Department of Ophthalmology and Visual Science, St. Vincent's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Korea.
Invest Ophthalmol Vis Sci. 2018 Nov 1;59(13):5447-5454. doi: 10.1167/iovs.18-24083.
To determine the relationship between the sighting eye choice and functional and structural asymmetries in open-angle glaucoma (OAG).
Two hundred patients with bilateral OAG underwent dominant eye testing using a hole-in-a-card test. The paired eyes were divided into worse and better eyes according to the mean deviation (MD) of visual field (VF) results. Based on the results, patients whose sighting eyes corresponded to eyes with a better VF were designated as group 1, and those whose sighting eyes corresponded to eyes with a worse VF as group 2.
The sighting eye corresponded predominantly to eyes with better VFs (P < 0.001). The MD of the worse eye was significantly lower (P = 0.008), and the intereye difference in MD was significantly larger in group 1 than in group 2 (P < 0.001). In a comparison of regional VF threshold values and corresponding retinal nerve fiber layer thickness (RNFLT), the superior and inferior VF threshold values were consistently more deteriorated in the nonsighting worse eyes in group 1 (P = 0.009 and 0.003), compared with the sighting worse eyes in group 2, whereas the corresponding RNFLT was not significantly different between the groups. Multiple linear regression analysis showed that the sighting eye choice (P = 0.047), higher vertical cup-to disc ratio (P = 0.042), older age (P = 0.044), thinner average RNFLT (P = 0.007), and average ganglion cell-inner plexiform layer thickness of worse eyes (P < 0.001) were significantly associated with the MD of the worse eyes.
The sighting eye choice was associated with functional asymmetry between eyes with glaucoma. The functional deterioration was evident in nonsighting eyes with worse VFs.
确定开角型青光眼（OAG）视野（VF）中注视眼选择与功能和结构不对称之间的关系。
对 200 例双侧 OAG 患者进行主导眼测试，采用孔卡测试。根据平均偏差（MD）VF 结果将配对眼分为差眼和优眼。根据结果，将注视眼与VF 较好的眼相对应的患者指定为第 1 组，而将注视眼与VF 较差的眼相对应的患者指定为第 2 组。
注视眼主要对应于 VF 较好的眼（P < 0.001）。差眼的 MD 明显较低（P = 0.008），并且第 1 组中差眼的 MD 眼间差异明显大于第 2 组（P < 0.001）。在比较区域 VF 阈值值和相应的视网膜神经纤维层厚度（RNFLT）时，第 1 组中注视差眼的上、下 VF 阈值值明显恶化（P = 0.009 和 0.003），而第 2 组中注视差眼的阈值值则无明显差异，而两组之间的相应 RNFLT 没有明显差异。多元线性回归分析显示，注视眼选择（P = 0.047）、较高的垂直杯盘比（P = 0.042）、年龄较大（P = 0.044）、较薄的平均 RNFLT（P = 0.007）和较差眼的平均神经节细胞-内丛状层厚度（P < 0.001）与差眼的 MD 显著相关。
注视眼的选择与青光眼患者的双眼功能不对称有关。VF 较差的非注视眼的功能恶化更为明显。
