在开角型青光眼患者中，先前存在视野进展的眼中继续出现视野进展。

Continued visual field progression in eyes with prior visual field progression in patients with open-angle glaucoma.

机构信息

Department of Ophthalmology, University of Washington, Seattle, USA.

出版信息

J Glaucoma. 2010 Dec;19(9):598-603. doi: 10.1097/IJG.0b013e3181d12e1e.

DOI:10.1097/IJG.0b013e3181d12e1e

PMID:20179616

Abstract

PURPOSE

To evaluate continued visual field (VF) progression in eyes with prior VF progression from open-angle glaucoma, using event-based criteria.

METHODS

Retrospective observational case series of 70 eyes (70 patients) with open-angle glaucoma, treated for at least 2 years, that had earlier shown 1 step of VF progression. Further VF progression required a worsening of 3 adjacent points at the same location on 2 consecutive VF tests. Potential risk factors for continued progression were evaluated.

RESULTS

The mean follow-up was 127±43 months. Thirty-seven eyes (55%) continued to progress. At 5, 10, and 15 years after the initial VF, the Kaplan-Meier estimate of the risk of developing 2 steps of progression was 18%, 53%, and 71%. A shorter time to the first step of progression was significantly associated with further progression (P<0.001), as was slope of the VF mean deviation (P<0.001) and pattern standard deviation (P=0.041). Eyes with further progression had higher mean IOP after the first step of progression (P=0.026). Among 37 eyes with 2 steps of progression, the estimate of the risk of progressing further was 32% at 10 years after the initial VF.

CONCLUSION

Eyes with a relatively shorter time to initial VF progression from open-angle glaucoma are likely to continue to progress over long-term follow-up. More aggressive treatment in such eyes might reduce the likelihood of further VF progression.

摘要

目的

使用基于事件的标准，评估先前存在开角型青光眼视野（VF）进展的眼的继续 VF 进展。

方法

回顾性观察性病例系列研究，纳入 70 只眼（70 例）的开角型青光眼患者，这些患者接受了至少 2 年的治疗，先前曾出现过 1 步 VF 进展。进一步的 VF 进展需要在连续 2 次 VF 测试中，同一位置的 3 个相邻点恶化。评估了继续进展的潜在危险因素。

结果

平均随访时间为 127±43 个月。37 只眼（55%）继续进展。在初始 VF 后 5、10 和 15 年，Kaplan-Meier 估计发展 2 步进展的风险分别为 18%、53%和 71%。向第一步进展的时间越短，与进一步进展显著相关（P<0.001），VF 平均偏差斜率（P<0.001）和模式标准差（P=0.041）也是如此。进一步进展的眼在第一步进展后平均 IOP 更高（P=0.026）。在 37 只进展 2 步的眼中，在初始 VF 后 10 年，进一步进展的风险估计为 32%。