Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Medical Center, New York, New York, USA.
Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Medical Center, New York, New York, USA.
Am J Ophthalmol. 2019 Dec;208:415-420. doi: 10.1016/j.ajo.2019.08.024. Epub 2019 Sep 5.
Glaucoma patients commonly report increasing visual problems under low luminance or glare conditions, yet there is limited understanding of the structural basis of visual functional losses. This report examines the relationship between glaucomatous macular damage, assessed using structure-function correlation, and visual difficulty under low luminance conditions, as measured by Low Luminance Questionnaire (LLQ).
Observational cohort study.
Setting: Tertiary care referral center.
A total of 252 eyes of 126 participants with mild or moderate open-angle glaucoma (24-2 mean deviation [MD] better than -12 dB) selected from a consecutive sample.
Focal and diffuse macular defects were identified based on corresponding abnormal regions on probability maps from spectral-domain optical coherence tomography (SDOCT) optic disc and macular cube scans, and 10-2 and 24-2 visual fields (VF).
LLQ scores.
Eighty-two of the 126 (65%) better eyes (defined by 24-2 VF MD) had evidence of macular damage, while the remaining 44 did not have macular damage. Of the 82 with damage, 33 (40%) had diffuse damage and 49 (60%) had focal damage. After adjusting for 24-2 MD and age in the multivariable regression, diffuse macular damage remained a significant predictor of the LLQ subscales "difficulty with extreme lighting" (P = .0024), ''difficulty with low lighting" (P = .037), and "diminished mobility"; (P = .042). In contrast, there was no significant difference in LLQ scores in any subscale between participants with focal macular damage and those without macular damage.
Mild diffuse glaucomatous macular damage, as detected by abnormal topographic regions on measures of structure and function, is associated with decreased LLQ scores.
青光眼患者常报告在低亮度或眩光条件下视觉问题加重，但对视觉功能丧失的结构基础知之甚少。本报告探讨了使用结构-功能相关性评估的青光眼黄斑损伤与低亮度条件下视觉困难（通过低亮度问卷[LLQ]测量）之间的关系。
观察性队列研究。
地点：三级保健转诊中心。
从连续样本中选择的共 126 名患有轻度或中度开角型青光眼（24-2 平均偏差[MD]优于-12 dB）的 252 只眼。
根据来自频域光学相干断层扫描（SD-OCT）视盘和黄斑立方体扫描以及 10-2 和 24-2 视野（VF）的概率图上的相应异常区域，确定局灶性和弥漫性黄斑缺陷。
LLQ 评分。
在 126 只较好眼（定义为 24-2 VF MD）中，82 只（65%）存在黄斑损伤，而其余 44 只眼没有黄斑损伤。在 82 例有损伤的病例中，33 例（40%）有弥漫性损伤，49 例（60%）有局灶性损伤。在多变量回归中，校正 24-2 MD 和年龄后，弥漫性黄斑损伤仍然是“极端照明困难”（P =.0024）、“低照明困难”（P =.037）和“运动能力下降”的 LLQ 亚量表的显著预测因子（P =.042）。相比之下，在有或没有黄斑损伤的参与者之间，在任何亚量表中，LLQ 评分均无显著差异。
在结构和功能测量中通过异常的地形区域检测到的轻度弥漫性青光眼黄斑损伤与 LLQ 评分降低相关。
