CLINICALLY DETECTABLE NERVE-FIBER ATROPHY PRECEDES THE ONSET OF GLAUCOMATOUS FIELD LOSS
CLINICALLY DETECTABLE NERVE-FIBER ATROPHY PRECEDES THE ONSET OF GLAUCOMATOUS FIELD LOSS
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DOI：
10.1001/archopht.1991.01080010079037
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发表时间：
1991-01-01
影响因子：
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通讯作者：
WITT, KA
中科院分区：
文献类型：
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作者：
SOMMER, A;KATZ, J;WITT, KA
对1344只眼压升高的患眼每年进行标准化视野检查、神经纤维层检查和彩色眼底照相。 在83只眼睛中，昏迷性视野缺损符合手动动态和阈上静态视野检查的严格标准。 单个神经纤维层照片由两名蒙面观察者读取。 在首次发生视野丧失时，在88%的可读照片中，两种识别出的神经纤维层缺陷更敏感; 60%（6/10）的眼睛在视野丧失前6年已经有神经纤维层缺陷。 正常眼神经纤维层异常率为11%（3/27），高血压眼为26%（84/327）。 神经纤维层缺损的部位与视野缺损的部位密切对应，但神经纤维层缺损的范围普遍较广。 检查者的经验和视神经损伤的严重程度影响结果。 轻度局灶性缺损比更严重的弥漫性萎缩更容易识别。 神经纤维层缺损随着时间的推移而扩大，常由邻近区域的损害发展和合并而成。
Standardized perimetry and nerve fiber layer and color fundus photography were performed annually on 1344 eyes with elevated intraocular pressures. In 83 eyes, glaucomatous field defects developed that met rigid criteria on manual kinetic and suprathreshold static perimetry. Individual nerve fiber layer photographs were read by two masked observers. The more sensitive of the two identified nerve fiber layer defects in 88% of readable photographs at the time field loss first occurred; 60% (6/10) of eyes already had nerve fiber layer defects 6 years before field loss. In contrast, the nerve fiber layer was considered abnormal in only 11% (3/27) of normal eyes and 26% (84/327) of hypertensive eyes. The location of nerve fiber layer and field defects closely corresponded, but nerve fiber layer loss was generally more wide-spread. Examiner experience and severity of optic nerve damage influenced results. Mild focal defects were more readily recognized than more severe diffuse atrophy. Nerve fiber layer defects expanded with time, often by the development and coalescence of adjacent areas of damage.