大杯盘比患者眼压和视野及电生理的分析研究

Analysis and study of intraocular pressure,visual field and P-ERG on patients with big cup / disk

目的:分析研究大杯盘比(cup/disk,C/D)患者24h眼压、视野及电生理的变化情况。方法:选择大C/D(C/D>0.3)患者120例240眼,并根据C/D大小将其分为两组:A组,0.3<C/D<0.6,67例114眼;B组,C/D≥0.6,73例126眼。选择正常对照组(C/D≤0.3)40例80眼。行24h眼压检查、30-2 SITA-标准静态阈值视野检查及图形视网膜电图检查(pattern electroretinogram,P-ERG)。比较分析三组患者上述检查指标的差异性。结果:对于24h眼压,三组患者眼压均值比较无显著统计学差异(P>0.05),波动幅度比较有显著统计学差异(P<0.05);B组患者眼压波动幅度明显高于正常对照组,差异具有统计学意义(P<0.05)。对于静态阈值视野,三组患者平均偏差(mean deviation,MD)及图样标准差(pattern standard deviation,PSD)比较有显著统计学差异(P<0.05);两两比较,与正常对照组相比,B组患者MD及PSD明显增加,差异具有统计学意义(P<0.05),而A组则无显著统计学差异(P>0.05);A,B两组相比,B组患者MD及PSD明显高于A组,差异具有统计学意义(P<0.05)。对于P-ERG检查,三组患者P50波潜伏期比较无显著统计学差异(P>0.05),波幅比较有显著统计学差异(P<0.05);两两比较,与正常对照组相比,B组患者P50波振幅明显降低,差异具有统计学意义(P<0.05),而A组则无显著统计学差异(P>0.05);A,B两组相比,B组患者P50波振幅明显低于A组,差异具有统计学意义(P<0.05)。结论:当C/D≥0.6时,患者24h眼压监测、静态阈值视野检查及图形视网膜电流图P50波有明显改变。对于大杯盘比患者,仅行单次眼压检查是远远不够的,应予以详细视功能检查。同时,将C/D 0.6作为可疑青光眼的筛查标准是可行的。

AIM： To analyze and study the changes of intraocular pressure （ IOP） , visual field and P-ERG on patients with big cup/disk （C/D） in 24h. METHODS： A total of 120 cases （ 240 eyes ） diagnosed with big C/D （C/D〉0. 3） were divided into group A （C/D〈0. 6, 67 cases, 114 eyes ） and group B （ C/D≥0. 6, 73 cases, 126 eyes）. Forty cases （80 eyes） with small C/D （C/D≤0. 3） were chosen as control group. All cases underwent 24h IOP examination, vision examination of 30-2 SlTA - standard static threshold and pattern electroretinogram （ P-ERG） examination. The differences between the examination indexes of the three groups were analyzed. RESULTS：There was no significant statistical difference in the 24h average IOP （P〉0. 05） among the three groups, while the amplitudes had significant statistical differences （P〈0. 05）. Compared with the control group, the IOP amplitudes of group B were obviously higher, and the difference was of statistical significance （P〈0. 05）. ln terms of static threshold visual fields, the mean deviations （MD） and pattern standard deviations （PSD） of the three groups had significant statistical differences （ P 〈 0. 05 ）. Comparison between every two groups：compared with the control group, the MD and the PSD were significantly increased in group B, and the difference was of statistical significance （P〈0. 05）; while there was no significant statistical difference in group A （P〉0. 05）;Compared with group A, the MD and the PSD weresignificantly higher in group B, and the difference was of statistical significance （P〈0. 05）. ln terms of P-ERG examination, there was no significant statistical difference in P50’s latent periods among the three groups （P〉0. 05）, but there were significant statistical differences in amplitudes （P〈0. 05）. Comparison between every two groups： compared with the control group, the P50’s amplitude was significantly decreased in group B, and the difference was of statistical significance （P〈0. 05）, while there was no significant statistical difference in group A （P〉0. 05）; Compared with group A, the P50’s amplitude of group B was significantly lower, and the difference was of statistical significance （P〈0. 05）. CONCLUSION： When the patients’ C/D is no less than 0. 6, there are obvious changes of 24h IOP, static threshold visual field and P-ERG’s P50 wave. For patients with big C/D, a single IOP examination is far from sufficient, so an in-depth visual function examination should be performed. Meanwhile, it’s feasible to regard C/D 0. 6 as a screening criterion for suspected glaucoma.