Department of Ophthalmology, Faculty of Medicine, Kagawa University, Miki, Kagawa, Japan.
Acta Ophthalmol. 2016 Dec;94(8):e683-e687. doi: 10.1111/aos.13089. Epub 2016 May 26.
This study aimed to elucidate the relationship between visual field defects in the upper and lower hemifields and the corresponding oxygen saturation of the retinal vessels in patients with glaucoma.
Patients with glaucoma (n = 44) exhibiting more than a 10 dB difference between the upper and lower total deviation (TD) were enrolled in the study. After measuring the retinal vessel oxygen saturation by a non-invasive spectrophotometric retinal oximeter, the hemifields in one eye of each patient were divided into worse (worse TD) and better (better TD) hemifield areas. We additionally evaluated a separate group of 40 patients with glaucoma who exhibited less than a 5 dB difference between the upper and lower TD. Statistical analysis was performed using a Student's t-test.
A higher mean venous saturation of oxygen (SaO ) was observed in the worse (59.0 ± 8.0%) hemifield compared to the better (55.4 ± 7.2%) hemifield (p < 0.01). The mean arteriovenous difference in the SaO was lower in the worse (44.4 ± 9.0%) hemifield compared to the better (48.6 ± 11.4%) hemifield (p = 0.02). However, when we evaluated the worse and better hemifields in the patients who had less than a 5 dB difference in the upper and lower hemifield TD, we found no statistically significant differences for either the retinal SaO in the venous vessels or the arteriovenous difference.
Advanced glaucomatous visual field defects were associated with increased SaO in the venous vessels and a decreased arteriovenous difference in the SaO . The present results suggest there is a reduced retinal oxygen extraction in eyes with glaucomatous damage due to retinal ganglion cell loss.
本研究旨在阐明青光眼患者视野上下半缺损与视网膜血管相应氧饱和度之间的关系。
纳入视野上、下总偏差(TD)差值大于 10dB 的青光眼患者(n=44)。使用非侵入性分光光度视网膜血氧计测量视网膜血管氧饱和度后,将每位患者一只眼的半视野分为较差(较差 TD)和较好(较好 TD)半视野区。我们还评估了另一组 40 名上、下 TD 差值小于 5dB 的青光眼患者。使用学生 t 检验进行统计分析。
较差半视野的静脉血氧饱和度(SaO )平均值(59.0±8.0%)高于较好半视野(55.4±7.2%)(p<0.01)。较差半视野的 SaO 平均动静脉差(44.4±9.0%)低于较好半视野(48.6±11.4%)(p=0.02)。然而,当我们评估上、下 TD 差值小于 5dB 的患者的较差和较好半视野时,我们发现静脉 SaO 和 SaO 动静脉差均无统计学差异。
晚期青光眼视野缺损与静脉 SaO 升高和 SaO 动静脉差降低有关。本研究结果表明,由于视网膜神经节细胞丧失,青光眼损害的眼中视网膜氧提取减少。