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瑞典原发性开角型和剥脱性青光眼患者新诊断时视野进展的比较。

Comparison of visual field progression in new-diagnosed primary open-angle and exfoliation glaucoma patients in Sweden.

机构信息

Eye Department, Skaraborg Hospital, Skövde, Sahlgrenska Academy, Gothenburg University & Karolinska Institute, 541 85, Skövde, Sweden.

出版信息

BMC Ophthalmol. 2020 Aug 5;20(1):322. doi: 10.1186/s12886-020-01592-w.

Abstract

BACKGROUND

The present study aimed to compare visual field progression in new-diagnosed exfoliation versus open-angle glaucoma patients.

METHODS

Retrospective study. The study included patients with new-diagnosed primary open-angle and exfoliation glaucoma. All patients were followed for 3 years with reliable visual fields. At least five reliable fields were needed for inclusion. Exfoliation and open-angle glaucoma were defined based on the European Glaucoma Society guidelines. Visual field evaluation was performed using the software threshold 24-2 of the Humphrey Field Analysis.

OUTCOMES

Visual field progression. For visual field progression, three different strategies were used: mean deviation (MD), visual field index (VFI), and the guided progression analysis (GPA).

RESULTS

The study included 128 subjects, of the 54 in the open-angle and 74 in the exfoliation glaucoma group. The MD difference values were higher in the exfoliation (- 3.17 dB) than in the primary open-angle (- 1.25 dB) glaucoma group in the three-year follow-up period. The difference between groups was significant (t-test, p = < 0.001). The difference in VFI was calculated for the 3 years follow-up period. The difference was higher in the exfoliation (- 7.65%) than in the primary open (- 1.90%) glaucoma group (t-test, p = < 0.001). The GPA showed progression in 58% of cases in exfoliation, and 13% in primary open glaucoma group (Chi-square, p = < 0.001).

CONCLUSION

The present study found a more frequent and faster visual field progression in exfoliation than in primary open-angle glaucoma patients. New-diagnosed exfoliation glaucoma patients must be controlled and treated more strictly than primary open-angle glaucoma patients to avoid visual field deterioration.

摘要

背景

本研究旨在比较新诊断的剥脱性青光眼与开角型青光眼患者的视野进展。

方法

回顾性研究。该研究纳入了新诊断的原发性开角型和剥脱性青光眼患者。所有患者均接受了 3 年的可靠视野随访。纳入标准至少需要 5 个可靠视野。剥脱性青光眼和开角型青光眼的定义基于欧洲青光眼学会的指南。视野评估采用 Humphrey Field Analyzer 软件阈值 24-2 进行。

结果

视野进展。对于视野进展,使用了三种不同的策略:平均偏差(MD)、视野指数(VFI)和引导进展分析(GPA)。

研究纳入了 128 名受试者,其中 54 名来自开角型青光眼组,74 名来自剥脱性青光眼组。在 3 年的随访期内,剥脱性青光眼组(-3.17dB)的 MD 差值明显高于原发性开角型青光眼组(-1.25dB)。两组间差异具有统计学意义(t 检验,p<0.001)。在 3 年的随访期内计算了 VFI 的差值。剥脱性青光眼组(-7.65%)的差异明显高于原发性开角型青光眼组(-1.90%)(t 检验,p<0.001)。GPA 显示,58%的剥脱性青光眼患者出现进展,13%的原发性开角型青光眼患者出现进展(卡方检验,p<0.001)。

结论

本研究发现,剥脱性青光眼患者的视野进展比原发性开角型青光眼患者更频繁、更快。新诊断的剥脱性青光眼患者必须比原发性开角型青光眼患者更严格地控制和治疗,以避免视野恶化。

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本文引用的文献

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Risk Factors for Fast Visual Field Progression in Glaucoma.青光眼视野快速进展的危险因素。
Am J Ophthalmol. 2019 Nov;207:268-278. doi: 10.1016/j.ajo.2019.06.019. Epub 2019 Jun 22.
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Risk Factors for Rapid Glaucoma Disease Progression.青光眼疾病快速进展的危险因素。
Am J Ophthalmol. 2018 Feb;186:170-171. doi: 10.1016/j.ajo.2017.10.039. Epub 2017 Dec 7.

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