Lau Ling-Ing, Liu Catherine Jui-ling, Chou Joe Ching-Kuang, Hsu Wen-Ming, Liu Jorn-Hon
Department of Ophthalmology, Taipei Veterans General Hospital, No. 201 Section 2 Shih-Pai Road, Shih-Pai, Taipei 11217, Taiwan.
Ophthalmology. 2003 Oct;110(10):1890-4. doi: 10.1016/S0161-6420(03)00666-3.
To evaluate the patterns of visual field defects in patients with chronic angle-closure glaucoma (CACG) with varying extent of optic nerve damage.
Prospective, consecutive, observational case series.
One hundred forty-six Asian patients with well-controlled CACG.
Visual field tests were performed using program 24-2 of the Humphrey Field Analyzer (Humphrey Instruments, San Leandro, CA) with the Swedish interactive thresholding algorithm standard. One hundred ten eligible visual fields were scored with the system adopted by the Advanced Glaucoma Intervention Study and were categorized into 4 groups accordingly: mild, moderate, severe, and end-stage. Each hemifield was divided into the nasal, paracentral, and arcuate areas, and field loss that involved respective areas was defined as nasal step, paracentral scotoma, and arcuate scotoma.
The distribution of field defect patterns in each group was evaluated. The mean deviation (MD) was compared among the 3 areas within one hemifield and between each pair of corresponding areas across the median raphe.
The nasal area was the most commonly damaged area in the mild group, being noted in 52% of eyes in the superior hemifield and 58% of eyes in the inferior hemifield. In the moderate group, field loss involving both the nasal and arcuate areas dominated the superior hemifield, whereas field loss involving all three areas dominated the inferior hemifield. The MD of the nasal area was the worst among the three areas in each hemifield of the mild and moderate groups, as well as in the inferior hemifield of the severe group (all P < 0.001). There were no significant differences in the MD of each area between the superior hemifield and their inferior counterparts. However, the superior hemifield as a whole showed a better MD than the inferior hemifield (P=0.034) in the mild group.
Visual field loss that involved the nasal area was the most common pattern in the early stage of CACG. The MD of the nasal area was worse than those of the arcuate and the paracentral areas within the same hemifield in the mild, moderate, and severe groups of CACG patients.
评估不同视神经损伤程度的慢性闭角型青光眼（CACG）患者的视野缺损模式。
前瞻性、连续性、观察性病例系列研究。
146例病情得到良好控制的亚洲CACG患者。
使用Humphrey视野分析仪（Humphrey Instruments，美国加利福尼亚州圣莱安德罗）的24-2程序及瑞典交互式阈值算法标准进行视野检查。采用高级青光眼干预研究采用的系统对110份合格视野进行评分，并据此分为4组：轻度、中度、重度和终末期。每个半视野分为鼻侧、旁中心和弓形区域，累及相应区域的视野缺损分别定义为鼻侧阶梯、旁中心暗点和弓形暗点。
评估每组视野缺损模式的分布情况。比较一个半视野内3个区域以及中缝两侧每对相应区域之间的平均偏差（MD）。
在轻度组中，鼻侧区域是最常受损的区域，在上半视野中52%的患眼以及下半视野中58%的患眼出现该区域受损。在中度组中，累及鼻侧和弓形区域的视野缺损在上半视野中占主导，而下半视野中累及所有三个区域的视野缺损占主导。在轻度和中度组的每个半视野以及重度组的下半视野中，鼻侧区域的MD在三个区域中最差（均P<0.001）。上半视野与其下半视野对应区域之间的MD无显著差异。然而，在轻度组中，上半视野整体的MD优于下半视野（P=0.034）。
累及鼻侧区域的视野缺损是CACG早期最常见的模式。在CACG患者的轻度、中度和重度组中，同一半视野内鼻侧区域的MD比弓形区域和旁中心区域的MD更差。
