开角型青光眼中的眼压依赖性损害和眼压非依赖性损害提供线索。本文简要回顾了包括正常眼压性青光眼和高眼压性青光眼或原发性开角型青光眼的视野缺损进展或模式报告在内的最新研究。在约50%的正常眼压性青光眼中,眼压是导致病情发展的因素之一,预计这些患者的视野在5年内会进一步恶化。这一数字可能高于原发性开角型青光眼患者,后者通过手术将眼压控制在十几毫米汞柱左右。当正常眼压性青光眼与高眼压性青光眼或原发性开角型青光眼在总体视野损失程度上相匹配时,许多研究注意到两组之间视野缺损模式存在差异。正常眼压性青光眼的视野缺损相对更局限且更靠近注视点,尤其是在鼻上象限,且在下半视野可能更明显。其他心理物理学测试结果似乎也支持上述发现。

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