The association between glaucomatous visual fields and optic features in the ocular treatment study nerve head hypertension
The association between glaucomatous visual fields and optic features in the ocular treatment study nerve head hypertension
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DOI：
10.1016/j.ophtha.2006.05.061
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发表时间：
2006-09-01
期刊：
影响因子：
13.7
通讯作者：
Hypertension, Ocular
中科院分区：
文献类型：
--
作者：
Keltner, John L.;Johnson, Chris A.;Hypertension, Ocular
目的：在高眼压治疗研究中，对高眼压参与者进行随访，以确定视神经乳头（ONH）和视野（VF）相对于基线的变化之间的相关性。设计：纵向随机临床试验。参与者：152名高眼压参与者的168只眼睛，年龄在40至80岁之间。方法：将考克斯风险模型应用于3232只眼睛，其中包括81只通过发展昏迷性VF而达到研究终点的眼睛（VF终点）和128只通过发展视盘变化达到研究终点的眼睛主要结果测量：根据VF或视盘的变化确定原发性开角型青光眼终点。结果：41只眼通过VF和视盘标准达到终点; 40只眼仅达到VF终点，87只眼仅达到视盘终点。达到孤立椎间盘或视野终点的时间相似。视野终点更有可能（P < 0.0001）出现在具有以下ONH特征的眼睛中：ONH出血、视盘边缘变薄或水平杯盘（C/D）比增大。视盘终点更有可能（P < 0.0001）的眼睛，表现出以下VF功能：鼻阶或部分弓形VF缺陷的证据，或增加的模式标准偏差（PSD）。结论：VF和视盘必须监测同样的努力，因为任何一个可能显示的第一个证据青光眼损害。基于立体摄影观察的ONH变化（边缘变薄、出血或C/D比值轻微增加）和VF变化（鼻阶梯/部分弓形缺损或PSD增加的证据）表明，这些病例发生青光眼的风险增加。这些细微的发现应通过重复检测和与其他临床结果的相关性来确认。
Purpose: To determine the association between change from baseline in the optic nerve head (ONH) and the visual field (VF) during follow-up of ocular hypertension participants in the Ocular Hypertension Treatment Study.Design: Longitudinal randomized clinical trial.Participants: One hundred sixty-eight eyes of 152 ocular hypertensive participants ages 40 to 80 years.Methods: Cox hazard models were applied to 3232 eyes, which included 81 eyes that reached a study end point by developing a glaucomatous VF (VF end point) and 128 eyes that reached a study end point by developing an optic disc change (optic disc end point).Main Outcome Measures: Primary open-angle glaucoma end point as determined by changes in the VF or optic disc.Results: Forty-one eyes reached an end point by both VF and optic disc criteria; 40 eyes reached only a VF end point, and 87 reached only an optic disc end point. Times to reach isolated disc or field end points were similar. Visual field end points were more likely (P < 0.0001) in eyes that showed the following ONH features: an ONH hemorrhage, thinning of the optic disc rim, or enlargement of the horizontal cup-to-disc (C/D) ratio. Optic disc end points were more likely (P < 0.0001) in eyes that showed the following VF features: some evidence of a nasal step or a partial arcuate VF defect, or an increase in the pattern standard deviation (PSD).Conclusions: Both the VF and the optic disc must be monitored with equal diligence, because either may show the first evidence of glaucomatous damage. Changes in the ONH based on stereophotographic observation (rim thinning, hemorrhage, or a slight increase in C/D ratio) and VF changes (evidence of a nasal step/partial arcuate defect or an increase in PSD) suggest that these cases have an increased risk of developing glaucoma. Confirmation of such subtle findings should be sought through repeat testing and correlation with other clinical results.