Nevalainen Jukka, Paetzold Jens, Papageorgiou Eleni, Sample Pamela A, Pascual John P, Krapp Elke, Selig Bettina, Vonthein Reinhard, Schiefer Ulrich
Department of Ophthalmology, University of Oulu, Oulu, Finland.
Graefes Arch Clin Exp Ophthalmol. 2009 Dec;247(12):1659-69. doi: 10.1007/s00417-009-1134-2. Epub 2009 Jul 29.
The goal of this work was to (i) determine patterns of progression in glaucomatous visual field loss, (ii) compare the detection rate of progression between locally condensed stimulus arrangements and conventional 6 degrees x 6 degrees grid, and (iii) assess the individual frequency distribution of test locations exhibiting a local event (i.e., an abrupt local deterioration of differential luminance sensitivity (DLS) by more than -10 dB between any two examinations).
The visual function of 41 glaucomatous eyes of 41 patients (16 females, 25 males, 37 to 75 years old) was examined with automated static perimetry (Tuebingen Computer Campimeter or Octopus 101-Perimeter). Stimuli were added to locally enhance the spatial resolution in suspicious regions of the visual field. The minimum follow-up was four subsequent sessions with a minimum of 2-month (median 6-month) intervals between each session. Progression was identified using a modified pointwise linear regression (PLR) method and a modified Katz criterion. The presence of events was assessed in all progressive visual fields.
Eleven eyes (27%) showed progression over the study period (median 2.5 years, range 1.3-8.6 years). Six (55%) of these had combined progression in depth and size and five eyes (45%) progressed in depth only. Progression in size conformed always to the nerve fiber course. Seven out of 11 (64%) of the progressive scotomata detected by spatially condensed grids would have been missed by the conventional 6 degrees x 6 degrees grid. At least one event occurred in 64% of all progressive eyes. Five of 11 (46%) progressive eyes showed a cluster of events.
The most common pattern of progression in glaucomatous visual fields is combined progression in depth and size of an existing scotoma. Applying individually condensed test grids remarkably enhances the detection rate of glaucomatous visual field deterioration (at the expense of an increased examination time) compared to conventional stimulus arrangements.
本研究的目的是：（i）确定青光眼性视野缺损的进展模式；（ii）比较局部密集刺激排列与传统6度×6度网格之间进展的检测率；（iii）评估表现出局部事件（即任意两次检查之间微分亮度敏感度（DLS）突然局部下降超过-10 dB）的测试位置的个体频率分布。
对41例患者（16例女性，25例男性，年龄37至75岁）的41只青光眼眼进行自动静态视野检查（图宾根计算机视野计或Octopus 101视野计）。在视野的可疑区域添加刺激以局部提高空间分辨率。最短随访为连续四次检查，每次检查间隔至少2个月（中位数为6个月）。使用改良的逐点线性回归（PLR）方法和改良的卡茨标准确定进展情况。在所有进展性视野中评估事件的存在情况。
在研究期间，11只眼（27%）出现进展（中位数为2.5年，范围为1.3 - 8.6年）。其中6只眼（55%）在深度和范围上均有进展，5只眼（45%）仅在深度上有进展。范围的进展始终符合神经纤维走行。在11例由空间密集网格检测到的进展性暗点中，有7例（64%）会被传统的6度×6度网格遗漏。在所有进展性眼中，64%至少发生了一次事件。11例进展性眼中有5例（46%）出现了事件簇。
青光眼性视野进展最常见的模式是现有暗点在深度和范围上的联合进展。与传统刺激排列相比，应用单独密集的测试网格显著提高了青光眼性视野恶化的检测率（代价是检查时间增加）。
