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[阈值和超阈值视野检查中青光眼性视野缺损的记录]

[Documentation of glaucomatous visual field defects in threshold and suprathreshold perimetry].

作者信息

Stark H

出版信息

Klin Monbl Augenheilkd. 1992 Mar;200(3):187-98. doi: 10.1055/s-2008-1045736.

DOI:10.1055/s-2008-1045736
PMID:1578877
Abstract

In contrast to normal subjects, the individual stimulus threshold for differential light sensitivity (DLS) in glaucoma patients fluctuates considerably. The sensitivity and the size of the defect are correlated: with a higher individual stimulus threshold, i.e. when sensitivity deteriorates, the number of defects decreases. Conversely, when the individual stimulus threshold drops, i.e. when sensitivity improves, the number of defects recorded increases. The trend is the same with extensive Grade 3 defects. This correlation between sensitivity and defect size means that the number and depth of individual defects change constantly, due to the fluctuation of the individual stimulus threshold. In follow-up examinations test positions with permanent defects (a defects) can be distinguished from those where defects have been detected several times, but not permanently (b defects) and, respectively, only once in 2 1/2 years (c defects). Defects must therefore be classified not only according to depth, but also according to behaviour at individual test positions. Such a classification can be accomplished by tabulating all newly numbered test positions and the defects identified there. After 5 visual field examinations the defects are then classified as a, b, or c defects. They are then identified by colour symbols and transferred to a test position chart representing a synopsis of 5 visual fields. The chart not only permits exact topographical analysis but also furnishes information on certain structural features of the glaucomatous visual field: stable nuclear areas of a defects surrounded by fluctuating peripheral defects (b defects) or concomitant c defects. After a further 1 1/2-2 years, 5 more follow-ups are summarized, classified and transferred to a follow-up test position chart. Comparison of these two test position charts furnishes information of major prognostic value.

摘要

与正常受试者相比,青光眼患者的个体差异光敏感度(DLS)刺激阈值波动很大。敏感度与缺损大小相关:个体刺激阈值越高,即敏感度下降时,缺损数量减少。相反,当个体刺激阈值降低,即敏感度提高时,记录到的缺损数量增加。广泛的3级缺损也是如此。敏感度与缺损大小之间的这种相关性意味着,由于个体刺激阈值的波动,个体缺损的数量和深度不断变化。在随访检查中,可将有永久性缺损的测试位置(a类缺损)与那些多次检测到缺损但并非永久性的位置(b类缺损)以及分别在2年半内仅检测到一次缺损的位置(c类缺损)区分开来。因此,缺损不仅要根据深度分类,还要根据各个测试位置的表现进行分类。这种分类可以通过将所有新编号的测试位置及其发现的缺损制成表格来完成。经过5次视野检查后,缺损再分为a、b或c类缺损。然后用颜色符号标识它们,并转移到代表5次视野概要的测试位置图表上。该图表不仅允许进行精确的地形分析,还能提供有关青光眼视野某些结构特征的信息:a类缺损的稳定核心区域被波动的周边缺损(b类缺损)或伴随的c类缺损包围。再过1年半到2年,再总结、分类5次以上的随访结果,并转移到随访测试位置图表上。比较这两张测试位置图表可提供具有重要预后价值的信息。

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