Chauhan B C, LeBlanc R P, Shaw A M, Chan A B, McCormick T A
Department of Ophthalmology, Dalhousie University, Halifax, Nova Scotia, Canada.
Ophthalmology. 1997 Mar;104(3):532-8. doi: 10.1016/s0161-6420(97)30279-6.
The authors determined the frequency of repeatable diffuse loss as the only form of visual field damage in patients with early to moderate open-angle glaucoma in a prospective follow-up study.
The study contained 113 patients (median age, 64 years; range, 17-89 years) who were tested at 6-month intervals with program 30-2 of the Humphrey Field Analyzer (Humphrey Instruments Inc., San Leandro, CA). Although the inclusion criterion for visual acuity was > or = 20/40, on entry, 94 (83.2%) patients had an acuity of > or = 20/25. Cumulative defect curves were generated for all visual fields (median per patient, 7; range, 4-9). After randomizing the order and removing all patient information, two observers independently rated each visual field as being "normal" or showing "diffuse," "localized," or "diffuse and localized" loss. We defined repeatable diffuse loss as occurring when at least two thirds of the number of fields in the follow-up were classified as "diffuse."
Fourteen patients (12.4%) had repeatable diffuse loss according to the cumulative defect curves. After reviewing their clinical charts, we excluded six of these patients because of early lens changes despite good visual acuity and three because of a suggestion of localized loss (on pattern deviation probability plots) in addition to the predominantly diffuse loss. The remaining five (4.4%) patients had repeatable diffuse loss that was due solely to open-angle glaucoma.
Although diffuse visual field loss is exaggerated by factors other than glaucoma in the majority of patients, it can occur repeatedly in a small number of patients as the only sign of visual field damage.
在一项前瞻性随访研究中，作者确定了早期至中度开角型青光眼患者中可重复性弥漫性视野缺损作为视野损害唯一形式的发生率。
该研究纳入了113例患者（年龄中位数为64岁；范围为17 - 89岁），使用Humphrey视野分析仪（Humphrey Instruments Inc.，加利福尼亚州圣莱安德罗）的30 - 2程序每隔6个月进行一次检测。尽管视力的纳入标准为≥20/40，但在入组时，94例（83.2%）患者的视力≥20/25。为所有视野生成累积缺损曲线（每位患者的中位数为7条；范围为4 - 9条）。在对顺序进行随机化并去除所有患者信息后，两名观察者独立将每个视野评定为“正常”或显示“弥漫性”“局限性”或“弥漫性和局限性”缺损。我们将可重复性弥漫性缺损定义为随访中至少三分之二的视野被分类为“弥漫性”时出现的情况。
根据累积缺损曲线，14例患者（12.4%）存在可重复性弥漫性缺损。查看他们的临床病历后，我们排除了其中6例患者，原因是尽管视力良好但存在早期晶状体改变，以及3例除主要为弥漫性缺损外还存在局限性缺损迹象（在模式偏差概率图上）的患者。其余5例（4.4%）患者的可重复性弥漫性缺损仅由开角型青光眼引起。
尽管在大多数患者中，除青光眼外的其他因素会夸大弥漫性视野缺损，但在少数患者中，它可作为视野损害的唯一迹象反复出现。
