Department of Psychology, Columbia University, New York, New York2Tufts University School of Medicine, Boston, Massachusetts.
Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York5Department of Ophthalmology, New York University School of Medicine, New York, New York.
JAMA Ophthalmol. 2014 Mar;132(3):291-7. doi: 10.1001/jamaophthalmol.2013.7656.
The macula is essential for visual functioning and is known to be affected even in early glaucoma. However, little is currently understood about the prevalence and nature of central vision loss in early glaucoma.
To determine the prevalence and characteristics of visual field (VF) defects in the central 10° in glaucoma suspects and patients with mild glaucoma using a prospective design.
DESIGN, SETTING, AND PARTICIPANTS: This prospective observational cohort study was conducted at an outpatient glaucoma specialty clinic. One hundred eyes from 74 patients with glaucomatous optic neuropathy and a 24-2 VF with mean deviation better than -6 dB were prospectively studied and tested with a 10-2 test.
Reliable: VF hemifields were classified as abnormal based on a cluster criterion, and abnormal 10-2 VFs were categorized based on the pattern of abnormal points: arcuatelike, widespread, or other. In addition, at each point of the 10-2 VF, the total deviation values were averaged across eyes and the number of abnormal points with total deviation values below a specific criterion level were calculated. RESULTS There appeared to be as many abnormal 10-2 hemifields (53%) as abnormal 24-2 hemifields (59%). Of the eyes with normal 24-2 hemifields, 16% were classified as abnormal when the 10-2 test was used. Of the abnormal 10-2 hemifields, 68%, 8%, and 25% were arcuatelike, widespread, and other, respectively. The average total deviation values and number of abnormal points plots revealed superior VF defects that were deeper and closer to fixation than those in the inferior VF.
The 10-2 VF was abnormal in nearly as many hemifields as was the 24-2 VF, including some with normal 24-2 VF, suggesting that the 24-2 test is not optimal for detecting early damage of the macula. The pattern of the defects was in agreement with a recent model of macular damage.
黄斑对于视觉功能至关重要，即使在早期青光眼也已知其受到影响。然而，目前对于早期青光眼的中央视力丧失的患病率和性质知之甚少。
采用前瞻性设计，确定青光眼疑似患者和轻度青光眼患者的中央 10°视野（VF）缺损的患病率和特征。
设计、设置和参与者：这项前瞻性观察性队列研究在一家门诊青光眼专科诊所进行。前瞻性研究了 74 例具有青光眼视神经病变和平均偏差大于-6 dB 的 24-2VF 的 100 只眼，并使用 10-2 测试进行了测试。
可靠：根据聚类标准将 VF 半视野分类为异常，根据异常点的模式将异常 10-2VF 分类为弧形、广泛或其他。此外，在 10-2VF 的每个点，平均了所有眼睛的总偏差值，并计算了总偏差值低于特定标准水平的异常点的数量。结果：似乎有与异常 24-2 半视野（59%）一样多的异常 10-2 半视野（53%）。在使用 10-2 测试时，24-2 半视野正常的眼睛中有 16%被归类为异常。在异常的 10-2 半视野中，分别有 68%、8%和 25%为弧形、广泛和其他。平均总偏差值和异常点图揭示了优于下 VF 的更深处和更接近注视点的 VF 缺陷。
10-2VF 的异常半视野数量与 24-2VF 一样多，包括一些 24-2VF 正常的情况，这表明 24-2 测试对于检测黄斑的早期损伤并不理想。缺陷模式与最近的黄斑损伤模型一致。
