Department of Psychology, Columbia University, New York, NY 10027, USA.
Invest Ophthalmol Vis Sci. 2011 Jan 25;52(1):519-26. doi: 10.1167/iovs.10-5174. Print 2011 Jan.
To compare glaucoma progression by functional and structural tests.
The authors prospectively studied 33 glaucoma patients (55 eyes); 20 eyes (15 patients) had disc hemorrhage, and 35 eyes (18 patients) had exfoliation glaucoma. The following tests were performed at two baseline and three follow-up examinations: frequency doubling perimetry (FDT), 24-2 Humphrey visual fields (HVF), multifocal visual evoked potentials (mfVEP), and optical coherence tomography (OCT). To identify progression, the baseline measurements were averaged and compared to those obtained at the final examination. Stereophotographs of the optic disc were obtained at baseline and compared with those at the final examination.
Patients were followed up for 21.1±1.8 months. For HVF there were significant changes in mean deviation (MD) in eight (14.5%) eyes but in pattern standard deviation (P/SD) in only two (3.6%) eyes. For FDT, there were significant changes in MD in 13 (23.6%) eyes. Five eyes showed changes in MD for HVF and FDT. For mfVEP, there was an increase in abnormal points in nine (16.4%) eyes. Six of these eyes did not show significant HVF or FDT changes. For OCT, RNFL average thickness values were significantly decreased in nine (16.4%) eyes. Nine (16.4%) eyes showed progression on stereophotography; four of these eyes did not show significant changes on OCT and functional tests.
Each test showed evidence of progression in some eyes. However, agreement among tests and stereophotography regarding which eyes showed progression was poor, illustrating the importance of following up patients with a combination of functional and structural tests.
比较功能和结构测试对青光眼进展的影响。
作者前瞻性研究了 33 例青光眼患者（55 只眼）；20 只眼（15 例）有视盘出血，35 只眼（18 例）有剥脱性青光眼。在两次基线和三次随访检查中进行了以下测试：频率加倍视野计（FDT）、24-2 Humphrey 视野（HVF）、多焦视觉诱发电位（mfVEP）和光学相干断层扫描（OCT）。为了确定进展，将基线测量值平均并与最后一次检查获得的值进行比较。在基线和最后一次检查时获得视盘的立体照片并进行比较。
患者随访 21.1±1.8 个月。HVF 的平均偏差（MD）在 8 只眼（14.5%）中发生显著变化，但在模式标准差（P/SD）中仅在 2 只眼（3.6%）中发生显著变化。FDT 的 MD 在 13 只眼（23.6%）中发生显著变化。5 只眼 HVF 和 FDT 的 MD 发生变化。mfVEP 中有 9 只眼（16.4%）异常点增加。其中 6 只眼 HVF 和 FDT 无显著变化。OCT 中，RNFL 平均厚度值在 9 只眼（16.4%）中显著降低。9 只眼（16.4%）的眼底照相显示进展；其中 4 只眼的 OCT 和功能测试无明显变化。
每种测试在一些眼中都显示出进展的迹象。然而，测试和立体摄影在哪些眼中显示进展方面的一致性很差，这说明了用功能和结构测试相结合来随访患者的重要性。
