Octopus 101型视野计在检测缺血性视神经病变中的观察

Application of Octopus 101 automated perimetry with kinetic and static program in patients with the anterior ischemic optic neuropathy

目的 评价Octopus 101型自动视野计动态和静态程序在检查前部缺血性视神经病变（MON）中各自的优缺点,探讨两种视野检查方法在AION疾病中的临床应用价值.方法 对2006年6月至2008年9月经北京协和医院门诊确诊的45例MON患者进行Octopus自动视野计动态视野检查和中心30°及周边60°静态自动视野的检查.分析比较患者静态程序中的平均缺陷度（MD）、丢失方差（LV）、动态程序中不同视标参数下等视线的面积及反应延迟时间（RT）及其与年龄的相关性等.结果 AION可出现各种与视神经相关的视野缺损,较常见的有鼻侧缺损（25%）、下半偏盲（20.83%）和盲点相连的下方束状缺损（20.83%）,动态视野检查有不同程度的等视线内陷,Ⅲ-4e与Ⅰ-2e两种不同的视标对MON患者检出的等视线面积差异有统计学意义（P＜0.01）;Ⅰ-2e视标更多地发现了周边视野的缺损.结论 Octopus 101自动视野计可以在同一视野计上先后完成静态及动态视野的检查.临床上对于可能既累及中心30°,又累及周边视野的如AION等疾病,有必要联合动、静态视野检查法,以更准确地捕捉到30°视野范围内的暗点及周边视野的压陷,且能最大限度地发挥了检查视标标准化、检查结果量化的优势.

ObjectiveTo investigate the clinical significance of the Octopus 101 kinetic and Static combined automatic perimetry in Anterior Ischemic Optic Neuropathy （AION）. To assess the merit and demerit of Octopus 101 kinetic and static combined automatic perimetry performed in AION cases. Methods 45 AION patients were detected with Octopus 101 with kinetic and static 30° ,60°scope static program from June 2006 to September 2008. The mean defect（MD） ,loss variance（LV）, areas of isopter, and reaction time were analyzed. The correlation between MD,areas of isopter and reaction time were analyzed. Results In AION, there are kinds of visual field defect related to the optic lesions in static perimetry examing.Kinetic programme display the isopter deletion.Isopter areas usingⅠ-2e and Ⅲ- 4e stimulus are significantly different （ P 〈 0. 05 ）. Smaller stimulus can find more periphery changes in AION. Conclusions The Octopus 101 perimeter can provide static and kinetic program in the same sitting. In clinical practice it is necessary to perform both static and kinetic examination in patients with AION because the visual field defects are diverse, and the data provided by static and kinetic program are complementary.