开角型青光眼视盘周围脉络膜萎缩与视野缺损的相关性研究

The Relationship between Peripapillary Choroidal Atrophy and Visual Field Defects in Open Angle Glaucoma

目的:探讨原发性开角型青光眼(primaryopenangleglaucoma,POAG)和可疑开角型青光眼(suspectedopenangleglaucoma,SOAG)视盘周围脉络膜萎缩(peripapillarychoroidalatrophy,PPCA)的发生率及不同分区的面积大小与视野指数平均缺损(Meandefect,MD)之间的相关性。方法:对128只POAG和78只SOAG行静态视野检查及眼底视盘彩色照相,对有PPCA改变的视盘确定其α区和(或)β区,并测出不同分区的面积。结果:POAG组中,PPCA的α和β区的发生率分别为57.03%和39.84%,面积均数分别为(0.54±0.37)mm2和(1.68±1.06)mm2,MD为(8.31±3.66)dB;SOAG组中,α和β区的发生率分别为43.59%和26.92%,面积均数分别为(0.42±0.29)mm2和(1.15±0.67)mm2,MD则为(4.16±2.07)dB。在2组病例中,α区和β区面积值与MD之间均具有显著意义的正性相关(P<0.001)。结论:PPCA不同分区的面积值与MD之间具有显著相关性;β区的发展是辨认青光眼或青光眼性视神经损害是否进展的重要参数,有助于发现及预测青光眼病情的发展。

Purpose： To study the relationship between peripapillary choroidal atrophy （PPCA） and mean defect（MD） in visual field in primary open angle glaucoma（POAG） and suspected open angle glaucoma （SOAG）. Methods： One hundred and twenty-eight eyes with POAG and 78 eyes with suspected open angle glaucoma were examined with Oculus Twinfield static threshold perimetry test （program 24-2） and monocular disc color photographs. Results ： In POAG group, the incidence rate of α-area and β-area were 57.03% and 39.84%, respectively. The average area of α-zone and β-zone were （0.54±0.37） mm^2 and （ 1.68 ± 1.06） mm^2. The mean defect is （ 8.31 ± 3.66） dB. In suspected open angle glaucoma, they were 43.59% and 26.92%,（0.42±0.29） mm^2 and （1.15±0.67） mm^2, and（4.16±2.07）dB, respectively. The area of α and β has strongly positive correlation with MD in two groups. （P 〈 0.001 ）. Conclusion： PPCA has strong correlation with MD, the progress of β area was an important parameter to identify glaucoma.