The Hospital Universitario de Canarias, La Laguna, Spain.
Br J Ophthalmol. 2010 Apr;94(4):414-8. doi: 10.1136/bjo.2009.170480. Epub 2009 Dec 3.
To observe the prospective follow-up results of functional and morphological data in patients with early, moderate and suspected glaucoma.
Eyes (n=156; average mean defect (MD)=2.2 dB) were examined every 3 months for an average of 3.6 years. Progression was estimated using regression analysis of the indices rim area and Glaucoma Probability Score of the Heidelberg retinal tomograph, mean thickness of the fibre layer using laser polarimetry with corneal compensation, MDs of standard, Pulsar and frequency doubling technology perimetries, and the threshold noiseless trend (TNT) program for the standard and Pulsar perimetries.
TNT showed more than twice the diagnostic capacity of other methods. The maximum diagnostic sensitivity was obtained with TNT Pulsar. This procedure indicated progression in 40% of cases after seven examinations, and presented the lowest number of cases of progression not confirmed in two consecutive examinations. Most of the progressions of initial glaucoma were diffuse, without changes in the lens or loss of visual acuity. Heidelberg retinal tomograph and laser polarimetry made few diagnoses of progression. The diagnostic agreement between different methods was low, but higher between functional than morphological procedures.
Functional indices, especially Pulsar, showed better detection of progression than morphological indices.
观察早期、中度和疑似青光眼患者的功能和形态数据的前瞻性随访结果。
对 156 只眼（平均平均缺损（MD）=2.2dB）进行检查，平均随访 3.6 年，每 3 个月检查一次。使用海德堡视网膜断层扫描仪的边缘区域和青光眼概率评分、角膜补偿后的激光偏振测量纤维层平均厚度、标准、脉冲和倍频技术的 MDs、标准和脉冲的无声趋势（TNT）程序的回归分析来估计进展。
TNT 的诊断能力是其他方法的两倍多。TNT 脉冲在最大诊断灵敏度。该程序在七次检查后有 40%的病例显示进展，在两次连续检查中进展未被确认的病例数最少。大多数初始青光眼的进展是弥漫性的，晶状体或视力丧失没有变化。海德堡视网膜断层扫描仪和激光偏振测量仪很少诊断出进展。不同方法之间的诊断一致性较低，但功能方法比形态方法的诊断一致性更高。
功能指标，特别是脉冲，比形态指标更能检测出进展。
