Natural History of Open-Angle Glaucoma
Natural History of Open-Angle Glaucoma
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DOI：
10.1016/j.ophtha.2009.06.042
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发表时间：
2009-12-01
期刊：
影响因子：
13.7
通讯作者：
Leske, M. Cristina
中科院分区：
文献类型：
--
作者：
Heijl, Anders;Bengtsson, Boel;Leske, M. Cristina
目的：本文基于早期显性青光眼试验（EMGT），提供了3种最常见的青光眼类型中青光眼视野缺损进展的前瞻性自然病史数据。设计：EMGT患者队列随机分配至未经治疗的对照组，并随访至进展时间，此时可以开始治疗。参与者：我们评估了118例对照患者：方法：每3个月用Humphrey 30-2全阈值测试程序检查一次视野。主要观察指标：对周长平均偏差（MD）值进行线性回归分析，并将进展率定义为以分贝/年为单位的回归系数。进展眼的视力和进展时间的确定使用EMGT事件为基础的预定进展标准来自青光眼变化概率Maps.Results：中位和四分位数的视功能丧失率为-0.40（1.05）dB/年的整体和-0.46（1.61）HTG，-0.22（0.65）NTG，和-1.13（6.13）PEXG。因此，患者间变异性较大。平均发生率显著高于中位数：总体为-1.08 dB/年，HTG为-1.31 dB/年，NTG为-0.36 dB/年，PEXG为-3.13 dB/年。各组之间的中位视功能进展率差异具有统计学意义（NTG与HTG，P = 0.003; PEXG与非PEXG，P
Objective: This article, based on the Early Manifest Glaucoma Trial (EMGT), provides prospective natural history data on progression of glaucomatous field defects in 3 of the most common glaucoma types.Design: Cohort of EMGT patients randomized to the untreated control group and followed up to the time of progression, when treatment could be initiated.Participants: We evaluated 118 control patients: 46 with high-tension glaucoma (HTG), 57 with normal-tension glaucoma (NTG), and 15 with pseudoexfoliation glaucoma (PEXG).Methods: Visual fields were tested every 3 months with the Humphrey 30-2 Full Threshold test program.Main Outcome Measures: Linear regression analyses of the perimetric mean deviation (MD) values were performed, and the rate of progression was defined as the regression coefficient in decibels per year. Percentages of progressed eyes and time to progression were determined using EMGT event-based predetermined progression criteria derived from Glaucoma Change Probability Maps.Results: The median and interquartile rates of visual function loss were -0.40 (1.05) dB/year overall and -0.46 (1.61) in HTG, -0.22 (0.65) in NTG, and -1.13 (6.13) in PEXG. Thus, interpatient variability was large. Mean rates were considerably higher than medians: -1.08 dB/year overall, -1.31 in HTG, -0.36 in NTG, and -3.13 in PEXG. Differences in median visual function progression rates among groups were statistically significant (NTG vs. HTG, P = 0.003; PEXG vs. non-PEXG, P