眼底检查诊断开角型青光眼的临床分析

Clinical Analysis on the Diagnosis of Open Angle Glaucoma by Fundus Examination

目的通过青光眼眼底照相推测HUMPHREY视野的视野缺损。方法原发性开角型青光眼70例133眼。将眼底照相分为上下两个象限,判断是否有青光眼眼底改变,并通过青光眼眼底改变推测视野缺损,推测结果与实际视野缺损相比较。比较结果分为正确、过多、过少3个评价组。结果正确评估组101眼(75.9%),过多评估组27眼(20.3%),过少评估组5眼(3.8%)。过多评估组眼底所见:初期改变17眼(63.0%),近视眼6眼(22.2%),大视乳头4眼(14.8);过少评估眼底所见:近视眼2眼(40.0),乳头边缘部正常2眼(40.0%),视神经上方低形成(SSOH)1眼(20.0%)。结论96.2%的病例可以通过眼底的检查判断出青光眼的改变,但如大视盘、近视眼及SSOH等病例通过眼底检查较困难。

Objective To see if we can speculate ususal field damages from optic fundus changes.Methods We divided fundus into superior and inferior fields.Masking the results by HF,We evaluated glaucomatous findings of IMAGEnet fundus photographs in each field respectively.We estimated corresponding VFDs to optic fundus fingings.We compared those VFDs to HF VFDs.Results were classified into three groups.1 Ok estimated group ：we estimatedVFDs from optic fundus photographs correctly coincidents to HF VFDs in both superior and inferior fields.2 Over estimated group ：we estimated VFDs from optic fudus photographs to HF VFDs at least in a field.3 Underestimated group.we estimated VFDs from optic fundus photographs to HF VFDs at least in a field.Results One hundred and thirty three eyes were included in this study.Ok estimated group include 101 eyes（75.9%）.Over estimated group include 27 eyes（20.3%）.Under estimated Group include 5 eyes（3.8%）.Glaucomatous findings from fundus photographs matched to HF VFDs in about 90% of cases.Conclusion Fundus examination is important to confirm VFDs.To estimated glaucomatous findings in photographs is difficult in patients with large disc,high myopia and other diseases like SSOH.