Glaucoma Center of Excellence, Wilmer Institute, Johns Hopkins, Baltimore, Maryland, USA.
Singapore National Eye Centre, Singapore, Singapore.
Curr Opin Ophthalmol. 2020 Mar;31(2):85-90. doi: 10.1097/ICU.0000000000000644.
A process is ongoing to produce a definition of glaucomatous optic neuropathy (GON) using quantitative, objective data from structural and functional tests. At present, a common practice is to define GON by subjective features said to be 'characteristic' as judged by those experienced in glaucoma care.
An objective definition would standardize the comparison of clinical research results across studies, without precluding simultaneous use of idiosyncratic definitions in the same reports. To achieve this goal, expert opinion was solicited to reach optimal agreement on one or more consensus, GON definitions. An interactive period of online discussion by 176 international experts led to 110 responses in an online survey that narrowed possible definitional structures into testable criteria.
Two approaches to validation of one or more sets of criteria for definite and possible GON are ongoing. The general principles include definition for each eye individually, inclusion of a borderline category, no intraocular pressure criterion, and both structural and functional defects in appropriate physical locations. Each validation approach uses clinician diagnosis as a standard against which objective criteria are compared, with the initial approach using a three-level categorical scale, and the second approach using 0--100 scaling.
目前正在使用结构和功能测试的定量、客观数据来制定青光眼视神经病变（GON）的定义。目前，一种常见的做法是通过经验丰富的青光眼护理人员判断为“特征性”的主观特征来定义 GON。
客观定义将标准化临床研究结果在不同研究中的比较，同时不排除在同一报告中同时使用特殊定义。为了实现这一目标，征求了专家意见，以就一个或多个共识 GON 定义达成最佳一致。176 名国际专家通过在线互动讨论，在在线调查中收到了 110 份回复，这些回复将可能的定义结构缩小为可测试的标准。
正在进行一种或多种确定和可能的 GON 标准的验证方法。一般原则包括对每只眼睛进行单独定义，包括边界类别，不包括眼内压标准，以及适当物理位置的结构和功能缺陷。每种验证方法都将临床医生的诊断作为与客观标准进行比较的标准，第一种方法使用三级分类量表，第二种方法使用 0-100 量表。
