Quigley H A, Katz J, Derick R J, Gilbert D, Sommer A
Dana Center for Preventive Ophthalmology, Johns Hopkins Hospital, Baltimore, MD 21205.
Ophthalmology. 1992 Jan;99(1):19-28. doi: 10.1016/s0161-6420(92)32018-4.
From annual examinations of 813 ocular hypertensive eyes, the authors compared optic disc and nerve fiber layer photographs in 2 age-matched subgroups: 37 eyes that converted to abnormal visual field tests at the end of a 5-year period and 37 control eyes that retained normal field tests. Disc change was detected in only 7 of 37 (19%) converters to field loss and in 1 of 37 (3%) controls. Progressive nerve fiber layer atrophy was observed in 18 of 37 (49%) converters and in 3 of 37 (8%) controls. Serial nerve fiber layer examination was more sensitive than color disc evaluation in the detection of progressive glaucoma damage at this early stage of glaucoma. The evaluation of cup-to-disc ratio or of the nerve fiber layer appearance in the initial photograph taken 5 years before field loss were equally predictive of future field damage. The position of nerve fiber layer defects was highly correlated with the location of subsequent visual field loss.
通过对813只高眼压眼的年度检查，作者在两个年龄匹配的亚组中比较了视盘和神经纤维层照片：一组是在5年期末视野检查转为异常的37只眼，另一组是视野检查保持正常的37只对照眼。在37只视野丧失转变者中，仅7只（19%）检测到视盘变化，而在37只对照眼中有1只（3%）检测到视盘变化。在37只转变者中有18只（49%）观察到进行性神经纤维层萎缩，而在37只对照眼中有3只（8%）观察到进行性神经纤维层萎缩。在青光眼的这个早期阶段，连续神经纤维层检查在检测进行性青光眼损害方面比彩色视盘评估更敏感。在视野丧失前5年拍摄的初始照片中对视杯与视盘比值或神经纤维层外观的评估，对未来视野损害具有同样的预测性。神经纤维层缺损的位置与随后视野丧失的部位高度相关。
