Stewart W C, Chorak R P, Hunt H H, Sethuraman G
Glaucoma Service, Medical University of South Carolina, Charleston 29425-2236.
Am J Ophthalmol. 1993 Aug 15;116(2):176-81. doi: 10.1016/s0002-9394(14)71282-6.
We evaluated factors associated with decreased or stable visual function in 72 patients with primary open-angle glaucoma and complete cupping of the optic disk who were followed up five years or more. We found a significantly lower mean (15.4 +/- 2.7 mm Hg) and peak (24.5 +/- 6.9 mm Hg) intraocular pressure in those patients whose vision remained stable vs those whose vision decreased (21.3 +/- 3.2 and 39.2 +/- 11.0 mm Hg, respectively) (t-test, P < .001). Additionally, the variance of each patient's individual intraocular pressure readings measured during the follow-up period was lower in the group with stable vision (4.5 mm Hg) than in those in whom vision decreased (9.0 mm Hg) (F test, P < .001). Stepwise discriminant analysis disclosed that mean intraocular pressure, variance of an individual's intraocular pressure measurements over time, history of argon laser trabeculoplasty, and compliance with therapy discriminated 92.9% of patients (52 of 56) whose vision remained stable and 87.5% of patients (14 of 16) whose vision decreased. Reduction of intraocular pressure and compliance with therapy are important in patients with complete glaucomatous cupping of the optic disk.
我们评估了72例原发性开角型青光眼且视盘完全凹陷、随访时间超过5年的患者中与视力下降或稳定相关的因素。我们发现，视力保持稳定的患者其平均眼压（15.4±2.7mmHg）和峰值眼压（24.5±6.9mmHg）显著低于视力下降的患者（分别为21.3±3.2和39.2±11.0mmHg）（t检验，P<.001）。此外，在随访期间测量的每位患者个体眼压读数的方差，视力稳定组（4.5mmHg）低于视力下降组（9.0mmHg）（F检验，P<.001）。逐步判别分析显示，平均眼压、个体眼压随时间测量的方差、氩激光小梁成形术史以及治疗依从性能够区分92.9%视力保持稳定的患者（56例中的52例）和87.5%视力下降的患者（16例中的14例）。降低眼压和治疗依从性对于视盘完全青光眼性凹陷的患者很重要。
