Singapore Eye Research Institute and Singapore National Eye Centre, Singapore.
Singapore Eye Research Institute and Singapore National Eye Centre, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Am J Ophthalmol. 2011 Sep;152(3):463-469. doi: 10.1016/j.ajo.2011.02.023. Epub 2011 Jun 14.
To investigate the long-term rates of blindness and visual field (VF) progression in treated primary angle-closure glaucoma (PACG) patients.
Retrospective observational case series.
PACG patients with ≥10 years of follow-up were analyzed. All VFs (static automated perimetry, central 24-2 threshold test) performed were reviewed and reliable VFs (fixation losses <20%, false positives and false negatives <33%) were scored using the Advanced Glaucoma Intervention Study (AGIS) system. Progression of a VF defect was defined as a change of ≥4 from baseline on 2 consecutive VF tests.
From the 137 eyes of 87 patients with PACG with ≥10 years of follow-up identified, 6% and 30.1% were blind based on initial visual acuity (VA) and VF criteria respectively and 12.0% had an initial AGIS score of 20; these were excluded. Eighty-three eyes from 57 patients (all Chinese, mean age 59.9 ± 8.2 years, 67.5% female) were analyzed. The mean AGIS score was 5.14 ± 4.37 at baseline. VF deterioration was detected in 27 eyes (32.5%) of 21 patients, with 4.8% and 7.2% of eyes progressing to blindness based on VA and VF criteria respectively. On Cox regression, eyes with VF progression had higher mean overall IOP (P < .001), and higher prevalence of previous acute angle closure (AAC, P = .008).
Over 10 years, a third of PACG patients were found to have VF progression, with 7% progressing to blindness while on treatment. Eyes with higher mean overall IOP and a history of previous AAC were more likely to have VF progression.
研究治疗性原发性闭角型青光眼（PACG）患者的长期失明率和视野（VF）进展率。
回顾性观察性病例系列研究。
分析了随访时间≥ 10 年的 PACG 患者。回顾了所有进行的 VF（静态自动视野计，中央 24-2 阈值测试），并使用高级青光眼干预研究（AGIS）系统对可靠的 VF（固视丢失<20%，假阳性和假阴性<33%）进行评分。VF 缺损的进展定义为在连续 2 次 VF 测试中至少有 4 次变化。
从 137 只眼的 87 例随访时间≥ 10 年的 PACG 患者中，根据初始视力（VA）和 VF 标准，分别有 6%和 30.1%失明，并且 12.0%患者的初始 AGIS 评分为 20；这些患者被排除在外。对 57 例患者（均为中国人，平均年龄 59.9±8.2 岁，女性占 67.5%）的 83 只眼进行了分析。基线时平均 AGIS 评分为 5.14±4.37。在 21 例患者中，有 27 只眼（32.5%）出现 VF 恶化，其中分别有 4.8%和 7.2%的眼根据 VA 和 VF 标准进展为失明。在 Cox 回归中，VF 进展的眼具有更高的平均总眼压（P<.001），并且有更高的既往急性闭角型青光眼（AAC）患病率（P=.008）。
在 10 年以上的时间里，发现三分之一的 PACG 患者出现 VF 进展，其中 7%在治疗过程中失明。眼压较高且有既往 AAC 病史的眼更有可能出现 VF 进展。
