目的分析年轻可疑青光眼的临床特征以指导临床早期诊断。方法 54例(108眼)≤30岁年轻可疑青光眼患者,分析年龄、性别、症状、眼压和眼底、房角、屈光度、视野、光学相干断层扫描(OCT)结果及确诊情况。结果年轻可疑青光眼男女比例1.57︰1...目的分析年轻可疑青光眼的临床特征以指导临床早期诊断。方法 54例(108眼)≤30岁年轻可疑青光眼患者,分析年龄、性别、症状、眼压和眼底、房角、屈光度、视野、光学相干断层扫描(OCT)结果及确诊情况。结果年轻可疑青光眼男女比例1.57︰1;就诊年龄7~30岁;仅1例有家族史;14例(25.93%)患者伴有眼部症状。所有患者中单纯高眼压型[眼压>21 mm Hg(1 mm Hg=0.133 kPa)]占53.70%(29/54),单纯杯盘比(C/D)异常占18.52%(10/54),两者兼有占27.78%(15/54);近视69眼(63.89%);全部房角开放;视野异常29眼(26.85%);OCT异常39眼(36.11%);排除青光眼21例(38.89%),确诊为开角型青光眼8例(14.81%)。结论年轻可疑青光眼患者发病隐匿,绝大部分症状不典型或无症状,合并近视的患者较多,年轻患者一定要重视眼压和眼底的检查,特别对于屈光不正、视力下降和有危险因素的患者不要忽视行视野和OCT进行详细的排查和密切随访。展开更多
Purpose: To assess whether baseline retinal nerve fiber layer (RNFL) measurements obtained with a scanning laser polarimeter, the GDx Nerve Fiber Analyzer, (Laser Diagnostic Technologies Inc., San Diego, California) a...Purpose: To assess whether baseline retinal nerve fiber layer (RNFL) measurements obtained with a scanning laser polarimeter, the GDx Nerve Fiber Analyzer, (Laser Diagnostic Technologies Inc., San Diego, California) are predictive of development of repeatable glaucomatous visual field damage in glaucoma suspect eyes. Design: Cohort study. Methods: Participants were recruited from the UCSD longitudinal Diagnostic Innovations in Glaucoma Study (DIGS). One eye from each of 160 glaucoma suspects with normal standard automated perimetry (SAP) visual fields at baseline was studied. Study eyes were divided into convert and nonconvert groups based on the development of three consecutive glaucomatous visual fields during follow- up. SLP parameters, IOP, vertical cup disk ratio, stereophotograph assessment as glaucoma or normal, corneal thickness, and visual field indices were included in univariate and multivariate Cox proportional hazards models to determine which SLP RNFL and ocular parameters were predictive of visual field conversion. Results: Sixteen (10% )- eyes developed repeatable visual field damage (converts) and 144 (90% ) did not (nonconverts). Mean (95% CI) follow- up time until visual field conversion for convert eyes was 2.7 (1.7, 3.6) years. Mean total follow- up of nonconvert eyes was 3.8 (3.5, 4.1) years. Four out of thirteen examined baseline SLP parameters and baseline SAP Mean Deviation (MD), SAP Pattern Standard Deviation (PSD), and glaucomatous stereophotograph assessment were significant univariate predictors of visual field conversion. In multivariate models adjusted for age, IOP and CCT, SLP parameters inferior ratio, ellipse modulation, and UCSD linear discriminant function (LDF)were significant predictors of visual field conversion. When SAP PSD and stereophotograph assessment were also included in the multivariate model inferior ratio and UCSD LDF remained independently predictive of visual field loss. Conclusions: Thinner baseline SLP RNFL measurements were independent predictors of visual field damage. In addition to thinner SLP RNFL measurements, higher baseline SAP PSD, and baseline glaucomatous stereophotograph assessment each contributed to an increased risk of the development of abnormal visual fields in glaucoma suspect patients. SLP RNFL measurements were independently predictive of future visual loss even when age, IOP, CCT, vertical cup disk ratio, and SAP PSD were included in the model.展开更多
文摘目的分析年轻可疑青光眼的临床特征以指导临床早期诊断。方法 54例(108眼)≤30岁年轻可疑青光眼患者,分析年龄、性别、症状、眼压和眼底、房角、屈光度、视野、光学相干断层扫描(OCT)结果及确诊情况。结果年轻可疑青光眼男女比例1.57︰1;就诊年龄7~30岁;仅1例有家族史;14例(25.93%)患者伴有眼部症状。所有患者中单纯高眼压型[眼压>21 mm Hg(1 mm Hg=0.133 kPa)]占53.70%(29/54),单纯杯盘比(C/D)异常占18.52%(10/54),两者兼有占27.78%(15/54);近视69眼(63.89%);全部房角开放;视野异常29眼(26.85%);OCT异常39眼(36.11%);排除青光眼21例(38.89%),确诊为开角型青光眼8例(14.81%)。结论年轻可疑青光眼患者发病隐匿,绝大部分症状不典型或无症状,合并近视的患者较多,年轻患者一定要重视眼压和眼底的检查,特别对于屈光不正、视力下降和有危险因素的患者不要忽视行视野和OCT进行详细的排查和密切随访。
文摘Purpose: To assess whether baseline retinal nerve fiber layer (RNFL) measurements obtained with a scanning laser polarimeter, the GDx Nerve Fiber Analyzer, (Laser Diagnostic Technologies Inc., San Diego, California) are predictive of development of repeatable glaucomatous visual field damage in glaucoma suspect eyes. Design: Cohort study. Methods: Participants were recruited from the UCSD longitudinal Diagnostic Innovations in Glaucoma Study (DIGS). One eye from each of 160 glaucoma suspects with normal standard automated perimetry (SAP) visual fields at baseline was studied. Study eyes were divided into convert and nonconvert groups based on the development of three consecutive glaucomatous visual fields during follow- up. SLP parameters, IOP, vertical cup disk ratio, stereophotograph assessment as glaucoma or normal, corneal thickness, and visual field indices were included in univariate and multivariate Cox proportional hazards models to determine which SLP RNFL and ocular parameters were predictive of visual field conversion. Results: Sixteen (10% )- eyes developed repeatable visual field damage (converts) and 144 (90% ) did not (nonconverts). Mean (95% CI) follow- up time until visual field conversion for convert eyes was 2.7 (1.7, 3.6) years. Mean total follow- up of nonconvert eyes was 3.8 (3.5, 4.1) years. Four out of thirteen examined baseline SLP parameters and baseline SAP Mean Deviation (MD), SAP Pattern Standard Deviation (PSD), and glaucomatous stereophotograph assessment were significant univariate predictors of visual field conversion. In multivariate models adjusted for age, IOP and CCT, SLP parameters inferior ratio, ellipse modulation, and UCSD linear discriminant function (LDF)were significant predictors of visual field conversion. When SAP PSD and stereophotograph assessment were also included in the multivariate model inferior ratio and UCSD LDF remained independently predictive of visual field loss. Conclusions: Thinner baseline SLP RNFL measurements were independent predictors of visual field damage. In addition to thinner SLP RNFL measurements, higher baseline SAP PSD, and baseline glaucomatous stereophotograph assessment each contributed to an increased risk of the development of abnormal visual fields in glaucoma suspect patients. SLP RNFL measurements were independently predictive of future visual loss even when age, IOP, CCT, vertical cup disk ratio, and SAP PSD were included in the model.
