De Moraes Carlos Gustavo, Demirel Shaban, Gardiner Stuart K, Liebmann Jeffrey M, Cioffi George A, Ritch Robert, Gordon Mae O, Kass Michael A
Arch Ophthalmol. 2012 Dec;130(12):1541-6. doi: 10.1001/jamaophthalmol.2013.1137.
To compare rates of visual field (VF) change in ocular hypertensive eyes with and without optic dischemorrhage (DH).
Ocular Hypertension Treatment Study subjects(minimum 10 reliable VF tests, followed up 5 years) were included. Trend analyses of VF sequences over time of DH and non-DH eyes were assessed by regression of mean deviation (MDR) and pointwise linear regression (PLR). The main outcome measures were rates of VF change in DH and non-DH eyes.
Two thousand six hundred seven eyes (1378 participants) were included. The mean (SD) number of VF tests per eye was 23.7 (4.9) spanning a mean (SD) of 12.2 (2.0) years. At least 1 DH was detected in 187 eyes(7.2%), of which 52 eyes had recurrent DH. Mean deviation rate of change was significantly worse in DH compared with non-DH eyes (mean [SD], −0.17 [0.27] vs−0.07 [0.19] dB/y; P<.01). Significant PLR progression occurred more frequently in eyes with DH (odds ratio,3.6; P<.01), which increased when 2 or more DHs were present (odds ratio, 4.2; P=.01). Eyes initially randomized to treatment were less likely to have a DH during follow-up.
Eyes with DH had more rapid VF deterioration when assessed by global (MDR) or local (PLR)trend analysis than eyes without DH. Eyes with recurrent DH had similar rates of global VF change (MDR)when compared with eyes with a single DH but reached criteria for rapid PLR change more often. Intraocular pressure reduction in ocular hypertension reduces the risk of developing a DH. Ocular hypertensive eyes with DH should be monitored closely and may need more aggressive therapy.
clinicaltrials.gov Identifier: NCT00000125
比较有和无视盘出血（DH）的高眼压眼中视野（VF）变化的速率。
纳入高眼压治疗研究的受试者（至少10次可靠的VF检查，随访5年）。通过平均偏差（MDR）回归和逐点线性回归（PLR）评估DH和非DH眼随时间的VF序列趋势分析。主要结局指标是DH和非DH眼中VF变化的速率。
纳入2607只眼（1378名参与者）。每只眼VF检查的平均（标准差）次数为23.7（4.9）次，平均（标准差）随访时间为12.2（2.0）年。187只眼（7.2%）检测到至少1次DH，其中52只眼有复发性DH。与非DH眼相比，DH眼的平均偏差变化率明显更差（平均[标准差]，−0.17[0.27]对−0.07[0.19]dB/年；P<0.01）。DH眼发生显著PLR进展的频率更高（优势比，3.6；P<0.01），当出现2次或更多次DH时增加（优势比，4.2；P=0.01）。最初随机分配接受治疗的眼在随访期间发生DH的可能性较小。
通过整体（MDR）或局部（PLR）趋势分析评估时，有DH的眼比没有DH的眼VF恶化更快。与单次DH的眼相比，复发性DH的眼整体VF变化（MDR）速率相似，但更常达到快速PLR变化的标准。降低高眼压症患者的眼压可降低发生DH的风险。有DH的高眼压眼应密切监测，可能需要更积极的治疗。
clinicaltrials.gov标识符：NCT00000125
