Grover S, Fishman G A, Anderson R J, Alexander K R, Derlacki D J
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago 60612, USA.
Ophthalmology. 1997 Mar;104(3):460-5. doi: 10.1016/s0161-6420(97)30291-7.
The authors quantitate the rate of visual field loss in patients with retinitis pigmentosa as it relates to different clinical field phenotypes.
Goldmann visual fields were obtained with target V4e in 77 patients and with target II4e in 71 patients who had either isolated or various genetic types of retinitis pigmentosa and who met certain entrance criteria. The visual fields were categorized into five distinct clinical field phenotypes on the basis of their pattern of field loss. Mixed-model methods for the analysis of longitudinal data were used to model the natural logarithm of the visual field area as a function of patient age and clinical field phenotype. The average half-life (time over which half of the remaining field area would be lost) of the visual field area for each phenotype was computed from the results of this analysis. Visual field data were not analyzed for patients with a normal clinical field phenotype (type 1).
Independent of the field phenotype, average half-life values were 7.3 years for target V4e and 6.8 years for target II4e, which were not statistically different (P = 0.16). Visual fields with partial or complete midperipheral ring scotomas (type 2) and those with only a residual central field (type 4) had a half-life of 9.5 and 9.4 years, respectively, for target V4e, and 8.9 and 8.0 years, respectively, for target II4e. Patients with partial peripheral restriction (type 5) lost visual fields with a half-life of 9.5 years for target V4e and 7.3 years for target II4e. None of these differences in the half-lives between the different phenotypes were statistically significant for either targets V4e or II4e. Fields with a residual central area and remaining temporal and/or nasal islands (type 3) had a half-life of 4.8 years for target V4e and 6.0 years for target II4e. The differences in half-lives between type 3 and each of the other field phenotypes were statistically significant for the V4e target, but not for the II4e target.
The results of this study can be useful for counseling patients with retinitis pigmentosa and various visual field phenotypes as to their potential rate of visual field loss.
作者对患有视网膜色素变性的患者的视野缺损率进行定量分析，以探讨其与不同临床视野表型的关系。
对77例患者使用V4e视标进行了Goldmann视野检查，对71例患者使用II4e视标进行了检查，这些患者患有孤立性或各种遗传类型的视网膜色素变性，且符合特定的入选标准。根据视野缺损模式，将视野分为五种不同的临床视野表型。使用纵向数据分析的混合模型方法，将视野面积的自然对数建模为患者年龄和临床视野表型的函数。根据该分析结果计算每种表型视野面积的平均半衰期（即剩余视野面积损失一半所需的时间）。未对临床视野表型正常（1型）的患者的视野数据进行分析。
与视野表型无关，V4e视标的平均半衰期为7.3年，II4e视标的平均半衰期为6.8年，两者无统计学差异（P = 0.16）。对于V4e视标，部分或完全中周边环形暗点（2型）的视野和仅残留中心视野（4型）的视野的半衰期分别为9.5年和9.4年；对于II4e视标，分别为8.9年和8.0年。周边部分受限（5型）的患者，V4e视标的视野半衰期为9.5年，II4e视标的视野半衰期为7.3年。对于V4e或II4e视标，不同表型之间的这些半衰期差异均无统计学意义。残留中心区域以及剩余颞侧和/或鼻侧岛状区域（3型）的视野，V4e视标的半衰期为4.8年，II4e视标的半衰期为6.0年。对于V4e视标，3型与其他每种视野表型之间的半衰期差异具有统计学意义，但对于II4e视标则无统计学意义。
本研究结果有助于为患有视网膜色素变性及各种视野表型的患者提供有关其潜在视野缺损率的咨询。
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