对比敏感度作为原发性闭角型青光眼术后随访评估指标的初步研究

A Preliminary Study of Contrast Sensitivity as a Postoperative Follow-up Evaluation Index for Primary Angle-closure Glaucoma

目的对比三种评价原发性闭角型青光眼术后视功能变化情况的检测方法,探索应用对比敏感度作为原发性闭角型青光眼术后随访评估指标的可行性。方法选取2020年10月-2021年10月在天津市眼科医院行手术治疗的66例(132只眼)作为青光眼组,青光眼组细分为两亚组:双眼中的一眼接受小梁切除术(66只眼)者设为TB组;另一眼接受激光虹膜周切术(66只眼)者设为LPI组。选取健康对照33例(66只眼)设为对照组。所有受试者均测量视力、视野和对比敏感度。结果三组视力、视野以及空间频率(3 cpd、6 cpd、12 cpd、18 cpd)对比敏感度比较,差异有统计学意义(P<0.05);TB组、LPI组、对照组的视力、视野、空间频率(3 cpd、6 cpd、12 cpd、18 cpd)对比敏感度分别比较,差异有统计学意义(P<0.05);LPI组和对照组视野、空间频率(12 cpd、18 cpd)对比敏感度比较,差异有统计学意义(P<0.05);而视力以及空间频率(3 cpd、6 cpd)对比敏感度比较,差异无统计学意义(P>0.05);青光眼组4个空间频率下对比敏感度和视野的相关性(r=0.524、0.662、0.566、0.483,P<0.05)均高于视力和视野之间的相关性(r=-0.337,P<0.05),其中在3个空间频率(3 cpd、6 cpd、12 cpd)下差异有统计学意义(P<0.05)。结论对比敏感度检查可以作为原发性闭角型青光眼术后随访的病情评估指标。

Objective To compare three methods for evaluating the changes of visual function after primary angle-closure glaucoma surgery,and to explore the feasibility of using contrast sensitivity as a follow-up evaluation index for primary angle-closure glaucoma.Methods A total of 66 patients(132 eyes)who underwent surgical treatment in Tianjin Eye Hospital from October 2020 to October 2021 were selected as the glaucoma group.The glaucoma group was subdivided into two subgroups:66 eyes underwent trabeculectomy in one of the two eyes were set as TB group;the other eye receiving laser peripheral iridectomy(66 eyes)was set as the LPI group.Thirty-three healthy controls(66 eyes)were selected as the control group.Visual acuity,visual field and contrast sensitivity were measured in all subjects.Results There were significant differences in visual acuity,visual field and spatial frequency(3 cpd,6 cpd,12 cpd,18 cpd)contrast sensitivity among the three groups(P<0.05).There were significant differences in visual acuity,visual field and spatial frequency(3 cpd,6 cpd,12 cpd,18 cpd)contrast sensitivity among TB group,LPI group and control group(P<0.05).There were significant differences in visual field and spatial frequency(12 cpd,18 cpd)contrast sensitivity between LPI group and control group(P<0.05),but there was no significant difference in visual acuity and spatial frequency(3 cpd,6 cpd)contrast sensitivity(P>0.05).The correlation between contrast sensitivity and visual field at four spatial frequencies(r=0.524,0.662,0.566,0.483,P<0.05)was higher than that between visual acuity and visual field(r=-0.337,P<0.05)in the glaucoma group,and the difference was statistically significant at three spatial frequencies(3 cpd,6 cpd,12 cpd)(P<0.05).Conclusion Contrast sensitivity examination can be used as an evaluation index for postoperative follow-up of primary angle-closure glaucoma.