新型青光眼进展分析方法的建立及临床应用研究

青光眼进展分析是是青光眼诊疗评估和随访的核心。视野是临床上最常用的青光眼进展评估方法，但稳定性和早期敏感性不足。而视盘和神经纤维层分析由于技术上的缺点，还不足以替代视野在青光眼进展评估中的作用。如何选用合适的分析方法去判断青光眼进展是临床的一大难题。本研究探索通过计算机模拟模型将视神经结构与功能变化对应起来，在原有GSS 2分析系统基础上，建立一种临床实用的整合了视野和视神经结构损害的分析方法，并设计成软件，对原发性青光眼的进展进行自动评估，使青光眼进展分析变的简便、可靠、易行。同时，将新的分析方法与传统的视野MD线性回归分析、AGIS评分、专家经验判断等进行敏感性、特异性和相互间的一致性对比，评估新方法的有效性和临床应用价值，探索青光眼进展分析的最佳途径。同时通过连续随访、评估，了解不同类型青光眼视神经损伤时结构与功能变化的时间和空间特点。

Glaucoma progression is one of the most important and challenging aspects of glaucoma management. Visual field is the most common clinic assessment of the glaucoma progression, but its stability and sensitivity at early stage are not satisfactory. However, due to the technical deficiency, the optic disk and retinal nerve fiber layer analysis still cannot substitute the visual field in the assessment of the glaucoma progression. Thus, how to choose a suitable assessment of glaucoma is still one of the clinic challenges. This study attempts to associate the optic structure with its functional changes through the computer simulation. Based on the GSS 2 analytical system, as well as the combination of the visual field inspection and diagnosis of the optic structural damage, a clinic assessment system and its computer application are developed. This application offers the automatic assessment for the primary glaucoma and makes the assessment of glaucoma easy, practical, and reliable. Meanwhile, with the comparisons of this new diagnostic method with the traditional MD linear regression analysis, AGIS scoring, and clinic judgments in terms of the sensitivity, specificity and consistency, this research evaluates the new diagnostic method and its clinic value. It aims to find the best way to the analysis of the glaucoma progression. And, the successive follow-up and evaluations show the structural figures of the different types and/or stages of glaucomatous optic nerve damages and functional changes.