Lestak Jan, Fůs Martin, Pitrova Sarka
Department of Natural Sciences, Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno 2, 27201, Czech Republic.
Clin Ophthalmol. 2024 Jan 3;18:1-7. doi: 10.2147/OPTH.S444057. eCollection 2024.
The aim of this study was to compare changes in the conventionally undiagnosed distal nasal visual field with RNFL in patients with early primary open-angle glaucoma (POAG).
59 eyes of 32 patients (18 women, 14 men) with early stage POAG were included. All eyes were found to have a normal visual field (fast threshold program of 50 degrees nasally and 22 degrees temporally) with the Medmont M700. Visual acuity was 1.0 (with a possible correction ±3 D), and they had no other ocular pathology except glaucoma. The visual field was subsequently examined with the same instrument by moving the fixation point 40 degrees temporally (spatially adaptive program) and simultaneously turning the head 10 degrees nasally. A total of 89 examination points were included using flicker stimuli in a range of 0-120 degrees nasally. Nerve fiber layer (RNFL) and vessel density (VD) was measured using the in-built software of the Avanti RTVue XR instrument. Using Pearson's correlation coefficient, the results of visual field examination with RNFL without and after correction (by subtracting VD from total RNFL value) in the superior-nasal (SN-5) and inferior-nasal (IN-8) segments were compared.
In all eyes, changes were found in the distal periphery of the nasal part of the visual field. No correlation was noted by comparison with RNFL. After adjusting RNFL for VD, we observed no correlation in the SN segment (5) (r=-0.03) and a very weak correlation in the IN segment (8) (r=-0.16).
With a normal visual field tested by the rapid threshold glaucoma program, changes in the distal part of the nasal periphery of the visual field were found in the entire cohort and did not correlate with the RNFL and RNFL results after correction from VD.
本研究旨在比较早期原发性开角型青光眼(POAG)患者传统上未被诊断的鼻侧远周边视野与视网膜神经纤维层(RNFL)的变化。
纳入32例患者(18例女性,14例男性)的59只早期POAG眼睛。使用Medmont M700检测发现所有眼睛的视野正常(鼻侧50度和颞侧22度的快速阈值程序)。视力为1.0(可矫正±3 D),除青光眼外无其他眼部病变。随后使用同一仪器,将注视点向颞侧移动40度(空间自适应程序)并同时将头部向鼻侧转动10度来检查视野。在鼻侧0 - 120度范围内使用闪烁刺激共纳入89个检查点。使用Avanti RTVue XR仪器的内置软件测量神经纤维层(RNFL)和血管密度(VD)。使用Pearson相关系数,比较鼻上(SN - 5)和鼻下(IN - 8)节段未校正和校正后(从总RNFL值中减去VD)的视野检查结果与RNFL的相关性。
在所有眼睛中,均发现鼻侧视野远周边部有变化。与RNFL比较未发现相关性。在将RNFL校正VD后,我们观察到在SN节段(5)无相关性(r = -0.03),在IN节段(8)有非常弱的相关性(r = -0.16)。
在通过快速阈值青光眼程序检测视野正常的情况下,整个队列中均发现鼻侧视野远周边部有变化,且与RNFL以及校正VD后的RNFL结果均无相关性。