Rohrschneider K, Burk R O, Völcker H E
Universitäts-Augenklinik Heidelberg.
Ophthalmologe. 1994 Dec;91(6):811-9.
The object of this study was to investigate the perceptibility of changes in the topography of the optic nerve head during follow up with laser scanning tomography (LST), with a minimum observation period of 24 months.
We evaluated the changes in cup and rim area, cup volume, and mean and maximum cup depth in 50 eyes (8 control eyes, 21 glaucomatous eyes, 21 eyes in which glaucoma was suspected by LST over a mean follow-up time of 36 +/- 10 (range 24-49) months and compared them with the results of computerized static perimetry (Octopus). Changes were considered to be significant if they were larger than three times the maximum deviation measured in one parameter and larger than the maximum deviation in one other parameter [27].
Among 10 eyes that showed increasing cup values, 5 initially presented with striking disc cups, and no pathologic function tests; in none of these eyes was functional loss revealed by perimetry during the follow-up period. Of the 5 glaucomatous eyes in which progression was found on optic disc morphometry, 4 had increasing defects revealed by computerized static perimetry (Octopus 500).
The results confirm the value of LST. In 6 eyes in which LST revealed a significant increase in the optic cup values, perimetry did not demonstrate progression of the functional loss. Therefore, LST should be used in the follow up of all patients with glaucoma or suspected glaucoma, in addition to conventional computerized perimetry.
本研究的目的是通过激光扫描断层扫描(LST)进行随访,观察视神经乳头形态变化的可察觉性,最短观察期为24个月。
我们评估了50只眼睛的杯盘面积、杯盘容积、平均杯深和最大杯深的变化(8只对照眼,21只青光眼眼,21只通过LST怀疑患有青光眼的眼睛),平均随访时间为36±10(范围24 - 49)个月,并将其与电脑静态视野检查(Octopus)的结果进行比较。如果变化大于一个参数测量的最大偏差的三倍且大于另一个参数的最大偏差,则认为变化具有显著性[27]。
在杯盘值增加的10只眼睛中,5只最初表现为明显的视盘杯状凹陷,且无病理功能测试;在这些眼睛中,随访期间视野检查均未发现功能丧失。在5只经视盘形态测量发现病情进展的青光眼眼中,4只通过电脑静态视野检查(Octopus 500)发现缺损增加。
结果证实了LST的价值。在6只LST显示视杯值显著增加的眼睛中,视野检查未显示功能丧失的进展。因此,除了传统的电脑视野检查外,LST应用于所有青光眼或疑似青光眼患者的随访。