Gloor B
Augenklinik, Universitätsspital, Zürich.
Fortschr Ophthalmol. 1990;87 Suppl:S163-71.
The follow-up and management of glaucoma are based on the measurement of IOP, on psychophysical examination, and morphological evaluation of the papilla, the nerve fiber layer, and the chamber angle. Applanation tonometry is still the method of choice for IOP measurement. Disinfection with 70% alcohol protects against AIDS. Air-puff applanation tonometry is not exact enough. Although certain authors would like to define primary open-angle glaucoma solely on the changes of the papilla and visual field, we still cannot do without pressure as an indicator for the presence of glaucoma and the quality of therapy follow-up. Additional psychophysical examinations such as color perception, contrast sensitivity, flicker perimetry, and pattern ERG are not yet perfected for the practice and do not replace computerized threshold perimetry. The later has taken a giant step forward with the new evaluation program. However, in spite of these advancements in perimetry, morphology of the papilla and of the nerve fiber layer has assumed such a central role that it must be included in routine glaucoma follow-up. At present, standardized "hand planimetry" is still superior to scanners and laser ophthalmoscopes.
青光眼的随访与管理基于眼压测量、心理物理学检查以及视乳头、神经纤维层和房角的形态学评估。压平眼压测量法仍是测量眼压的首选方法。用70%酒精消毒可预防艾滋病。气吹式压平眼压测量法不够精确。尽管某些作者希望仅根据视乳头和视野的变化来定义原发性开角型青光眼,但我们仍离不开眼压作为青光眼存在及治疗随访质量的指标。诸如色觉、对比敏感度、闪烁视野检查和图形视网膜电图等其他心理物理学检查在实际应用中尚未完善,也不能替代电脑化阈值视野检查。随着新的评估程序,后者向前迈出了一大步。然而,尽管视野检查有这些进展,视乳头和神经纤维层的形态学已占据核心地位,必须纳入青光眼常规随访中。目前,标准化的“手动平面测量法”仍优于扫描仪和激光检眼镜。