原发性开角型青光眼与正常人群搏动性眼血流量比较研究

目的　探讨原发性开角型青光眼 (POAG)的血流变化规律 ,及其作为诊断指标的敏感性和特异性。方法　选择POAG患者 10 0例 (10 0只眼 ) ,其中男、女各 5 0例 ,均取单眼测量。POAG诊断标准 :(1) 3次不同时间测量眼压值 >2 5mmHg(1mmHg =0 133kPa) ,眼压升高时房角开放 ;(2 ) 2 4h眼压差值 >8mmHg ;(3)典型青光眼性视乳头改变 ;(4)典型青光眼性视野缺损。正常对照者男、女各5 0例 (5 0只眼 ) ,选择条件 :(1)性别相同 ;(2 )年龄相差 <5岁 ;(3)屈光不正 ,屈光度数差异 <± 2 0 0DS。采用搏动性眼血流量 (POBF)测定仪 ,测量项目包括搏动性眼血流量、脉搏周期内眼压变化值(IOPPA)、脉率 (PR)、最大眼压值 (Max Iop)、最小眼压值 (Min IOP)、眼压均值 [(Max IOP Min IOP) /2次眼压均值 (Ave IOP) ]。青光眼组与正常对照组测定数值比较采用配对t检验 ,Ave IOP的变化值及视野检测均值和标准差与POBF的变化值做相关性分析 ;计算POBF值作为诊断指标的特异性和敏感性。结果　POAG组与正常对照组非研究因素有可比性 ,POAG组POBF值为 (9 72± 3 4 7) μl/s ,正常对照组POBF值为 (12 0 4± 4 6 8) μl/s;POAG患者的POBF、PV、PA、Ave IOP值均小于正常对照组 ,差异有显著意义 (P <0 0 5 )。视野检测均值和标准差与PO

A comparison study of pulsitile ocular blood flow in normal eyes and primary open angle glaucoma

OBJECTIVE: To compare pulsatile ocular blood flow (POBF) and intraocular pressure (IOP) in primary open angle glaucoma (POAG) and normal control group matched for age, sex and refraction error, to investigate the rule of hem-dynamics in POAG and to determine the sensitivity and specificity of POBF measurement as a diagnostic test for glaucoma. METHODS: Prior to the test a questionnaire was completed to determine age, sex, refractive error, family history of glaucoma, history of eye diseases, ocular medication, medical history and using of systemic beta-blockers. Patients of POAG were determined by following diagnostics standards: (1) Three IOP >25 mm Hg in different times of one day. (2) The fluctuate of IOP > 8 mm Hg during 24 hours. (3) Typical glaucoma changes in the visual field. (4) Typical glaucoma changes in optic disc. There were 100 POAG subjects with single eye observed (50 male and 50 female). We picked up 100 eyes randomly (50 male and 50 female) in 534 normal persons who matched for following conditions: (1) Sex. (2) Discrepancy of age less than 5 years. (3) Discrepancy of the refraction error less than +/- 2.00 DS. as the normal comparison group. The tonometer used was the POBF Tonometry. Pulse amplitude of IOP (PA), pulsatile ocular blood flow (POBF), pulse/heart rate (PR), maximum-IOP (max-IOP), minimum-IOP (min-IOP) and average IOP (aver-IOP) were obtained before the medical therapy and 1 or 2 weeks after the operation. The correlation between the POBF & mean value of the perimeter was analyzed. POBF was analyzed to determine the sensitivity and specificity of POBF measurement as a diagnostic test. RESULTS: The value of POBF in POAG and normal control was (9.72 +/- 3.47) microl/s and (12.04 +/- 4.68) microl/s, respectively. POAG patients' POBF, PV, PA, and AVE-IOP were less than those in the normal control, and the difference was statistically significant. There was no statistically significant correlation between the changes of visual field and POBF (r = 0.224, P = 0.219). The sensitivity and specificity of using the POBF for diagnosis of POAG (less than 10.75 microl/s being abnormal) were 0.422 and 0.623, respectively. CONCLUSION: Abnormal of vas-autoregulation and blood supply play a role in the pathogenesis of POA. Due to the lower sensitivity and specificity, it is not suitable to use POBF as a diagnostic test to distinguish the POAG and normal. But the POBF reflects the change of blood flow in a pulsing cycle and provide more information than the measurement of IOP only.