Prevalence and Nature of Early Glaucomatous Defects in the Central 10° of the Visual Field
Prevalence and Nature of Early Glaucomatous Defects in the Central 10° of the Visual Field
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DOI：
10.1001/jamaophthalmol.2013.7656
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发表时间：
2014-03-01
影响因子：
8.1
通讯作者：
Hood, Donald C.
中科院分区：
文献类型：
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作者：
Traynis, Ilana;De Moraes, Carlos G.;Hood, Donald C.
黄斑对于视觉功能是必不可少的，甚至在早期青光眼也会受到影响。然而，目前对早期青光眼中心视力丧失的发生率和性质了解甚少。目的采用前瞻性设计，确定青光眼可疑患者和轻度青光眼患者中央10度视野(VF)缺陷的发生率和特征。设计、设置和参与者这项前瞻性观察队列研究在一家门诊青光眼专科诊所进行。对74例(100只眼)青光眼视神经病变患者和平均偏差大于-6分贝的24-2VF进行10-2测试，根据聚类标准将可靠的VF半视野分为异常，根据异常点的类型将异常的10-2 VF分为弓状、广泛性或其他类型。此外，在10-2VF的每个点上，计算各眼的总偏差值，并计算总偏差值低于特定标准水平的异常点的数目。结果异常的10-2半视野(53%)与异常的24-2半视野(59%)的数目相同。在24-2半视野正常的眼中，使用10-2测试时，16%的眼被归类为异常。在异常的10~(-2)个半野中，弧形占68%，广泛性占8%，其他占25%。平均总偏差值和异常点数图显示上VF比下VF更深、更接近固定。结论与相关性：10-2VF异常的半视野几乎与24-2VF一样多，包括一些正常的24-2VF，提示24-2试验不是检测黄斑早期损害的最佳方法。这些缺陷的模式与最近的黄斑损伤模型一致。
IMPORTANCE The macula is essential for visual functioning and is known to be affected even in early glaucoma. However, little is currently understood about the prevalence and nature of central vision loss in early glaucoma.OBJECTIVE To determine the prevalence and characteristics of visual field (VF) defects in the central 10 degrees in glaucoma suspects and patients with mild glaucoma using a prospective design.DESIGN, SETTING, AND PARTICIPANTS This prospective observational cohort study was conducted at an outpatient glaucoma specialty clinic. One hundred eyes from 74 patients with glaucomatous optic neuropathy and a 24-2 VF with mean deviation better than -6 dB were prospectively studied and tested with a 10-2 test.MAIN OUTCOMES AND MEASURES Reliable VF hemifields were classified as abnormal based on a cluster criterion, and abnormal 10-2 VFs were categorized based on the pattern of abnormal points: arcuatelike, widespread, or other. In addition, at each point of the 10-2 VF, the total deviation values were averaged across eyes and the number of abnormal points with total deviation values below a specific criterion level were calculated.RESULTS There appeared to be as many abnormal 10-2 hemifields (53%) as abnormal 24-2 hemifields (59%). Of the eyes with normal 24-2 hemifields, 16% were classified as abnormal when the 10-2 test was used. Of the abnormal 10-2 hemifields, 68%, 8%, and 25% were arcuatelike, widespread, and other, respectively. The average total deviation values and number of abnormal points plots revealed superior VF defects that were deeper and closer to fixation than those in the inferior VF.CONCLUSIONS AND RELEVANCE The 10-2 VF was abnormal in nearly as many hemifields as was the 24-2 VF, including some with normal 24-2 VF, suggesting that the 24-2 test is not optimal for detecting early damage of the macula. The pattern of the defects was in agreement with a recent model of macular damage.