Estimating progression of visual field loss in glaucoma
Estimating progression of visual field loss in glaucoma
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DOI：
10.1016/s0161-6420(97)30192-4
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发表时间：
1997-06-01
期刊：
影响因子：
13.7
通讯作者：
Sommer, A
中科院分区：
文献类型：
--
作者：
Katz, J;Gilbert, D;Sommer, A
目的：作者估计了青光眼患者进行性视野丧失的患病率和发生率，随访时间中位数为 6.3 年。方法：使用线性回归来估计平均偏差、校正模式标准差 (CPSD)、基于青光眼 Hemifield 测试 (GHT) 的位置簇以及汉弗莱分析仪 C-30-2 视野的位置特定变化的进展率，结果：前两个连续视野异常的 56 名患者的 67 只眼睛GHT 也包括在内。几乎所有患者都在接受青光眼治疗或接受过手术。由于一个或多个 CPSD、GHT 簇或单个测试位置的恶化（回归斜率与零显着不同），19 只眼睛 (28%) 的视野恶化，5 只眼睛的校正模式标准差恶化，17 只眼睛的至少一个 GHT 簇恶化，15 只眼睛的一个或多个单独的测试位置恶化。对于视野恶化的患者，CPSD 每年增加 0.9 分贝，青光眼 Hemifield 测试簇每年下降 1.4 至 2.4 分贝，个别位置的恶化范围为每年 1.0 至 5.0 分贝。年龄（而非基线视野严重程度）可预测进一步的视野丧失。在基于蒙版照片的随访过程中，进行性视野丧失与神经纤维层变薄之间的关联比值比为 1.81（95% 置信区间：0.52, 6.33），而进行性视野丧失与视盘变化之间的关联比值比为 3.78（95% 置信区间；0.80, 18.16）结论：只有不到三分之一的青光眼患者出现进行性视野丧失，在 6 年内完成的 7 个视野中，无法检测到小于 1 dB/年的阈值灵敏度平均变化。在统计上检测到较小的变化之前，需要发生较大的变化或增加视野测试的频率。
Purpose: The authors estimated the prevalence and rates of progressive visual field loss in glaucoma patients followed annually for a median of 6.3 years.Methods: Linear regression was used to estimate rates of progression of mean deviation, corrected pattern standard deviation (CPSD), clusters of locations based on the Glaucoma Hemifield Test (GHT), and location specific changes in C-30-2 fields of the Humphrey Analyzer,Results: Sixty-seven eyes of 56 patients whose first two consecutive fields were abnormal on GHT were included. Almost all patients were under treatment or had undergone surgery for glaucoma. Visual field deteriorated in 19 (28%) eyes based on worsening of one or more CPSD, GHT clusters, or individual test locations (regression slopes significantly different from zero), Corrected pattern standard deviation deteriorated in 5 eyes, at least one GHT cluster deteriorated in 17 eyes, and one or more individual test locations deteriorated in 15 eyes. For those whose visual field deteriorated, CPSD increased by 0.9 dB/year, Glaucoma Hemifield Test clusters declined by between 1,4 and 2.4 dB/year, Deterioration at individual locations ranged from 1.0 to 5.0 dB/year. Age, but not baseline visual field severity, was predictive of further visual field loss, The odds ratio for the association between progressive visual field loss and thinning of the nerve fiber layer was 1.81 (95% confidence interval: 0.52, 6.33), and 3.78 (95% confidence interval; 0.80, 18.16) for the association between progressive visual field loss and optic disc changes during follow-up based on masked photograph readings.Conclusions: Less than one in three eyes of patients with glaucoma had any progressive field loss, Average changes in threshold sensitivities of less than 1 dB/year could not be detected with seven fields done over 6 years. Larger changes or increased frequency of visual field testing would need to occur before smaller changes could be detected statistically.