Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.
PLoS One. 2013 Jul 8;8(7):e69772. doi: 10.1371/journal.pone.0069772. Print 2013.
To investigate risk factors associated with progressive visual field (VF) loss in primary angle closure glaucoma (PACG).
We retrospectively reviewed medical record of PACG patients who had ≥5 reliable VF examinations (central 24-2 threshold test, Humphrey Field Analyzer) and ≥2 years of follow-up. Each VF was scored using Collaborative Initial Glaucoma Treatment Study system. Progression was defined if 3 consecutive follow-up VF tests had an increased score of ≥3 above the mean of the first 2 VF scores. Factors associated with VF progression were evaluated by Cox proportional hazards models.
A total of 89 eyes from 89 patients (mean age, 69.8 ± 7.9 years), who received a mean of 6.9 ± 2.3 VF tests (mean deviation at initial, -8.1 ± 4.4 dB) with a mean follow-up of 63.9 ± 23.9 months were included. VF progression was detected in 9 eyes (10%). The axial length (AL), anterior chamber depth, and intraocular pressure (IOP) in patients with and without progression were 22.5 ± 0.6 and 23.1 ± 0.9 mm, 2.5 ± 0.3 and 2.5 ± 0.3 mm, 14.8 ± 2.4 and 14.3 ± 2.3 mm Hg, respectively. AL was the only factor associated with progression in both Cox proportional hazards univariate (p = 0.031) and multivariate models (p = 0.023).
When taking into account age, IOP, follow-up period, and number of VF tests, a shorter AL is the only factor associated with VF progression in this cohort of Chinese patients with PACG. Further studies are warranted to verify the role of AL in progressive VF loss in PACG.
研究与原发性闭角型青光眼（PACG）患者进行性视野（VF）损失相关的危险因素。
我们回顾性分析了≥5 次可靠的 VF 检查（中央 24-2 阈值测试，Humphrey 视野分析仪）和≥2 年随访的 PACG 患者的病历。每个 VF 均使用合作性初始青光眼治疗研究系统进行评分。如果 3 次连续随访 VF 检查的评分比前 2 次 VF 评分的平均值增加≥3，则定义为进展。通过 Cox 比例风险模型评估与 VF 进展相关的因素。
共纳入 89 例患者（89 只眼），平均年龄为 69.8±7.9 岁，平均接受 6.9±2.3 次 VF 检查（初始平均偏差，-8.1±4.4dB），平均随访时间为 63.9±23.9 个月。在 9 只眼中（10%）检测到 VF 进展。进展患者和无进展患者的眼轴长度（AL）、前房深度和眼压（IOP）分别为 22.5±0.6mm 和 23.1±0.9mm、2.5±0.3mm 和 2.5±0.3mm、14.8±2.4mmHg 和 14.3±2.3mmHg。在 Cox 比例风险单因素（p=0.031）和多因素模型中（p=0.023），AL 是唯一与进展相关的因素。
在考虑年龄、IOP、随访时间和 VF 检查次数的情况下，较短的 AL 是本队列中中国 PACG 患者 VF 进展的唯一相关因素。需要进一步研究来验证 AL 在 PACG 进行性 VF 损失中的作用。
