Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Medical Center, Edward S. Harkness Eye Institute, New York, NY.
School of Medicine, University of Alabama, Birmingham, AL.
J Glaucoma. 2020 Jun;29(6):435-440. doi: 10.1097/IJG.0000000000001494.
In this longitudinal prospective cohort study of open-angle glaucoma patients, intraocular pressure (IOP) parameters (mean, fluctuation, and maximum) had a similar effect on glaucomatous progression in the central and peripheral visual field (VF) regions.
To study the effects of IOP on rates of glaucomatous central versus peripheral VF progression.
The African Descent and Glaucoma Evaluation Study (ADAGES) is a longitudinal prospective cohort study that recruited patients from 3 centers. A sample of those with established glaucoma were included in this study. The mean peripheral sensitivity (MPS) and the mean central sensitivity (MCS) were defined based upon the average total deviation of the peripheral and central (10 degrees) points of the 24-2 VF, respectively. Progression was based upon central and peripheral change from linear mixed-effects models. The relationships between VF progression and IOP mean, maximum, and fluctuation as continuous variables were also investigated. Main outcome measures were MPS and MCS progression rates.
A total of 452 eyes of 344 patients were studied. The mean number of VFs (SD) for each eye was 13.3 (6.4) over 9.1 (3.7) years. The mean baseline MD was -5.1 (3.9) dB and the mean rate of MD change was -0.26 dB/y [95% confidence interval (CI): -0.33 to -0.20, P<0.001]. Mean rates of MPS (-0.27 dB/y, 95% CI: -0.33 to -0.22, P<0.001) and MCS change (-0.26 dB/y, 95% CI: -0.31 to -0.21, P<0.001) were similar (P=0.351). Mean, fluctuation, and maximum IOP were significantly associated with MPS and MCS (all P<0.025).
The effect of IOP parameters on VF progression was statistically similar between central and peripheral VF regions.
在这项针对开角型青光眼患者的纵向前瞻性队列研究中，眼压（IOP）参数（平均值、波动和最大值）对中央和周边视野（VF）区域的青光眼进展有相似的影响。
研究 IOP 对青光眼中央与周边 VF 进展速度的影响。
非裔美国人与青光眼评估研究（ADAGES）是一项纵向前瞻性队列研究，从 3 个中心招募患者。本研究纳入了一些已确诊青光眼的患者。周边平均敏感度（MPS）和中央平均敏感度（MCS）分别根据周边和中央（10 度）24-2 VF 的总偏差平均值定义。进展是基于中央和周边的线性混合效应模型的变化。还研究了 VF 进展与 IOP 平均值、最大值和波动作为连续变量之间的关系。主要观察指标为 MPS 和 MCS 进展率。
共研究了 344 例患者的 452 只眼。每只眼的平均视野数（标准差）为 13.3（6.4）个，随访时间为 9.1（3.7）年。平均基线 MD 为-5.1（3.9）dB，MD 变化平均速率为-0.26 dB/y[95%置信区间（CI）：-0.33 至-0.20，P<0.001]。MPS 的平均变化率（-0.27 dB/y，95%CI：-0.33 至-0.22，P<0.001）和 MCS 变化率（-0.26 dB/y，95%CI：-0.31 至-0.21，P<0.001）相似（P=0.351）。IOP 的平均值、波动和最大值与 MPS 和 MCS 均显著相关（均 P<0.025）。
IOP 参数对中央和周边 VF 区域的 VF 进展的影响在统计学上相似。
