摘要
目的 探讨在旁中央暗点等公认的早期青光眼性视野损害表现之前存在的鼻侧等视线异常等不肯定损害的发生率及其诊断价值。方法 从 2 2 0例用 Goldmann式视野计、改良的 Armaly- Drance法作过视野检查的青光眼或可疑青光眼患者中 ,按下述方法选取 4组 81例 12 1眼的视野资料作比较分析。第一组为对称性大杯组 ,14例 2 3眼 ;第二组为眼压≥ 30 m m Hg的早期青光眼组 ,43例 70眼 ;第三组为一眼损害在中期以上 ,另眼为早期或不肯定性损害的不对称性青光眼组 ,16例 16眼 ;第四组为初查为不肯定性损害 ,动态观察中出现肯定损害的病例 ,8例 12眼。结果 第一、二组中不肯定损害的发生率分别为 17%和 80 % ,P <0 .0 1。第三组 16眼中 ,15眼有不肯定损害表现。第四组 12眼初查只有不肯定损害 ,以后发展为相关的肯定损害。结论 1青光眼组不肯定性损害发生率显著高于对称性大杯组 ;2有些不肯定损害可称为青光眼性视野损害的先兆表现 ,按其临床价值大小依次排列为 :鼻侧等视线异常、上下方等视线内陷、可疑旁中央暗点、生理盲点上下扩大或外露及颞侧等视线异常。
Objective To study the frequence and diagnostic value of such undefinited abnormalities as isopter changes at nesal side existing before such eary classical glaucomatous visual field defects as pracentral scotoma.Methods Visual field cards of 121 eyes(81 cases) were selected from 220 cases of glaucoma or glaucoma suspects examined by perimeter of Goldmann type with a modified Armaly-Drance method and analysied in 4 groups:①23 eyes(14 cases) with symmetrical large optic cup;②70 eyes(43 cases) of glaucoma of early stage with an intraocular pressure above 30 mmHg;③16 eyes(16 cases)of asymmetric glaucoma of which one eye had a visual field defect of moderate or late stage,the other eye had defects of early stage or indefinited abnormalities;④12 eyes (8 cases) of glaucoma of which the initial visual field cards showed only undefinited abnormalities but the recent cards showed classical glaucomatous visual field defects.Result The frequence of undefinited abnormalities in the group 1(17%)was remarkablly lower than that in the group 2(80%),P<0 01.15 of the 16 eyes in group 3 had undefinited abnormalities.12 eyes in group 4 had a classical glaucomatous visual field defects recently relating to the corresponding undefnited abnormalitites at inital examinations. Conclusion ①The incidence of undefinited adnormalities in the 3 groups of glaucoma was remarkably higher than that in the patients with symmetrical large optic cup;②Some of the undefinited abnormalities should be considered as predicative signs of glaucomatous visual field defects,these can be put in such order in accordance with the clinical value as:isopter abnormalities at nasal side,isopter sinking in the upper or lower part of the field,suspected paracentral scotoma,the enlargement or outer position of the physilogical blind spot up or down towarded,isopter abnormality at temple side.
出处
《临床眼科杂志》
2001年第1期10-13,共4页
Journal of Clinical Ophthalmology
关键词
青光眼
视野损害
先兆表现
Glaucoma Visual field defect Predicative sign
