Boodhna T, Saunders L J, Crabb D P
Optometry and Visual Science, School of Health Sciences, City University London, London, UK.
Eye (Lond). 2015 Dec;29(12):1613-9. doi: 10.1038/eye.2015.161. Epub 2015 Aug 28.
To examine changes in rates of visual field (VF) progression in patients attending a sample of glaucoma clinics in England between 1999 and 2012.
An archive of 473 252 Humphrey VFs recorded across the UK was retrospectively examined. Distribution of rates recorded in the first half of the decade was compared with the second. The relationship between age and severity of MD loss at baseline with rates of loss and frequency of testing was examined.
VF series from 18 926 eyes were analysed. Median rate of MD loss for the period before and after 2003 was -0.11 and -0.06 dB/year, respectively, but the proportion of eyes with medium or fast rates of MD loss remained constant. Median rate of MD loss in older (>70 years) eyes was faster than that observed in younger (<60 years) eyes (-0.21 compared with -0.01 dB/year). Median rate of loss did not vary with severity of MD loss at baseline. Frequency of testing, typically carried out annually, did not vary by age, rate of loss or disease severity.
VFs of eyes treated in the first half of the decade deteriorated more rapidly than those in the second half. Several factors might explain these differences but average effects were small and there was no reduction in the proportion of rapidly progressing eyes over the decade. Older age and, to a lesser extent, worse VF damage at diagnosis are indicators for faster VF loss in clinics, but frequency of VF testing was similar for all patients.
研究1999年至2012年间在英国部分青光眼诊所就诊的患者视野（VF）进展率的变化。
对英国记录的473252份Humphrey视野进行回顾性研究。比较了该十年前半期和后半期记录的进展率分布情况。研究了基线时年龄与平均偏差（MD）损失严重程度与损失率和检测频率之间的关系。
分析了18926只眼的视野系列。2003年前后期间MD损失的中位数率分别为-0.11和-0.06dB/年，但MD损失为中度或快速率的眼的比例保持不变。年龄较大（>70岁）的眼中MD损失的中位数率比年龄较小（<60岁）的眼更快（分别为-0.21和-0.01dB/年）。损失的中位数率在基线时不随MD损失的严重程度而变化。通常每年进行的检测频率不随年龄、损失率或疾病严重程度而变化。
该十年前半期接受治疗的眼的视野比后半期恶化得更快。有几个因素可能解释这些差异，但平均影响较小，并且在这十年中快速进展眼的比例没有降低。年龄较大以及在较小程度上诊断时较差的视野损害是诊所中视野更快丧失的指标，但所有患者的视野检测频率相似。
