Lewis J M, Priddy T, Judd J, Gordon M O, Kass M A, Kolker A E, Becker B
Department of Ophthalmology, Washington University School of Medicine, St. Louis, Missouri 63110.
Am J Ophthalmol. 1988 Nov 15;106(5):607-12. doi: 10.1016/0002-9394(88)90595-8.
In a retrospective study we reviewed the records of 788 subjects who had been corticosteroid tested with 0.1% dexamethasone four times daily to one eye for six weeks. All subjects had normal kinetic visual fields and optic nerve heads in both eyes at the time of testing and were followed up for a minimum of five years. Some subjects had normal baseline intraocular pressures whereas others were considered to have ocular hypertension. Of 276 individuals who were high corticosteroid responders (intraocular pressure greater than 31 mm Hg during dexamethasone administration), 36 (13.0%) developed glaucomatous visual field loss during the follow-up period. Only nine of 261 individuals (3.4%) who were intermediate responders (intraocular pressure 20 to 31 mm Hg during dexamethasone administration) and none of 251 individuals who were low responders (intraocular pressure less than 20 mm Hg during dexamethasone administration) developed glaucomatous visual field loss. However, the ability of the intraocular pressure response to dexamethasone to predict the development of glaucomatous visual field loss was not as good as the predictive power of a multivariate model that included patient age, race, baseline intraocular pressure, baseline outflow facility, baseline cup/disk ratio, and systemic hypertension.
在一项回顾性研究中，我们查阅了788名受试者的记录，这些受试者每天4次用0.1%地塞米松对一只眼睛进行皮质类固醇检测，持续6周。所有受试者在检测时双眼的动态视野和视神经乳头均正常，并至少随访了5年。一些受试者的基线眼压正常，而另一些则被认为患有高眼压症。在276名皮质类固醇高反应者（地塞米松给药期间眼压大于31 mmHg）中，36名（13.0%）在随访期间出现了青光眼性视野缺损。在261名中度反应者（地塞米松给药期间眼压为20至31 mmHg）中，只有9名（3.4%）出现了青光眼性视野缺损，而在251名低反应者（地塞米松给药期间眼压小于20 mmHg）中，无人出现青光眼性视野缺损。然而，地塞米松眼压反应预测青光眼性视野缺损发生的能力不如一个多变量模型的预测能力，该多变量模型包括患者年龄、种族、基线眼压、基线房水流畅系数、基线杯盘比和系统性高血压。
