Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, NY, USA.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Eye (Lond). 2024 Jun;38(8):1549-1555. doi: 10.1038/s41433-024-02949-x. Epub 2024 Feb 14.
To determine the locations on the 24-2 visual field (VF) testing grid that are most likely to progress in patients with ocular hypertension (OHTN). Based on a structural model of superior and inferior areas of relative vulnerability at the optic disc, we hypothesized that the nasal and paracentral regions are more prone to show a reduction in sensitivity.
Posthoc analysis of data collected in phases 1 and 2 of the Ocular Hypertension Treatment Study (OHTS). A pointwise analysis was applied to determine the progression patterns in the early and delayed treatment groups. Each group's progression rate and frequency were calculated for each of the 52 locations corresponding to the 24-2 VF strategy, using trend- and event-based analyses, respectively.
For the event-based analysis, the events were most commonly found in the nasal and paracentral regions. The same regions, with some modest variation, were found to have the fastest rates of progression (ROP) measured with trend analysis. A similar pattern of progression was observed in both the early and delayed treatment groups. The difference in event rates and ROP between the early and delayed treatment groups was also greatest in the nasal and paracentral regions.
Development of VF loss in ocular hypertensive eyes appears to be consistent with the vulnerability zones previously described in glaucomatous eyes with established VF loss. Ocular hypotensive treatment likely helps to slow the rate of progression in these regions. This suggests that careful monitoring of these locations may be useful.
确定在患有高眼压症（OHTN）的患者中，24-2 视野（VF）测试网格上最有可能进展的位置。基于视盘相对脆弱性的上下区域的结构模型，我们假设鼻侧和旁中央区域更容易出现敏感性降低。
对青光眼治疗研究（OHTS）的第 1 阶段和第 2 阶段收集的数据进行事后分析。应用逐点分析来确定早期和延迟治疗组的进展模式。使用趋势和事件分析，分别计算每组 52 个对应于 24-2 VF 策略的位置的进展率和频率。
对于基于事件的分析，事件最常见于鼻侧和旁中央区域。在趋势分析中，相同的区域具有最快的进展率（ROP），但略有变化。在早期和延迟治疗组中都观察到了相似的进展模式。早期和延迟治疗组之间的事件发生率和 ROP 的差异在鼻侧和旁中央区域也最大。
在患有高眼压症的眼中，VF 损失的发展似乎与先前在具有明确 VF 损失的青光眼眼中描述的脆弱区域一致。眼部降压治疗可能有助于减缓这些区域的进展速度。这表明仔细监测这些位置可能会很有用。
