SAP10-2视野检测程序发现视野损害前青光眼黄斑区视功能损伤的能力

10-2SAP visual field test finds macular defects in preperimetric glaucoma patients

目的探究视野损害前青光眼(PPG)患者行SAP10-2是否比临床上通常采用的SAP24-2更敏感而利于青光眼的早期诊断。统计SAP10-2哪些区域和位点最易发生视野损伤,以期提示临床工作中哪一区域的诊断提示意义最高。方法对符合纳入标准的36位视野损害前青光眼患者进行眼科基本检查和Humphrey中心24-2和10-2阈值检测(SITA-Standard)。将SAP10-2模式偏差图分为6个区域,分别统计各区平均缺损值(aMD)和模式偏差图的68个位点中存在视野损害的位点。结果纳入的36位视野损害前青光眼患者有21位(58%)的SAP10-2检查异常,说明SAP10-2比SAP24-2对极早期的视野损害的检出更敏感。SAP10-2异常的视野损害前患者视野损伤主要出现在上半侧[aMD=0.781±0. 089(1/L),P=0.001]和上六分之一区域[aMD=0.680±0.167(1/L),P=0.002],并且3、7、9、13、18、20、21、22、27、29、33、41、53、56、59这15个位点为最易出现损伤的位点,绝大部分位于视野上方,鼻侧和颞侧分布较均匀。结论 SAP10-2每个点位间距更小,检查更精细,比SAP24-2对极早期青光眼视野损害的检出更敏感,且这类视野损伤多出现于上方,鼻侧颞侧无明显差别。

To study whether 10-2 standard automatic perimetry(SAP) is more sensitive than 24-2 SAP for detecting very early visual field( VF) defects in preperimetric glaucoma(PPG). To find the most common 10-2 SAP VF defect areas and test points, so as to determine the highest correlation sector for early diagnose of glaucoma. Methods36 patients with preperimetric glaucoma meeting the inclusion criteria had a series of fundamental ophthalmology examinations, Humphrey Central 10-2 Threshold Test and Central 24-2 Threshold Test( SITA-Standard). Pattern deviation map of SAP10-2 were divided by 6 areas. The aMD value of every area were calculated, and every test point on the pattern deviation map underwent analysis to find the defected point. Results 21 of 36 PPG patients(58%) had abnormal10-2 SAP results. And the 10-2 SAP VF defects mostly lay in the superior hemisphere [ aMD = 0. 718 ± 0. 089( 1/L),P = 0. 001 ] and superior 1/6 sector [ aMD = 0. 680 ± 0. 167( 1/L), P = 0. 002 ]. Fifty Points’( no. 3,7,9,13,18,20,21,22,27,29,33,41,53,56,59) MD values below zero of over 90% PPG paitents which SAP10-2 were abnormal,which mostly fell in the superior hemisphere, without significant difference of temporal and nasal areas. Conclusions10-2 SAP is more sensitive than 24-2 SAP for detecting very early VF defects in PPG. The superior hemisphere and superior 1/6 sector were mostly vulnerable, and there was no significant difference between temporal and nasal areas.