Kim Joshua W, Chen Philip P
Department of Ophthalmology, University of Washington, Seattle, Washington, USA.
Ophthalmology. 2004 Nov;111(11):2126-32. doi: 10.1016/j.ophtha.2004.04.029.
To investigate the association between corneal pachymetry and visual field progression in patients with chronic open-angle glaucoma.
Retrospective case-control study.
Eighty-eight patients with primary open-angle glaucoma, pseudoexfoliative glaucoma, pigmentary glaucoma, or normal-tension glaucoma, followed for an average of 8 years, who had visual field loss and progression as defined by modified Anderson criteria. Cases with progression were matched for race, diagnosis, and age at pachymetry with controls who did not have progression.
Progression was defined by use of the modified Anderson criteria. Central corneal thickness (CCT) was determined by ultrasound pachymetry.
Visual field progression and corneal pachymetry.
The mean CCT in patients with visual field progression was significantly lower than the mean CCT in patients who did not progress (529+/-36 mum vs. 547+/-35 mum; P = 0.02). Those with thinner CCT were more likely to progress than those with thicker CCT as identified by Cox proportional hazards regression analysis (P = 0.01; hazard ratio, 1.44 for a 40-mum thinner CCT; 95% confidence interval, 1.12-1.80), and CCT was the only risk factor identified to be significantly associated with visual field progression.
In this case-control patient population, visual field progression in patients with open-angle glaucoma was significantly associated with thinner CCT.
研究慢性开角型青光眼患者角膜测厚与视野进展之间的关联。
回顾性病例对照研究。
88例原发性开角型青光眼、剥脱性青光眼、色素性青光眼或正常眼压性青光眼患者,平均随访8年,其视野缺损及进展符合改良安德森标准。进展型病例在种族、诊断及角膜测厚时的年龄方面与无进展的对照者相匹配。
采用改良安德森标准定义进展情况。通过超声测厚法测定中央角膜厚度(CCT)。
视野进展和角膜测厚。
视野进展患者的平均CCT显著低于未进展患者(529±36μm对547±35μm;P = 0.02)。通过Cox比例风险回归分析确定,CCT较薄者比CCT较厚者更易进展(P = 0.01;风险比,CCT每薄40μm为1.44;95%置信区间,1.12 - 1.80),且CCT是唯一被确定与视野进展显著相关的危险因素。
在该病例对照患者群体中,开角型青光眼患者的视野进展与较薄的CCT显著相关。