Choi Yun Jeong, Kim Martha, Park Ki Ho, Kim Dong Myung, Kim Seok Hwan
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea; Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea.
Acta Ophthalmol. 2014 Dec;92(8):e644-9. doi: 10.1111/aos.12411. Epub 2014 Apr 3.
To investigate the risk and risk factors for newly developed visual impairment in treated patients with normal-tension glaucoma (NTG) followed up on for 10 years.
Patients with NTG, who did not have visual impairment at the initial diagnosis and had undergone intraocular pressure (IOP)-lowering treatment for more than 7 years, were included on the basis of a retrospective chart review. Visual impairment was defined as either low vision (0.05 [20/400] ≤ visual acuity (VA) <0.3 [20/60] and/or 10 degrees ≤ central visual field (VF) <20 degrees) or blindness (VA <0.05 [20/400] and/or central VF <10 degrees) by World Health Organization (WHO) criteria. To investigate the risk and risk factors for newly developed visual impairment, Kaplan-Meier survival analysis and generalized linear mixed effects models were utilized.
During the 10.8 years mean follow-up period, 20 eyes of 16 patients were diagnosed as visual impairment (12 eyes as low vision, 8 as blindness) among 623 eyes of 411 patients. The cumulative risk of visual impairment in at least one eye was 2.8% at 10 years and 8.7% at 15 years. The risk factors for visual impairment from treated NTG were worse VF mean deviation (MD) at diagnosis and longer follow-up period.
The risk of newly developed visual impairment in the treated patients with NTG was relatively low. Worse VF MD at diagnosis and longer follow-up period were associated with development of visual impairment.
调查接受治疗的正常眼压性青光眼（NTG）患者随访10年期间新发视力损害的风险及危险因素。
基于回顾性病历审查纳入初诊时无视力损害且接受眼压（IOP）降低治疗超过7年的NTG患者。视力损害根据世界卫生组织（WHO）标准定义为低视力（0.05[20/400]≤视力（VA）<0.3[20/60]和/或10度≤中心视野（VF）<20度）或失明（VA<0.05[20/400]和/或中心VF<10度）。为调查新发视力损害的风险及危险因素，采用了Kaplan-Meier生存分析和广义线性混合效应模型。
在平均10.8年的随访期内，411例患者的623只眼中，16例患者的20只眼被诊断为视力损害（12只眼为低视力，8只眼为失明）。至少一只眼视力损害的累积风险在10年时为2.8%，在15年时为8.7%。接受治疗的NTG患者视力损害的危险因素为诊断时较差的VF平均偏差（MD）和较长的随访期。
接受治疗的NTG患者新发视力损害的风险相对较低。诊断时较差的VF MD和较长的随访期与视力损害的发生相关。
