LV Prasad Eye Institute, Banjara Hills, Hyderabad, India.
Ophthalmology. 2011 Feb;118(2):249-53. doi: 10.1016/j.ophtha.2010.05.027. Epub 2010 Aug 21.
To evaluate the relationship between severity of visual field (VF) loss at presentation and rate of VF progression in glaucoma.
Clinic-based, retrospective study.
We included 512 eyes of 310 primary glaucoma patients.
We analyzed the VFs of all subjects of primary glaucoma who had >5 VFs between 1989 and 2008. Based on the mean deviation (MD), we classified the VF loss as mild (MD > -6 dB), moderate (MD ≤ -6 to ≥ -12 dB) or severe (MD < -12 dB). Guided Progression Analysis software which gives the rate of progression (ROP) of Visual Field Index per year was used to assess the ROP.
Relationship between severity of VF loss at presentation and ROP.
The median duration of follow-up was 6.8 years. The ROP increased (worsened) by 0.02% per year for every dB worsening of MD (P = 0.02) and for every year of increasing age (P = 0.001). Association between MD and ROP showed a significant positive relationship in mild (β = 0.18; P = 0.001) and a significant negative relationship in severe (β = -0.16; P<0.001) VF loss category. Association between MD and ROP was not significant in the moderate VF loss category (β = -0.05; P = 0.61).
In early stages of glaucoma, the ROP worsened as the severity increased, but, in later stages of the disease, ROP became smaller as the severity increased. There is a need for better methods to detect progression in eyes with severe glaucomatous damage.
评估青光眼患者初诊时视野（VF）损失严重程度与 VF 进展率之间的关系。
基于临床的回顾性研究。
纳入了 310 例原发性青光眼患者的 512 只眼。
分析了所有在 1989 年至 2008 年间接受超过 5 次 VF 检查的原发性青光眼患者的 VF。根据平均偏差（MD），我们将 VF 损失分为轻度（MD > -6dB）、中度（MD ≤ -6 至≥-12dB）或重度（MD < -12dB）。使用指导进展分析软件（Guided Progression Analysis software）评估每年视觉 Field Index 的进展率（ROP）。
初诊时 VF 损失严重程度与 ROP 之间的关系。
中位随访时间为 6.8 年。ROP 每年增加（恶化）0.02%，MD 每恶化 1dB（P = 0.02）和年龄每增加 1 岁（P = 0.001）。MD 与 ROP 之间的关系在轻度 VF 损失组（β = 0.18；P = 0.001）呈显著正相关，在重度 VF 损失组（β = -0.16；P<0.001）呈显著负相关。在中度 VF 损失组，MD 与 ROP 之间的关系不显著（β = -0.05；P = 0.61）。
在青光眼早期，随着病情的加重，ROP 恶化，但在疾病的晚期，随着病情的加重，ROP 变小。对于严重青光眼损伤的眼睛，需要更好的方法来检测进展。
