Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee.
Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee.
Ophthalmol Glaucoma. 2018 Jul-Aug;1(1):52-60. doi: 10.1016/j.ogla.2018.05.005. Epub 2018 Jul 3.
To identify patterns and rates of visual field (VF) loss in primary open-angle glaucoma (POAG) across different levels of severity.
Retrospective, observational case series.
Visual fields of 278 eyes of 139 patients with POAG (9 years of follow-up with ∼17 visits) from the Rotterdam Eye Hospital in The Netherlands were analyzed to identify patterns and rates of VF loss.
Rate of VF decline for the entire VF, each region, and test point. Hemifield asymmetric rate if VF decline for each region and test point.
Total deviation (TD) values were extracted from the Humphrey VF Analyzer (Carl Zeiss Meditec, Dublin, CA). Eyes were stratified into 3 glaucoma stages by means of the mean deviation (MD): better than -6 decibels (dB), worse than -6 dB and better than -12 dB, and worse than -12 dB. Each hemifield was divided into 5 regions according to the Glaucoma Hemifield Test (GHT): central, paracentral, nasal, and peripheral arcuates 1 and 2. Point-wise and region-wise asymmetric patterns of VF loss and rate of VF loss were identified by comparing the values in the superior hemifield and the inferior hemifield at each severity level using a generalized estimating equation.
The mean age of the patients was 60.2±10.3 years (mean ± standard deviation [SD]). The rate of MD loss, for all eyes taken together, was -0.11 dB/year. In the cross-sectional analysis, in eyes in the early and moderate stages, central and peripheral arcuate 2 regions in the superior hemifield were worse than their inferior counterpart, whereas in the advanced stage all GHT regions in the superior hemifield were significantly worse than the corresponding regions in the inferior hemifield (P ≤ 0.05). In the longitudinal analysis, there was no significant difference in the rate of VF loss between the GHT regions in the superior and inferior hemifields.
Our findings suggest that in POAG, VF damage is worse in the superior hemifield than in the inferior hemifield.
在不同严重程度的原发性开角型青光眼（POAG）中，确定视野（VF）丧失的模式和速率。
回顾性、观察性病例系列。
对荷兰鹿特丹眼科医院的 139 名 POAG 患者的 278 只眼（9 年随访，约 17 次就诊）的视野进行分析，以确定 VF 丧失的模式和速率。
整个视野、每个区域和测试点的 VF 下降率。如果每个区域和测试点的 VF 下降，记录半视野不对称率。
从 Humphrey VF 分析仪（Carl Zeiss Meditec，都柏林，CA）中提取总偏差（TD）值。通过平均偏差（MD）将眼分为 3 个青光眼阶段：好于-6 分贝（dB），差于-6 dB 且好于-12 dB，差于-12 dB。根据青光眼半视野测试（GHT），将每个半视野分为 5 个区域：中央、旁中央、鼻侧和外周弓形 1 和 2。在每个严重程度级别，通过比较每个严重程度级别的上半视野和下半视野的值，使用广义估计方程确定 VF 损失的点和区域不对称模式和 VF 损失率。
患者的平均年龄为 60.2±10.3 岁（平均值±标准差[SD]）。所有眼睛的 MD 损失率为-0.11 dB/年。在横断面分析中，在早期和中期阶段的眼中，上半视野的中央和外周弓形 2 区比下半视野差，而在晚期阶段，上半视野的所有 GHT 区都明显比下半视野差（P≤0.05）。在纵向分析中，上半视野和下半视野的 GHT 区域之间的 VF 损失率没有显著差异。
我们的研究结果表明，在 POAG 中，上半视野的 VF 损伤比下半视野更严重。
