早中期原发性开角型青光眼固视行为的改变

Fixation behavior in early and moderate primary open angle glaucoma

目的应用微视野计MP-1研究早中期原发性开角型青光眼（primaryopenangleglauco．ma，POAG）固视行为的改变。方法前瞻性的筛选39只早中期POAG眼及22只正常眼进行微视野10°黄斑程序的检查。在MP-1检查黄斑光敏感度（meansensitivity，MS）的过程中自动记录受试者的固视稳定性及固视位置的变化。MP-1结果的参数包括中央10°、6°、2°以及中央60的鼻上、颞上、颞下和鼻下四象限的平均MS。比较POAG眼及正常眼的各MP-l参数及固视行为，并分析POAG眼MP-l各参数与固视稳定性之间的关系。结果POAG与正常眼相比固视稳定性的下降有统计学意义（P=0．016），与固视稳定性相关的MP-1参数包括中央10°（r=0．416，P=0．008），6°（，=0．401，P=0．011），20（r=0．376，P=0．018），中央6°的颞下象限（r=0．399，P：0．012）和鼻下象限（r=0．387，P=0．015）的平均MS。POAG眼的固视位置均为显著中心固视。结论早中期POAG与正常对照组相比固视稳定性明显下降。固视行为的改变可能是POAG视神经病变的一个早期征兆。

Objective To assess the fixation behavior in early and moderate primary open angle glaucoma （POAG） by using MicroPerimetry MP-1. Methods Prospectively enrolled 39 early and moderate POAG eyes and 22 normal eyes to do the microperimetry using the maeula 10° program of the microperimeter （MP-1）. During the test, the stability and location of the fixation in each sub- ject eye were recorded. The parameters of MP-I result included the mean macular sensitivity （MS） of the central 10°, 6°, 2°, superonasal, superotemporal, inferotemporal and inferonasal quadrants of the central 6°. The fixation behavior and the MP-1 parameters were compared between POAG and control groups. The correlation between the fixation behavior and each MP-1 parameter was ana- lyzed in POAG patients. Results Fixation stability was decreased in POAG （P =0.016）. It correlat- ed with the parameters of MP-1, which included the mean MS of central 10°（r =0.416, P =0.008）, 6°（r =0.401, P =0.011）, 2°（r =0.376, P =0.018）, inferotemporal （r=0.399, P =0.012） and inferonasal （r =0.387, P =0.015） quadrants of the central 6°. All the POAG patients had a predominantly central fixation. Conclusions Early and moderate POAG eyes present with fixation instability in this study. Alteration of fixation behavior may be an early sign of POAG.