倍频视野计对开角型青光眼正常半侧视野的检测结果

Frequency-doubling perimetry in examination of open-angle glaucoma with hemifield defect

目的 了解倍频视野计 (frequency doublingperimetry ,FDP)检测早期青光眼视野异常的能力。方法 对Humphery视野计检测结果仅为半侧视野异常的 4 9例 (49只眼 )开角型青光眼患者 ,进行FDP(C 2 0阈值程序检测 )及海德堡视网膜断层扫描仪 (Heidelbergretinaltomography ,HRT)检测。根据检测结果 ,将患者分成FDP正常组及异常组 ;再将两组的HRT检测参数进行比较分析。结果FDP检测的平均光敏感度与HRT视野检测结果的平均偏差有显著相关性 (r =0 5 83,P <0 0 0 0 )。Humphery检测的异常半侧视野 ,FDP检测显示正常的仅占 2 0 % (1/ 4 9)。而Humphery检测的正常半侧视野 ,FDP检测显示异常的为 4 0 8% (2 0 / 4 9) ,与其相对应视乳头的HRT检测参数相比 ,FDP异常组的视杯面积和杯 /盘面积比值较FDP正常组的检测值大 (t=2 36 0和 2 4 39,P <0 0 5 ) ,而盘缘面积和盘缘容积则较FDP正常组小 (t=2 32 9和 2 5 79,P <0 0 5 )。结论 FDP不仅能检测出HRT发现的视野缺损 ,而且能显示HRT尚未能检测出的早期青光眼视野异常 ;FDP检测结果与HRT检测参数显示的青光眼性视乳头变化相一致。

Objective To determine whether frequency doubling perimetry (FDP) can find visual field defect of early glaucoma which can not be found by conventional perimetry Methods Forty nine eyes of 49 patients with open angle glaucoma and hemifield defect detected by Humphery Field Analyzer (HFA) were tested by both FDP (threshold test C 20) and Heidelberg Retina Tomograph (HRT) For each hemifield, its FDP result was evaluated According to the FDP results in intact HFA hemifields, the patients were divided into FDP normal group and FDP abnormal group The HRT parameters of half disk corresponding to the intact HFA hemifields were compared between these two groups Results There was a strong correlation between the mean sensitivity of FDP and mean deviation of HFA results ( r =0 58, P <0 01) In intact HFA hemifields, 41% (20/49) of eyes showed visual loss in FDP tests, while in defective HFA hemifields, only 2% (1/49) of eyes was normal in FDP test For the HRT parameters of half disk corresponding to the intact HFA hemifields, cup area and cup/disk area ratio were statistically bigger and rim area and rim volume were statistically smaller in FDP abnormal group than in FDP normal group Conclusion FDP is able to detect early glaucomatous visual field damage which can not be detected by HFA, but can be explained by the optic nerve glaucomatous changes in HRT parameters