Quigley H A, Tielsch J M, Katz J, Sommer A
Dana Center for Preventive Ophthalmology, Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Am J Ophthalmol. 1996 Sep;122(3):355-63. doi: 10.1016/s0002-9394(14)72062-8.
To estimate the rate of visual field loss in persons with open-angle glaucoma.
The visual field data obtained by Goldmann perimetry from 151 persons with open-angle glaucoma from the Baltimore Eye Survey were graded on a nine-level severity scale. Approximately one half of these persons had previously diagnosed glaucoma and were being treated. Using regression analysis, their scores were compared to other features, including age, vertical cup/disk ratio, treatment status, gender, race, and intraocular pressure. These data were used to estimate the average rate of progressive field loss and blindness in glaucoma.
Among 112 black subjects, the severity of visual field damage was significantly associated with age (P < .02), history of glaucoma treatment (P < .04), and intraocular pressure (P < .0001). Using the relationship between age and damage, we estimated that the rate of deterioration of black glaucoma subjects was two grading levels per decade, which is consistent with previous reports. For 39 white subjects, the inclusion of age improved the model relationship between damage score and other variables. The best estimate of individual damage rate for whites was similar to that in blacks. However, the statistical association of age and damage in whites was less strong than in blacks, possibly because of fewer white subjects in the sample.
While glaucoma is a frequent cause of visual disability, rate of progressive visual field loss is not sufficient to lead to bilateral blindness in the majority of those affected. Aggressiveness of glaucoma therapy should be related to the rate of visual field loss stressing confirmation of field progression.
评估开角型青光眼患者的视野缺损率。
对巴尔的摩眼病调查中151例开角型青光眼患者通过Goldmann视野计获得的视野数据进行九级严重程度分级。这些患者中约一半先前已被诊断为青光眼并正在接受治疗。采用回归分析，将他们的评分与其他特征进行比较，包括年龄、垂直杯盘比、治疗状态、性别、种族和眼压。这些数据用于估计青光眼患者视野进行性缺损和失明的平均发生率。
在112名黑人受试者中，视野损害的严重程度与年龄（P <.02）、青光眼治疗史（P <.04）和眼压（P <.0001）显著相关。利用年龄与损害之间的关系，我们估计黑人青光眼患者的恶化率为每十年两个分级水平，这与先前的报告一致。对于39名白人受试者，纳入年龄改善了损害评分与其他变量之间的模型关系。白人个体损害率的最佳估计与黑人相似。然而，白人中年龄与损害的统计关联不如黑人强，可能是因为样本中的白人受试者较少。
虽然青光眼是导致视力残疾的常见原因，但在大多数受影响者中，视野进行性缺损率不足以导致双侧失明。青光眼治疗的积极程度应与视野缺损率相关，强调视野进展的确认。
