Boden Catherine, Blumenthal Eytan Z, Pascual John, McEwan Gavin, Weinreb Robert N, Medeiros Felipe, Sample Pamela A
Hamilton Glaucoma Center and Visual Function Laboratory, Department of Ophthalmology, University of California, San Diego, La Jolla, California 92093, USA.
Am J Ophthalmol. 2004 Dec;138(6):1029-36. doi: 10.1016/j.ajo.2004.07.003.
To determine typical patterns of repeatable glaucomatous visual field progression.
Retrospective analysis of data obtained from two prospective studies.
Included were 72 eyes of 72 patients tested up to six times over 2 years, and 40 eyes of 40 patients followed annually for up to 12 years. Each patient had two abnormal baseline visual fields, abnormal optic nerves, and serial fields. Progression was identified using three methods: by glaucoma change probability using total deviation (GCP-TD) and pattern deviation (GCP-PD) plots and by a clinical criteria. Progression was categorized as deepening or expansion of an existing scotoma, or a new scotoma.
The percentage of eyes repeatably progressed ranged from 17% to 27%. The most common pattern of progression was a deepening of an existing scotoma in the annual group, followed by expansion. With two follow-ups required, percentages for deepening only were 20% (clinical classifier). A combination of expansion and deepening was most common for the GCP criteria: 15% (GCP-TD classifier), and 10% (GCP-PD classifier) for the annual group. For the semiannual group, deepening was most common with the clinical criteria (11% of eyes), and deepening with expansion was most common by GCP criteria (14%, GCP-TD and GCP-PD). No eyes showed repeatable new scotomas.
Glaucomatous visual fields progress in the area of the visual field where baseline testing showed an existing scotoma. Follow-up testing might be improved by concentrating on already defective locations and using sparser test patterns or screening algorithms in normal areas of the visual field.
确定青光眼性视野重复性进展的典型模式。
对两项前瞻性研究获得的数据进行回顾性分析。
纳入72例患者的72只眼，在2年内进行了多达6次测试，以及40例患者的40只眼，每年随访长达12年。每位患者有两个异常的基线视野、异常的视神经和系列视野。使用三种方法确定进展情况：通过使用总偏差（GCP-TD）和模式偏差（GCP-PD）图的青光眼变化概率以及临床标准。进展被分类为现有暗点的加深或扩大，或新暗点。
重复性进展的眼的百分比范围为17%至27%。最常见的进展模式是年度组中现有暗点的加深，其次是扩大。需要两次随访时，仅加深的百分比为20%（临床分类器）。对于GCP标准，扩大和加深的组合最为常见：年度组中为15%（GCP-TD分类器）和10%（GCP-PD分类器）。对于半年组，临床标准下加深最为常见（11%的眼），GCP标准下加深伴扩大最为常见（14%，GCP-TD和GCP-PD）。没有眼显示重复性新暗点。
青光眼性视野在基线测试显示存在暗点的视野区域进展。通过专注于已经有缺陷的位置并在视野正常区域使用更稀疏的测试模式或筛查算法，可能会改善随访测试。
