Characteristics of central visual field defect after macular hole surgery

AIM: To investigate the characteristics of postoperative central visual field defect(cVFD) in patients with macular hole(MH).METHODS: Eighteen eyes from 18 MH patients were involved in this retrospective study which reviewed square root of loss variance(sLV) and mean defect(MD) of the visual field test in all subjects. The relationship between cVFD and MH stage, as well as the postoperative ellipsoid zone disruption were evaluated using Spearman's correlation test. RESULTS: Our analysis determined Spearman coefficient is 0.705 for the correlation between sLV and MH stage(P<0.01), 0.877 for the correlation between sLV and postoperative ellipsoid zone disruption(P<0.01) and 0.721 for the correlation between MD and postoperative ellipsoid zone disruption(P<0.01). A significant relationship was also detected between postoperative ellipsoid zone disruption and MH stage(r=0.470, P<0.05). Univariate regression analysis indicated that sLV and MD were associated with postoperative ellipsoid zone disruption(P<0.01, P<0.01, respectively). CONCLUSION: Postoperative cVFD is highly correlated with MH stage and postoperative ellipsoid zone disruption in patients with MH.

Retinal Functional Changes Measured by Microperimetry after Intravitreal Ranibizumab Injection and Sulfotanshinone Sodium Injection for Macular Edema Secondary to Retinal Vein Occlusion

Objectives: To study the visual field changes after intravitreal ranibizumab (IVR) injection and sulfotanshinone sodium (SS) injection for macular edema (ME) secondary to retinal vein occlusion (RVO), and discuss the value of microperimetry as a routine diagnostic test in the follow-up of RVO patients. Methods: This was a retrospective, interventional, case-series study. Twelve eyes of 12 RVO patients, including 6 eyes with central RVO (CRVO) and 6 eyes with branch RVO (BRVO) were included. The eyes were treated with IVR (0.5 mg) injections and SS injections (20 mg per day, one week consecutively in one month). The outcomes measured included best corrected visual acuity (BCVA), central retinal thickness (CRT), mean defect (MD), pattern standard deviation (PSD), macular light sensitivity of the central 16 points in CRVO group and the central 8 points in BRVO group before and after the treatment. Statistical analyses were then performed on the main outcome measures. Results: An improvement of BCVA was found in all patients after treatment with significant difference (t = 7.74, p p p p > 0.05). All RVO patients had their macular light sensitivity of the involved part improved significantly (t = 5.03, p p p < 0.01). The Pearson’s correlation was calculated among BCVA, MD, macular light sensitivity and CRT. No obvious significance was found between CRT and BCVA outcomes, whereas MD and mean macular light sensitivity outcomes were closely related to BCVA results in the BRVO group and the latter showed a more intimate correlation. No similar correlation was found in RVO and CRVO group. Conclusion: IVR injection and SS injection together could effectively improve the therapeutic effect in RVO patients with ME. Microperimetry could be used as a routine diagnostic test and a possible valuable tool in the follow-up of patients with RVO, especially in BRVO.

A virtual model of the retina based on histological data as a tool for evaluation of the visual fields

Background:To settle the fundamentals of a numerical procedure that relates retinal ganglion-cell density and threshold sensitivity in the visual field.The sensitivity of a generated retina and visual pathways to virtual stimuli are simulated,and the conditions required to reproduce glaucoma-type defects both in the optic-nerve head(ONH)and visual fields are explored.Methods:A definition of selected structural elements of the optic pathways is a requisite to a translation of clinical knowledge to computer programs for visual field exploration.The program is able to generate a database of normalized visual fields.The relationship between the number of extant receptive fields and threshold sensitivity is plotted for background sensitivity and corresponding automated perimetry.A solution in two planes to the 3D distribution of axons in the ONH is proposed.Visual fields with induced damage in the optic disc are comparable in pattern and quantity to glaucomatous records.Results:The two-level simulation of the ONH facilitates the analysis of optic-cup/retinal defects.We can generate the virtual optic pathways tailored to the age and morphology of the patient’s eye,and it is possible to reproduce glaucomatous damage by“reverse engineering”engineering.The virtual cortical model renders a quantitative relationship between visual defect and neural damage.Conclusions:A two-level computing of the retina/optic nerve facilitates the analysis of neuroretinal defects and can be incorporated to automatic perimeters to facilitate visual field analysis.

Incomplete fluid-air exchange technique for idiopathic macular hole surgery

AIM: To explore an improved procedure involving incomplete fluid-air exchange for idiopathic macular hole(IMH), and the closure rate, visual function, and the visual field of macular holes(MHs) were evaluated.METHODS: This prospective randomized controlled study, included 40 eyes of 40 patients with IMH who were treated with pars plana vitrectomy and peeling of the internal limiting membrane. They were grouped by random digital table. Twenty-one eyes underwent incomplete fluidair exchange(IFA) and 19 eyes underwent traditional complete fluid-air exchange(CFA) as the control group. Outcomes included best-corrected visual acuity(BCVA), intraocular pressure, and optical coherence tomography, light adaptive electroretinography, and visual field evaluations.RESULTS: All MHs <400 μm were successfully closed. BCVAs before and 6 mo after surgery were 0.82±0.41 logMAR and 0.28±0.17 logMAR in IFA group and 0.86±0.34 logMAR and 0.34±0.23 logMAR in CFA group, respectively. The electroretinogram analysis of patients in IFA group revealed increases in b-wave amplitudes at 1, 3, and 6 mo after surgery. Additionally, patients in IFA group showed an amplitude increase of 28.6% from baseline at 6 mo(P<0.05), while no obvious improvements were noted in CFA group. Although there were no statistically significant improvements in either group, the IFA group showed a slight increase in mean sensitivity(P>0.05).CONCLUSION: IFA is a reliable method that offers comparable closure rate to CFA and facilitates improvements in visual function.

Visual Allesthesia in a Patient with Glioblastoma Multiforme

Purpose: To report a rare case of visual allesthesia in a patient with glioblastoma multiforme. Material - Methods : A 46 – year old male presented in emergency ophthalmologic department complaining for difficulties in performing tasks related to color discrimination in his occupation (PC technician). The patient underwent a thorough ophthalmological examination and then he was referred to the neurological department for further evaluation. Results: The patient presented an atypical pattern of color perception disturbance. His best corrected visual acuity decreased progressively during hospitalization. He also experienced visual allesthesia paroxysmally (illusory left homonymous transpositions of subjects viewed in the right homonymous visual field). The visual field evaluation revealed homonymous left hemianopsia. Magnetic resonance imaging revealed glioblastoma multiforme confirmed by biopsy. Conclusions: A thorough ophthalmological and neuro-imaging control is suggested in patients with sudden color perception disturbance. Patients with temporal or occipital cortex damage may experience visual allesthesia.

晚期青光眼患者视野缺损程度影响因素分析

目的探讨晚期青光眼患者视野缺损程度的影响因素。方法选择2019年1月至2023年1月在新乡医学院第一附属医院就诊的晚期青光眼患者206例(206眼)为研究对象,回顾性分析患者的临床和随访资料,依据其视野缺损程度分为颞侧视岛组(n=134)和管状视野组(n=72),采用单因素和多因素logistic回归分析晚期青光眼患者视野缺损程度的危险因素。结果单因素分析结果显示,患者是否合并高度近视眼、青光眼类型、随访眼压峰值、随访眼压平均值、用药种类、累计用药种类与晚期青光眼视野缺损程度有关(P<0.05)。多因素logistic回归分析结果显示,合并高度近视眼、慢性原发性闭角型青光眼(CPACG)、随访眼压峰值≥21 mm Hg(1 mm Hg=0.133 kPa)为晚期青光眼患者视野缺损程度的危险因素(P<0.05)。结论晚期青光眼患者颞侧视岛的发生率较高,应对高度近视眼、CPACG、随访眼压峰值≥21 mmHg的患者加强眼压监控及相关眼健康教育,以改善视野缺损程度。

脑后动脉梗死患者局部缺血性病变程度预测视野缺损改善的临床价值

目的 研究大脑后动脉(PCA)梗死患者局部缺血性病变程度(rEIL)预测视野缺损(VFD)改善的临床价值。方法 2020年9月—2023年7月,前瞻性纳入PCA缺血性梗死引起的半侧VFD患者38例,上象限VFD 35例,下象限VFD 29例。利用弥散加权成像计算视觉皮层rEIL。将随访3个月时视野评分(VFS)改善20%定义为VFD显著改善。利用Spearman相关性和Logistic回归模型评估预测半侧VFD或上/下象限VFD改善的相关因素。受试者工作特征(ROC)曲线分析对组合不同的变量亚组进行多变量分类测试。结果 22例(57.89%)半侧VFD显著改善,上象限VFD和下象限VFD显著改善率分别为40.00%和44.83%。经Spearman分析,舌回和距状回rIEL(%)与半侧/上象限/下象限ΔVFS均呈负相关,另外楔状回rIEL(%)与半侧ΔVFS也呈负相关(P<0.05)。经单因素和多因素Logistic回归分析,舌回和距状回rEIL(%)可能是半侧VFD或上象限VFD改善较差的独立预测因素(P<0.05)。ROC结果显示,临床变量(年龄+入院时NIHSS+基线VFS+梗死体积)联合舌回和距状回rEIL可提高VFD改善结局的预测效能,曲线下面积由0.767(95%CI:0.618~0.916)增加至0.963(95%CI:0.891~1.000)。结论 基于单独皮层的rEIL可相对准确地预测VFD的改善。将舌回和距状回rEIL数据补充到临床变量中可以提高PCA梗死后VFD预测模型的效能。

经鼻蝶垂体瘤切除手术前后视野分析

目的通过对垂体瘤患者术前及术后3个月视野进行分析,探讨经鼻蝶垂体瘤切除术后患者视野变化的特点以及可能的影响因素。方法收集瑞金医院神经外科行经鼻蝶垂体瘤切除术且有完整随访资料的36例患者,分析术前及术后3个月视野变化。结果入组患者中,视野缺损组与视野正常组垂体瘤的诊断年龄以及肿瘤大小比较差异有统计学意义(P<0.05);经鼻蝶垂体瘤切除术后,8例术前双眼视野正常患者中有1例出现了单眼视野缺损;术前存在不同程度视野缺损的28例患者中,视野缺损改善者18例;视野缺损未明显改善者8例,视野缺损较前严重者2例(单眼)。结论垂体瘤患者出现视野缺损的概率、视野缺损的严重程度与诊断年龄以及肿瘤大小有关;经鼻蝶垂体瘤切除术后大部分患者视野得到改善,视野改善与诊断年龄等相关。

视盘黑色素细胞瘤病例报道1例并文献回顾

视盘黑色素细胞瘤(MCOD)是临床罕见的疾病,容易和脉络膜黑色素瘤相混淆,两者治疗方式截然不同,MCOD为良性疾病,存在恶性转化可能,因此与恶性疾病进行鉴别,及时发现肿瘤恶性转化对后续治疗至关重要。本文报道1例体积较大的右眼MCOD,最佳矫正视力为20/20,眼底照相可见右眼视盘区近似椭圆形的黑色肿物,边界不清,呈羽毛状;眼部B型超声可见右眼视盘上圆顶状隆起占位病灶;视野弓形缺损;光学相干断层扫描成像提示右眼神经节细胞层变薄;光学相干断层扫描血管成像提示右眼血流密度增高,脉络膜血流缺损。诊断考虑为MCOD,未进行干预治疗,观察随访4个月后,瘤体无明显变化,嘱患者每年定期复查。分析检查结果发现:弓形视野缺损区域与患眼神经节细胞变薄区域有一致性,与脉络膜血流缺损、视网膜黄斑区血管密度增高具有相关性。通过对此病历进行总结归纳,并回顾文献研究,为临床医生提供诊断依据。

纸膜双层缺陷检测的视觉成像光场设计

为实现包装盒纸质基底层和透明膜层缺陷的同步检测,开展了对纸和膜缺陷的同步成像研究。首先,分别建立了标准球面积分光场、椭球面积分光场和弧面积分光场模型,并利用COMSOL Multiphysics 5.6对3类光场进行射线仿真,对比分析了球面积分光场下射线角度均匀性及辐照均匀性,通过正交仿真优化椭球面积分光场参数;其次,在椭球面积分光场环境、亮场前打光环境、暗场前打光环境下对包装盒成像。与此同时,对包装盒的油污、抵触、开口、泡皱、破损5项常见缺陷依次进行物理检测和机器视觉检测,验证缺陷成像的有效性。试验结果表明,在椭球面积分光场下成像,图像对纸质基底层缺陷特征、透明膜层缺陷特征均有较好的呈现效果,图像上油污、抵触、开口、泡皱、破损的物理检出率分别为96.2%、92.5%、100%、95%、92%,异常检出率分别为98.6%、97.5%、100%、100%、98.4%,缺陷类别检出率分别为97.6%、96%、100%、97%、96%。研究结果表明,椭球面积分光场光路角度和辐照强度均匀,覆透明膜包装盒的缺陷特征呈现清晰,满足工业生产的检测要求。

老年青光眼伴视野缺损患者反刍性沉思调查、危险因素及护理对策研究

目的:探讨老年青光眼伴视野缺损患者反刍性沉思调查现状、危险因素及护理对策。方法:选取2021年4月—2022年10月安阳市眼科医院收治的126例老年青光眼伴视野缺损患者作为研究对象。所有患者均接受事件相关反刍性沉思问卷(ERRI)调查,并进行单因素分析与多元线性回归分析。结果:126例老年青光眼伴视野缺损患者的ERRI得分为(29.95±5.73)分;意外伤害频率≥3次、低心理韧性水平、低社会支持度水平、未接受机能保健患者的目的性反刍性沉思得分更低,差异有统计学意义(t=2.617、4.224、2.492,P<0.05),意外伤害频率≥3次、家庭月收入<5000元、文化水平初中及以下、有焦虑情绪、低心理韧性、低社会支持度、未接受机能保健患者的侵入性反刍性沉思得分更高,差异有统计学意义(t=5.289、2.899、7.149、9.902、5.617、9.917、2.410,P<0.05);多元线性回归分析结果显示,意外伤害频率高、家庭月收入低、低文化水平、有焦虑情绪、低心理韧性、低社会支持度、未接受机能保健是影响老年青光眼伴视野缺损患者反刍性沉思的独立危险因素(P<0.05)。结论:老年青光眼伴视野缺损患者的反刍性沉思处于中等水平,其危险因素包括意外伤害频率高、家庭月收入低、低文化水平、有焦虑情绪、低心理韧性、低社会支持度、未接受机能保健,需根据上述因素制定针对性的护理对策进行干预。

Neuroimaging in atypical normal tension glaucoma:debating routine implementation in the absence of classic neurological findings

●AIM:To assess the necessity of neuroimaging in patients with neurological or atypical findings of normal tension glaucoma(NTG)who do not exhibit typical glaucoma manifestations.●METHODS:A retrospective analysis was conducted on 90 atypical NTG patients who underwent cranial magnetic resonance imaging(MRI)due to atypical symptoms.The demographic characteristics,clinical parameters,and radiological findings were recorded.●RESULTS:Among the patients,66.7%had abnormal radiology results,with the most common findings being gliosis(34.4%),sequelae of cerebrovascular events and vascular malformations(14.4%),and benign intracranial mass lesions(11%).Non-glaucomatous visual field defects were more frequently observed in patients with abnormal neuroimaging results.However,there were no significant differences in intraocular pressure,optic disc parameters,retinal nerve fiber layer thickness,and visual field indices between patients with normal and abnormal radiological results.The mean age of the patients was 58.74y.Interestingly,there was a significant age difference,with the abnormal radiology group having a higher median age(P=0.021).●CONCLUSION:The study highlights the importance of cranial imaging in older NTG patients to detect underlying pathologies and prevent misdiagnosis.It suggests that neuroimaging may be warranted in NTG patients with atypical visual field defects incompatible with glaucoma.However,routine neuroimaging in all NTG patients without classic neurological signs may not be necessary.

高度近视并发症眼底病变的研究进展

高度近视患病率逐年升高,并导致多种眼部并发症的发生,其中病理性近视成为全球不可逆性致盲性眼病的一大病因。高度近视患者视网膜灌注减少,并发生不同程度的视野缺损。高度近视对眼底造成了不可逆性的损害,导致青光眼易感性增加及近视性黄斑病变等的发生发展。因此,深入了解高度近视眼底及并发症的特点对于减缓高度近视进展、遏制其并发症的发生具有重大临床意义。本文将从高度近视眼底灌注、视野缺损以及高度近视并发症等方面详细介绍高度近视的危害性,指导临床医师早发现、早诊断、早干预高度近视及其并发症,从而减少高度近视患病率及致盲率,提高广大人民群众的视觉和生活质量。

脑卒中后视野缺损患者干预方案范围综述

目的:系统分析脑卒中后视野缺损患者干预方案的相关研究,识别、归纳及总结干预的具体内容、结局指标和干预效果,为临床实践及未来该领域研究提供参考。方法:采用范围综述研究框架,系统检索中国知网、维普数据库、万方数据库、中国生物医学文献数据库、PubMed、Web of Science、Embase、CINAHL、Cochrane Library共9个数据库。检索时限为建库至2024年4月10日。对纳入文献进行筛选、汇总和分析。结果:最终纳入12篇文献,总结脑卒中后视野缺损患者干预方法及结局指标,干预方法包括替代性干预、补偿性干预、恢复性干预等,结局指标包括日常生活活动能力、日常生活扩展活动能力、阅读表现、视野检查等。结论:目前针对脑卒中后视野缺损患者的干预方案内容多样化、证据质量较低、结局指标不统一,有待进一步开展高质量研究探索最佳训练计划和规范结局指标。未来应不断改进、优化康复策略,建立最佳的多学科结构,制定科学、系统、个性化方案。

脑动脉硬化对视交叉血供影响的形态学研究及临床意义

目的 :研究视交叉动脉起源、数量、分布及相关动脉的病理变化 ,为视交叉因缺血所致的视野缺损提供形态学依据。方法 :在体视显微镜和手术显微镜下 ,对 10 2侧成人脑标本进行观察 ,研究视交叉动脉起源、数量和分布 ,对其中年龄 5 0～ 70岁的 60侧脑标本的视交叉和相关动脉做病理切片观察。结果 :视交叉动脉主要来自颈内动脉、后交通动脉和大脑前动脉 ,其中单来源型占 48% ,双来源型占 2 7.3 % ,三来源型占 7.9%。病理切片观察动脉管壁有粥样硬化改变者 88.3 % ,其中被硬化斑块阻塞者占 5 .0 % ,部分阻塞者占 13 .3 %。小动脉阻塞相应的视交叉组织切片 ,可见有神经纤维萎缩变性。结论 :5 0岁以上出现不明原因的视野缺损 ,尤其是鼻上象限视野缺损可能是由脑动脉硬化引起视交叉血供障碍所致。

复方血栓通胶囊联合卡波金对糖尿病视网膜病变患者血清炎症因子及视野缺损的影响

目的观察复方血栓通胶囊联合卡波金对糖尿病视网膜病变患者血清炎症因子及视野缺损的影响。方法将72例糖尿病视网膜病变患者随机分为2组。对照组36例予羟苯磺酸钙片治疗,治疗组38例在对照组治疗基础上加用复方血栓通胶囊联合卡波金治疗。2组均治疗5个月后统计临床疗效,并观察2组治疗前后视野缺损、空腹血糖(FPG)、餐后2 h血糖(2h PG)、糖化血红蛋白(HbA1c)、血浆同型半胱氨酸(Hcy)、血清胱抑素C(Cys C)、超敏C反应蛋白(hs-CRP)、血清转化生长因子β1(TGF-β1)、白细胞介素-6(IL-6)及血清谷胱甘肽过氧化物酶(GSH-Px)变化情况。结果治疗组总有效率明显高于对照组(P<0.05)。2组治疗后视野灰度值、血管瘤体积均显著降低(P均<0.05);对照组治疗后出血斑面积、黄斑水肿无明显变化(P均>0.05),而治疗组均显著降低(P均<0.05);治疗组视野灰度值、血管瘤体积、出血斑面积及黄斑水肿降低程度均优于对照组(P均<0.05)。2组治疗后FPG、2h PG、HbA1c、Cys C、Hcy、TGF-β1及炎性因子hs-CRP、IL-6含量均较治疗前显著降低(P均<0.05),血清GSH-Px水平均显著升高(P均<0.05),且治疗组上述指标改善情况均明显优于对照组(P均<0.05)。结论复方血栓通胶囊联合卡波金治疗糖尿病视网膜病变疗效显著,可能与抑制炎性因子表达、降低Hcy及TGF-β1水平、升高GSH-Px水平有关。

血栓通联合羟苯磺酸钙治疗糖尿病视网膜病变导致的视野缺损

目的:探讨血栓通联合羟苯磺酸钙应用于糖尿病视网膜病变导致的视野缺损的临床疗效。方法:选取我院收治的糖尿病视网膜病变患者64例作为研究对象,将其随机均分为观察组和对照组,对照组采用血栓通进行治疗,观察组在上述治疗的基础上加用羟苯磺酸钙进行联合治疗。治疗5mo后,比较两组糖尿病视网膜病变患者的临床疗效,治疗前后视野、荧光造影及眼底照相变化情况,观察患者的不良反应及复发情况。结果:两组患者的病情均明显好转,且观察组患者治疗有效率为97%,高于对照组的78%,差异比较有统计学意义(P<0.05);观察组患者出血斑明显降低治疗前后比较有显著性差异,具有统计学意义(P<0.05),观察组的视野灰度值、出血斑、血管瘤变化情况均明显优于对照组,具有统计学意义。观察组患者未出现不良反应,且复发率明显少于对照组,复发率比较有显著性差异(P<0.05)。结论:血栓通联合羟苯磺酸钙对糖尿病视网膜病变患者进行治疗,取得了比较满意的疗效,可以有效降低复发率,减少不良反应,显著改善临床症状,可在临床上推广应用。

视交叉胶质瘤的诊断和显微外科治疗

目的探讨视交叉胶质瘤的临床表现、诊断要点、病理及治疗方案。方法回顾性分析13例经手术和病理证实的视交叉胶质瘤。结果本组占同期鞍上胶质瘤的21%;青少年病人占大多数。视力下降、视野改变为主要症状;MRI可良好显示病灶特点及肿瘤与邻近结构的关系。手术采用一侧冠状切口经额下入路和(或)经纵裂入路,囊内切除肿瘤,充分内减压;术后行常规放射治疗。病理证实视交叉胶质瘤多为毛细胞型星形细胞瘤。结论视交叉胶质瘤具有一定的临床特征,显微手术切除疗效好。

滋肾健脾化瘀方联合视网膜光凝治疗对NPDR患者视野缺损、氨基酸代谢及血清细胞因子的影响

目的：分析滋肾健脾化瘀方联合视网膜光凝治疗对非增殖型糖尿病性视网膜病变（NPDR）患者视野缺损、氨基酸代谢及血清细胞因子的影响。方法：将2012年8月-2015年8月间在广州中医药大学第一附属医院接受治疗的NPDR患者80例纳入研究,按照随机数表法分为观察组及对照组患者各40例。对照组患者接受单独视网膜光凝治疗,观察组患者接受滋肾健脾化瘀方联合视网膜光凝治疗,对比两组患者的视野缺损、氨基酸代谢及血清细胞因子水平差异。结果：观察组患者的治疗后MD、CPSD值低于对照组患者,MS值高于对照组患者（P〈0.05）;观察组患者的治疗后血清谷氨酸、精氨酸、酪氨酸、缬氨酸、异亮氨酸、亮氨酸值均低于对照组患者（P〈0.05）;观察组患者的治疗后血清s VCAM-1、s ICAM-1、VEGF、Ang-2、SDF-1值低于对照组患者,APN值高于对照组患者（P〈0.05）。结论：滋肾健脾化瘀方联合视网膜光凝治疗可以减少NPDR患者的视野缺损,在优化病情、平衡全身代谢方面具有积极作用。

和血明目片联合弥可保对青光眼患者术后视神经功能保护作用的研究

目的探讨和血明目片联合弥可保对青光眼患者术后视神经功能的保护作用。方法选择2013年7月-2015年4月收治的96例(96只眼)青光眼患者,所有患者均行小梁切除术降眼压。按照随机数字表法将患者分为对照组与观察组,每组48例(48只眼)。对照组患者参照青光眼临床路径用药进行常规治疗,观察组患者采用和血明目片联合弥可保口服治疗,7 d为1个疗程,连续治疗4个疗程。观察两组手术患者药物治疗前、治疗后28 d血压、脉搏、视力、眼压、视野、视神经纤维层厚度的变化。结果 1药物对两组患者血压、脉搏治疗前、治疗后无明显影响,比较无统计学意义(P>0.05);2观察组与对照组治疗前、治疗后视力比较差异无统计学意义(P>0.05);3治疗后两组眼压与本组治疗前比较均明显下降;4治疗后观察组视野平均缺损(MD)、模式标准差(PSD)、视野平均敏感度(MS)与对照组比较明显降低(P<0.05);5治疗后观察组患者颞侧、上方、下方视网膜神经纤维层(RNFL)厚度减厚趋势慢于对照组(P<0.05)。结论和血明目片联合弥可保可以改善青光眼患者术后的视野平均敏感度,视野平均缺损,延缓视野损害,减轻了患者术后发作后视神经纤维层水肿,延长了RNFL变薄的时间,对青光眼患者术后视神经功能具有一定的保护作用。