Rate of Visual Field Progression in Eyes With Optic Disc Hemorrhages in the Ocular Hypertension Treatment Study
Rate of Visual Field Progression in Eyes With Optic Disc Hemorrhages in the Ocular Hypertension Treatment Study
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DOI：
10.1001/archophthalmol.2012.2324
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发表时间：
2012-12-01
影响因子：
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通讯作者：
Kass, Michael A.
中科院分区：
文献类型：
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作者：
De Moraes, Carlos Gustavo;Demirel, Shaban;Kass, Michael A.
目的：比较高眼压伴与不伴视盘出血患者的视野改变率。方法：研究对象包括至少10项可靠的视盘出血治疗试验，并随访5年。用均方差回归(MDR)和逐点线性回归(PLR)方法对双眼和非双眼的VF序列随时间的变化趋势进行分析。主要观察指标为双眼和非双眼的VF变化率。平均每只眼进行VF测试的次数为23.7次(4.9次)，平均时间为12.2年(2.0年)。187只眼(7.2%)至少有1只眼复发，其中52只眼复发。平均偏差率的差异有统计学意义(平均[SD]，-0.17[0.27]vs-0.07[0.19]db/y；P<；0.01)。发生显著的PLR进展更多地发生在患有DH的眼睛中(优势比，3.6；P<；0.01)，当存在两个或更多DHS时，PLR进展更明显(优势比，4.2；P=0.01)。结论：从整体(MDR)或局部(PLR)趋势分析来看，有DH的眼较无DH的眼VF恶化得更快。与单眼相比，复发的双眼整体室性心动过速改变(MDR)的比率相似，但达到快速PLR改变的频率更高。降低高眼压患者的眼压可降低患上糖尿病的风险。高眼压眼病应密切监测，并可能需要更积极的治疗。
Objective: To compare rates of visual field (VF) change in ocular hypertensive eyes with and without optic disc hemorrhage (DH).Methods: Ocular Hypertension Treatment Study subjects (minimum 10 reliable VF tests, followed up >= 5 years) were included. Trend analyses of VF sequences over time of DH and non-DH eyes were assessed by regression of mean deviation (MDR) and pointwise linear regression (PLR). The main outcome measures were rates of VF change in DH and non-DH eyes.Results: Two thousand six hundred seven eyes (1378 participants) were included. The mean (SD) number of VF tests per eye was 23.7 (4.9) spanning a mean (SD) of 12.2 (2.0) years. At least 1 DH was detected in 187 eyes (7.2%), of which 52 eyes had recurrent DH. Mean deviation rate of change was significantly worse in DH compared with non-DH eyes (mean [SD], -0.17 [0.27] vs -0.07 [0.19] dB/y; P < .01). Significant PLR progression occurred more frequently in eyes with DH (odds ratio, 3.6; P < .01), which increased when 2 or more DHs were present (odds ratio, 4.2; P = .01). Eyes initially randomized to treatment were less likely to have a DH during follow-up.Conclusions: Eyes with DH had more rapid VF deterioration when assessed by global (MDR) or local (PLR) trend analysis than eyes without DH. Eyes with recurrent DH had similar rates of global VF change (MDR) when compared with eyes with a single DH but reached criteria for rapid PLR change more often. Intraocular pressure reduction in ocular hypertension reduces the risk of developing a DH. Ocular hypertensive eyes with DH should be monitored closely and may need more aggressive therapy.