眼眶肿瘤致视野改变的类型及多因素分析

Patterns and Multiple Factors of Visual Field Changes in Patients of Orbital Tumors

目的研究眼眶肿瘤致视野改变的类型及相关因素。方法利用Humphrey720i计算机自动视野计对眼眶肿瘤患者进行视野检查,对研究结果进行分析。结果眶中部或眶尖肿瘤对普遍敏感性降低的影响存在显著性;视神经内侧受压对各象限阈值的影响无显著性,其余各方(上、下、外)对其影响均有显著性,视神经受压部位与各象限阈值降低之间的关系差异无显著性;肿瘤是否压迫眼球后壁和肿瘤在眶内位置均是造成平均缺损(MD)和模式标准差(PSD)下降的因素,肿瘤在眶内位置较肿瘤是否压迫眼球后壁更易引起视野指数下降,眶中部肿瘤和眶尖肿瘤之间MD无明显差别,但眶尖肿瘤对PSD的影响较眶中部肿瘤更为明显;随访分析表明压迫因素引起的视野改变为可逆的。结论眶尖肿瘤可造成视网膜光敏感性降低;眶尖肿瘤更易引起视野缺损;肿瘤压迫视神经可造成各象限视敏度降低;视神经受压部位与视野缺损方位无明显对应关系。

Objective To summarize patterns and related factors of visual field changes in patients of orbital tumors. Methods The static central visual fields were tested by Humphrey 720i automated perimeter in patients of orbital tumors. The statistics were analyzed. Results The effects of location （in the middle or in the puncta of tumors on general reduction between groups have significant differences. Tumors in interior side of optic nerve show no significant difference on thresholds between four quadrants. However, the other three show significant differences. The directions of compression of optic nerve have no significant difference on thresholds between four quadrants. Compression of the posterior wall and location in the obit may both cause the descending of mean defect and pattern standard deviation. But the latter have more significant effects. Mean defects （MD） have no significant difference between tumors in the middle of the orbit and in the puncta, but pattern standard deviation （PSD） do. The follow-up analysis show visual defects are reversible. Conclusions General reduction can be caused by tumors in puncta. Tumors in puncta lead to visual defects more frequently. Compression of optic nerve may descend thresholds in four quadrants. No significant corresponding relations showed between directions of compression and four quadrants.