蓝/黄视野与标准白色视野检测在早期青光眼诊断中敏感性的比较

Comparison of blue-on-yellow perimetry with standard automated perimetry in early diagnosis of POAG

目的 探讨蓝 /黄视野计与标准白色视野计检查在原发性开角型青光眼早期诊断中的价值。方法 采用瑞士产Octopus10 1型全自动视野计对早期原发性开角型青光眼 2 2例 44眼、对照组正常人 2 0例 40眼进行B/Y及W /W检测 ,视野检测采用tG2 测试程序 ,将中心 3 0°视野内全视网膜光敏感度均值及各象限光敏感度均值 (dB)进行比较。结果 两种视野计检测正常人B/Y较W/W检测全视网膜光敏感度均值低 ,相差 4 2 4dB。早期开角型青光眼B/Y较W /W检测全视网膜光敏感度均值差为 5 5 8dB ,对应各象限视网膜光敏感度均值差 5dB以上 ,视网膜光敏感度均值依次为鼻下>颞下 >鼻上 >颞上 ,以B/Y检测出的缺损面积大且深。早期开角型青光眼组 44眼B/Y检测视野阳性 3 2眼 ,( 72 73 % ) ,W /W检测视野阳性 17眼 ( 3 8 64 % ) ,两种视野计检测结果的异常率有显著差异 (P <0 0 5 )。结论 B/Y与W/W检测结果有良好的符合性 ,检测早期开角型青光眼的视野改变B/Y较W/W敏感。

Objective To assess the value of blue-on-yellow perimetry in the diagnosis of early open-angle glaucoma. Methods Forty-four eyes of 22 patients with early open angle glaucoma and 40 normal eyes were examined by the blue-on-yellow (short wavelength,B/Y)perimetry and standard automated(white-on-white,W/W) perimeter.The mean light sensitivity(MS) of the central 30° and each quadrant from two perimetries were calculated and analyzed statistically. Results The difference of MS in central 30° between two perimetries was 4.24 dB (t=18.12,P<0.01) in normal group.MS was significantly higher in W/W than in B/Y either in central 30° or in each corresponding quadrant (P<0.01).The MS difference between them was more than 5.58 dB(t=6.45, P<0.01),and the MS average difference of the corresponding quadrant was more than 5 dB(P<0.01 ).MS from four quadrant were different from other one.The lowest MS was in the superior temporal and the highest in inferior nasal quadrant.The defects in B/Y perimetry were larger and deeper than that in W/W perimetry.The result of corrected deviation points revealed that the defected testing points form B/Y perimetry were 2.23 times higher that from W/W perimetry.In the early glaucoma group,abnormal visual field rate from B/Y perimetry was 72.73%(32/44) and 38.64%(17/32) form W/W perimetry. Conclusion A good coincidence is demonstrated between B/Y and W/W perimetries both in normal and in early open angle glaucoma groups.B/Y perimetry is more sensitive than W/W perimetry to early glaucoma.