夜间眼压测量在疑似正常眼压性青光眼诊治中的应用价值研究

Nocturnal IOP in Diagnosis of Suspected Normal Tension Glaucoma

目的探讨夜间眼压测量在疑似正常眼压性青光眼(NPG)诊治中的应用价值,以减少高眼压性青光眼(HPG)的漏诊。方法选取我院2011年1月—2012年1月收治的疑似NPG患者共50例(96眼),根据夜间眼压测量结果将患者分为NPG组21例(38眼)和HPG组29例(58眼),比较两组患者的一般情况、日间和夜间眼压、视网膜神经纤维层厚度及视野。结果两组患者的性别构成(χ2=1.05,P=0.910)、平均年龄(t=3.20,P=0.760)、平均视力(t=0.17,P=0.480)比较,差异均无统计学意义。HPG组日间眼压谷值、峰值均大于NPG组,波动幅度小于NPG组(P<0.05)。HPG组夜间眼压谷值和峰值、波动幅度均大于NPG组(P<0.05)。HPG组16例、NPG组3例患者出现夜间眼压>21 mm Hg(1 mm Hg=0.133 kPa),HPG组夜间眼压>21 mm Hg发生率(55.2%)高于NPG组(14.3%)(χ2=4.31,P=0.035)。两组患者上方象限、下方象限、颞侧象限、鼻侧象限视网膜神经纤维层厚度及视网膜神经纤维层平均厚度,视野平均偏差及模式标准偏差比较,差异均无统计学意义(P>0.05)。结论夜间眼压测量能更好地反映受试者眼压变化,从而减少HPG的漏诊,值得在疑似NPG诊治中推广应用。

Objective To investigate the application value of nocturnal intraocular pressure（IOP） in diagnosis of suspected normal pressure glaucoma（NPG）,to reduce missed diagnoses of high pressure glaucoma（HPG）.Methods A total of 50 suspected NPG patients（96 eyes） admitted to this hospital from January 2011 to January 2012 were divided,according to nocturnal IOP results,into groups NPG（21 cases,38 eyes）,HPG（29 cases,58 eyes）.The general state of health,daytime / nighttime IOP,thickness of retinal nerve fibre layer and field of vision were compared between 2 groups.Results There was no significant difference in gender composition（χ^2= 1.05,P = 0.910）,mean age（t = 3.20,P = 0.760）,average visual acuity（t = 0.17,P = 0.480）.The valley and peak values at daytime and nighttime,fluctuation range of nocturnal IOP at nighttime were greater in HPG group than in NPG group（P〈0.05）.The fluctuation of nocturnal IOP at daytime was lower in HPG group than in NPG group（P〈0.05）.Sixteen patients of HPG group,3 of NPG group had nocturnal IOP 21 mm Hg,the incidence was higher in HPG group（55.2%） than in NPG group（14.3%）（χ^2= 4.31,P = 0.035）.There was no significant difference in retinal nerve fibre layer thickness,mean thickness in upper,bottom,temporal or nasal quadrants,mean deviation of visual field,standard deviation of pattern between 2 groups（P〈0.05）.Conclusion Nocturnal IOP measurement,which can reflect IOP changes better to reduce missed diagnoses of HPG,is worthy of application in diagnosis of suspected NPG.