轻度帕金森病患者视野变化特点分析

Visual field analysis in early mild Parkinson＇s disease

目的 观察轻度帕金森病（PD）患者视野光敏感度和视野缺损部位及形态的变化特点.方法 临床检查确诊的轻度PD患者33例66只眼（PD组）纳入研究.选取同期健康志愿者36名72只眼作为正常对照组.采用Humphrey-750全自动视野计对所有受检者行中心30-2视野检查,记录视野平均缺损（MD）值及模式标准差（PSD）值,青光眼半视野检测（GHT）结果;比较两组受检者局部及普遍光敏感度的强弱.结果 PD组、正常对照组平均MD值分别为（-3.4±2.5）、（-0.6±1.7）dB.两组平均MD值比较,差异有统计学意义（t=7.753 P=0.000）;平均PSD值分别为（4.3±2.6）、（2.1±1.8） dB,两组平均PSD值比较,差异有统计学意义（t=5.882 P=0.000）.PD组66只眼中,GHT处于正常界限以外31只眼;临界范围8只眼;正常范围内27只眼.视野正常27只眼,占40.9％;视野缺损39只眼,占59.1％.视野缺损的39只眼中,旁中心暗点16只眼,占视野缺损患眼的41.0％;鼻侧阶梯18只眼,占视野缺损患眼的46.2％;弓形暗点5只眼,占视野缺损患眼的12.8％.GHT处于正常范围以外的31眼中,旁中心暗点10只眼;鼻侧阶梯16只眼;弓形暗点5只眼.结论 轻度PD患者视野局部及普遍光敏感度明显下降;部分患眼出现视野上下方敏感度的差异和局限性视野缺损.

Objective To evaluate visual field changes in early mild Parkinson＇s disease.Methods A total of 66 eyes of 33 cases with early mild Parkinson＇s disease and 72 eyes of 36 age-matched normal individuals were enrolled into the study.Humphrey Field Analyzer Ⅱ was applied for central visual field test.The visual field indices of mean deviation （MD） and pattern standard deviation （PSD） were analyzed to evaluate the location and the characteristics of visual field defect in this study.Results Visual field indices MD （-3.4±2.5） dB was significantly changed in patients with PD when compared to the controls （-0.6 ± 1.7） dB.PSD （4.3±2.6） was significantly higher in patients with PD than that in the control group （2.1 ± 1.8） dB.Glaucoma hemifield test （GHT） assessment was within normal limits in the controls.Of the 33 patients （66 eyes） in PD,GHT showed outside normal limits in 31 eyes,borderline in 8 eyes,and within normal limits in 27 eyes.31 eyes outside normal limits appeared glaucomatous visual field defects,in which 16 with nasal step and 5 with arcuate defect.Conclusions Visual field indices including MD and PSD in early mild patients with PD were significantly worse than that in the controls group.GHT abnormalities could be found in early mild PD patients with visual field defects,including pericentral scotoma and nasal step,which mimicked glaucomatous changes.