Chauhan Balwantray C, Mikelberg Frederick S, Artes Paul H, Balazsi A Gordon, LeBlanc Raymond P, Lesk Mark R, Nicolela Marcelo T, Trope Graham E
Department of Ophthalmology and Visual Sciences, Dalhousie University, Victoria, Halifax, Nova Scotia B3H 2Y9, Canada.
Arch Ophthalmol. 2010 Oct;128(10):1249-55. doi: 10.1001/archophthalmol.2010.196. Epub 2010 Aug 9.
To determine rates of visual field change associated with risk factors for progression in the Canadian Glaucoma Study (abnormal anticardiolipin antibody level, age, female sex, and mean follow-up intraocular pressure [IOP]), and to evaluate the effect of IOP reduction on subsequent rates of visual field change in progressing patients.
Two hundred sixteen patients (median age, 65.2 years) were followed up at 4-month intervals with perimetry and were monitored for progression. Patients reaching an end point based on total deviation analysis underwent 20% or greater reduction in IOP. Rates of mean deviation (MD) change were calculated.
Patients with 0, 1, and 2 end points had a median of 18, 23, and 25 examinations, respectively. The median MD rate in progressing patients prior to the first end point was significantly worse compared with those with no progression (-0.35 and 0.05 dB/y, respectively). An abnormal anticardiolipin antibody level was associated with a significantly worse MD rate compared with a normal anticardiolipin antibody level (-0.57 and -0.03 dB/y, respectively). Increasing age was associated with a worse MD rate, but female sex and mean follow-up IOP were not. After the first end point, the median IOP decreased from 18.0 to 14.8 mm Hg (20% in individual patients), resulting in a significant MD rate change from -0.36 to -0.11 dB/y.
Patients with abnormal anticardiolipin antibody levels and increasing age had faster visual field change. Modest IOP reduction in progressing patients significantly ameliorated the rate of visual field decline.
clinicaltrials.gov Identifier: NCT00262626.
确定在加拿大青光眼研究中与病情进展风险因素（抗心磷脂抗体水平异常、年龄、女性性别以及平均随访眼压[IOP]）相关的视野变化率，并评估眼压降低对病情进展患者后续视野变化率的影响。
216例患者（中位年龄65.2岁）每4个月接受一次视野检查随访，并监测病情进展。基于总偏差分析达到终点的患者眼压降低20%或更多。计算平均偏差（MD）变化率。
有0个、1个和2个终点的患者分别接受了中位数为18次、23次和25次检查。与无病情进展的患者相比，首次终点前病情进展患者的中位MD率明显更差（分别为-0.35和0.05 dB/年）。与抗心磷脂抗体水平正常相比，抗心磷脂抗体水平异常与明显更差的MD率相关（分别为-0.57和-0.03 dB/年）。年龄增加与更差的MD率相关，但女性性别和平均随访眼压则不然。在首次终点后，中位眼压从18.0降至14.8 mmHg（个体患者降低20%），导致MD率从-0.36显著变为-0.11 dB/年。
抗心磷脂抗体水平异常和年龄增加的患者视野变化更快。病情进展患者适度降低眼压可显著改善视野下降率。
clinicaltrials.gov标识符：NCT00262626。
