Zahari Mimiwati, Mukesh Bickol N, Rait Julian L, Taylor Hugh R, McCarty Catherine A
Centre for Eye Research Australia, The University of Melbourne, Melbourne, Victoria, Australia.
Clin Exp Ophthalmol. 2006 Jan-Feb;34(1):20-6. doi: 10.1111/j.1442-9071.2006.01142.x.
To quantify the progression of visual field loss in participants with open angle glaucoma.
Cluster random samples of 3271 participants participated in this study. Each participant underwent a standardized ophthalmic examination, which included intraocular pressure measurement, Humphrey 24-2 Fastpac visual field testing and stereophotography of the optic disc. At baseline 118 participants were identified as possible, probable or definite open angle glaucoma and 74 (62.7%) of these were seen again at the follow-up examination. Progression of visual field loss was defined using three methods: the Advanced Glaucoma Intervention Study criteria, the modified Anderson criteria and the Blumenthal method.
In total, 49% of subjects showed progressive visual field loss with at least one method. The Blumenthal criteria yielded the highest rate of progression (37%), followed by the modified Anderson method (33%) and the Advanced Glaucoma Intervention Study method (16%). The progressive visual field loss was associated with baseline glaucoma status (P = 0.02); 65% of the definite glaucoma progressed, compared with 57% of the probable glaucoma and 25% of the possible glaucoma. Participants who had been previously diagnosed with glaucoma had a higher rate of progression (54%) when compared with those who had not been diagnosed previously (47%). In total, 50% (four of eight) of those receiving glaucoma medication at baseline had progressive visual field loss; all were in the definite glaucoma category.
Despite use of glaucoma medications the majority of glaucoma patients managed by their regular ophthalmologist experienced progressive visual field loss over a 5-year period.
量化开角型青光眼患者视野缺损的进展情况。
3271名参与者的整群随机样本参与了本研究。每位参与者都接受了标准化眼科检查，包括眼压测量、Humphrey 24-2快速视野检测以及视盘立体照相。在基线时，118名参与者被确定为可能、很可能或确诊的开角型青光眼患者，其中74名（62.7%）在随访检查中再次接受检查。视野缺损的进展采用三种方法定义：青光眼干预研究进展标准、改良的安德森标准和布卢门撒尔方法。
总体而言，49%的受试者至少用一种方法显示出视野缺损进展。布卢门撒尔标准得出的进展率最高（37%），其次是改良的安德森方法（33%）和青光眼干预研究方法（16%）。视野缺损进展与基线青光眼状态相关（P = 0.02）；确诊青光眼患者中有65%出现进展，相比之下，很可能青光眼患者为57%，可能青光眼患者为25%。与之前未被诊断出青光眼的参与者相比，之前被诊断出青光眼的参与者进展率更高（54%）。总体而言，基线时接受青光眼药物治疗的患者中有50%（8人中有4人）出现视野缺损进展；所有这些患者都属于确诊青光眼类别。
尽管使用了青光眼药物，但大多数由普通眼科医生管理的青光眼患者在5年期间仍出现了视野缺损进展。
