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1.
Purpose: To evaluate the characteristics of patients with previously undiagnosed primary open-angle glaucoma (POAG) in Korea.

Methods: This study examined data from 391 subjects obtained from the 2008–2009 Korean National Health and Nutrition Examination Survey (KNHANES). The KNHANES is a population-based, cross-sectional epidemiological survey. Participants aged 19 years or older completed standardized interviews and dilated ocular examinations, including measurement of intraocular pressure, visual fields with frequency doubling perimetry, and fundus photography. Data from the 361 patients with previously undiagnosed POAG were analyzed and compared with data from the 30 patients with previously diagnosed glaucoma.

Results: A total of 92.3% of POAG cases were undiagnosed before this study. Adjusted for age and sex, the strongest risk factor for undiagnosed glaucoma was longer elapsed time since last eye doctor visit. Glaucoma patients who had not visited an eye specialist in the last 3 years were 22 times (95% confidence interval, CI, 4.49–105.64, p < 0.001) more likely to have undiagnosed disease compared with patients who had visited an eye specialist in the last month. Another significant factor for previously undiagnosed glaucoma was smaller cup-to-disc ratio (odds ratio, OR, 0.60/0.1 units, 95% CI 0.43–0.85/0.1 units, p = 0.004). The higher vertical cup-to-disc ratio of a subject’s two eyes was significantly different between those with previously undiagnosed (0.69) and diagnosed (0.78) POAG (p = 0.001).

Conclusions: The undiagnosed POAG group had a longer interval from last eye doctor visit and smaller vertical cup-to-disc ratio compared to the diagnosed group.  相似文献   


2.
PurposeTo investigate the relationship between intereye visual field defect (VFD) asymmetry and subsequent VF progression in primary open-angle glaucoma (POAG).MethodsModerate-stage patients with POAG (226 eyes of 113 patients) with a single hemifield defect were followed for 8.7 years. Participants were categorized into three groups by initial VF pattern: (1) unilateral VFD, (2) bilateral VFD within same hemifield (superior–superior, inferior–inferior), (3) bilateral VFD within opposite hemifield (superior–inferior). The mean deviation (MD) difference between the intereye was defined as the intereye MD asymmetry index (iMAI). Intereye visual-sensitivity difference within the same hemifield was calculated as the intereye hemifield visual-sensitivity asymmetry index. Functional progression was detected by Glaucoma Progression Analysis. The overall rate of MD change and the association between new indices were evaluated by linear regression. A Kaplan-Meier survival analysis was performed and the factors associated with glaucoma progression were evaluated by Cox proportional hazard modeling.ResultsUnilateral VFD eyes and bilateral VFD eyes within opposite VF hemifield showed significant progression and faster rate of MD change compared with bilateral VFD eyes within same VF hemifield (71.1% vs. 45.9% vs. 21.1% [P = 0.001]; –1.27 dB/y vs. −0.64 dB/y vs. −0.32 dB/y [P = 0.001]). Unilateral VFD eyes showed the fastest time to VF progression compared with other groups (P = 0.002). A faster rate of MD change was associated with greater intereye MD asymmetry index (P = 0.001) and greater intereye hemifield visual-sensitivity asymmetric index (P = 0.031), which were significant risk factors for glaucoma progression (all P < 0.001).ConclusionsAmong POAG eyes with comparable hemifield VFDs, eyes without a corresponding hemifield defect in the fellow eye showed faster rates of progression compared with those with a corresponding hemifield defect.  相似文献   

3.
目的:观察具有准分子激光角膜屈光手术(简称准分子术)史的开角型青光眼患者的临床特征。方法:回顾 性病例研究。纳入2005─2018年北京大学第三医院眼科中心就诊、具有准分子术史且随访2年以上的 开角型青光眼患者。记录一般情况以及特殊检查结果,选取每例视野较差的眼或双眼相似者随机1眼 作为研究眼。对视野进展分析采用非参数分析(NPA)法。采用独立样本t检验及秩和检验进行分析。结果: 共纳入33例患者,青光眼确诊均在准分子术后,手术至青光眼确诊间隔(10.3±6.1)年,确诊时年龄 (37.5±10.4)岁,最高眼压<21 mmHg(1 mmHg=0.133 kPa)者27例(82%);中央角膜厚度为(456±47)μm。 眼底照相显示视网膜神经纤维层缺损18例(55%),无法辨认的15例(45%);杯/盘比为0.7±0.1。视 野平均缺损(MD)绝对值小于6的有18例(55%),6~12有8例(24%),12以上有7例(21%)。其中随 访2年以上21例,随访时间为(4.5±2.2)年;视野进展13例(62%),视野进展速度为(0.5±0.6)dB/年。 视野进展组与非进展组治疗后降眼压幅度分别为(28.3±20.7)%和(15.4±11.0)%(t=-1.867,P=0.078), 屈光回退发生率分别为92%和25%(P=0.003)。21例中屈光回退14例(64%),屈光回退组中12例 (12/14)视野进展,无回退组中1例视野进展(1/7)(P=0.003);屈光回退组的视野进展[(0.7±0.7)dB/年] 快于无回退组[(0.1±0.1)dB/年](t=-2.899,P=0.011)。结论:准分子术后的青光眼患者确诊时大多 处于病情早中期,4/5患者眼压在21 mmHg以下,通过眼底照相能明确视网膜神经纤维层缺损的只 占一半病例。随访中约2/3患者视野恶化,可能与屈光回退有关。  相似文献   

4.
PurposeTo demonstrate the clinical characteristics of juvenile-onset open angle glaucoma (JOAG) and to evaluate the prognostic factors for visual field (VF) progression in eyes with JOAG.MethodsThe medical records of 125 eyes of 72 patients with JOAG were analyzed retrospectively. At least four reliable VF tests were required to determine the VF progression, and the progression was defined using the modified Anderson criteria. Comparisons in clinical manifestations among groups were performed using independent t-test, and generalized estimating equations were also conducted.ResultsThe mean follow-up duration was 94.4 ± 50.5 months. Patients with JOAG showed a male preponderance (64 %), myopia (−4.99 ± 4.01 diopters) and a severe elevation of intraocular pressure (35.6 ± 10.8 mmHg). Forty-two JOAG patients (58 %) had complained of symptoms associated with vision and pain; however, one-third presented with no definite symptoms. Fifty-seven patients were diagnosed with JOAG in both eyes, and they were significantly older (p = 0.039) and had a greater family history (p = 0.035) than patients with unilateral JOAG. The progression group exhibited a significantly higher intraocular pressure at the last visit (p = 0.023) than the non-progression group.ConclusionsBecause patients with considerable JOAG had no definite symptoms, periodic eye examinations are needed. To prevent the VF''s progression, JOAG patients may require more careful management of intraocular pressure.  相似文献   

5.
Purpose To assess prospectively the relationship between nocturnal blood pressure reduction (dip) and progression of the visual field defect in patients with normal-tension glaucoma (NTG) or primary open-angle glaucoma (POAG).Patients and Methods The subjects studied were 38 patients with glaucoma (23 patients with NTG, 15 patients with POAG), in whom 48-h ambulatory blood pressure monitoring was conducted, who were followed for at least 4 years, and in whom reliable visual field tests were performed at least 5 times. The progression was determined by the mean deviation (MD) slope analysis system installed in the Humphrey field analyzer Statpac program. Glaucoma patients with a dip of <10% were assigned to the nondipper group, those with a dip of 10%–20% to the tipper group, and those with a dip of >20% to the extreme dipper group. The dipper group was defined as physiologic dippers, while the nondipper and the extreme dipper groups were defined as nonphysiologic dippers, to study the relationship between the disturbance of the dip and progression of the visual field defect.Results Thirteen patients showed significant progression, while 25 patients did not. There were no significant differences in the mean intraocular pressure and follow-up period between the patients with progression and those without progression. Half (7/14) of the nondippers, 20% (4/20) of the dippers, and 50% (2/4) of the extreme dippers showed progression, indicating a tendency of progression in the nondipper and the extreme dipper groups. The nonphysiologic dippers had a higher incidence of progression compared with the physiologic dippers (P = 0.05). Among the glaucoma patients in the nondipper and dipper categories only, those with progression had significantly smaller dips (P = 0.02).Conclusion These results suggest that disturbance in the physiologic dip may be involved in the progression of glaucoma. Jpn J Ophthalmol 2004;48:380–385 © Japanese Ophthalmological Society 2004  相似文献   

6.
Purpose: To study the features of the motion perception (MP) and explore the worth of the clinical application of MP test in primary open angle glaucoma (POAG).Methods: MPs were recorded from 41 patients (67 eyes) with POAG ang 56 normal subjects (112 eyes) by the MP software in PC compatible computer. Meanwhile , the MP ways and MP sites were analyzed and MP abnormal rate was compared to the clinical parameters and the visual function indices related to glaucoma. . Results: The results showed that the total abnormal rate of MP was 89. 5% in POAG, and the abnormal rate was 81. 6% in early stage of POAG, and MP abnormal degree had positive correlation with C/D, ocular tension and corrected loss variance (CLV), and negative correlation with visual acuity and mean sensitivity (MS), and no correlation with age and short-term fluctuation (SF) in the patients with POAG.Concusion: These results suggest that the MP test provides a newly effctive examination method in diagnosing the early POAG. Eye Science 1996;  相似文献   

7.
目的:探讨急性原发性闭角型青光眼(APACG)不同病程视野损害的特点及其影响因素。方法:病例对照研究。连续收集2015年9月至2016年9月于中山大学中山眼科中心确诊为APACG的患者。根据临床特征将患眼分为临床前期组、药物缓解期组、慢性期组,根据APACG急性发作持续时间将药物缓解期组及慢性期组患者分为急性发作持续时间7 d以内组及7 d以上组。选择同期在门诊体检者中年龄、性别相匹配的健康成年人作为正常对照组。记录所有对象临床特征,使用Humphrey 750型视野分析仪30-2 SITA-Standard标准阈值程序进行视野检查。比较各组间临床特征和视野检查结果,并分析眼压、杯盘比(C/D)、房角粘闭范围、急性发作时最高眼压、急性发作持续时间与视野平均偏差(MD)、视野指数(VFI)、模式标准差(PSD)等的相关性。采用卡方检验、独立样本t检验、方差分析、秩和检验及Spearman相关分析进行数据分析。结果:共纳入正常对照组20例(20眼),APACG患者74例(74眼),其中临床前期组24例,药物缓解期组28例,慢性期组22例。4组间VFI值和MD值总体差异有统计学意义(F=60.588、61.018,P < 0.001),组间两两比较发现慢性期组MD值和VFI值显著小于其他3组(P < 0.008),药物缓解期组MD值和VFI值显著小于正常对照组(P < 0.008)。4 组间PSD值总体差异有统计学意义(F=60.022,P < 0.001),组间两两比较发现慢性期组的PSD值均显著大于其他3组(P < 0.008),临床前期组和药物缓解期组PSD值均显著大于正常对照组(P < 0.008)。药物缓解期组MD值、VFI值与急性发作持续时间均呈中度负相关(r=-0.653,P < 0.001;r=-0.547,P=0.003),PSD值与急性发作持续时间呈中度正相关(r=0.579,P=0.001);慢性期组MD值、VFI值与急性发作持续时间呈中度负相关(r=-0.441,P=0.044;r=-0.531,P=0.011),与C/D呈中度负相关(r=-0.632,P=0.002;r=-0.633,P=0.002)。药物缓解期组急性发作持续时间7 d以内者的MD值和VFI值均大于急性发作持续时间7 d以上者(Z=-2.998,P=0.003;Z=-2.639,P=0.008)。结论:APACG急性发作后,药物缓解期组和慢性期组存在视野损害,且慢性期组视野损害较重。视野损害主要与急性发作持续时间有关。  相似文献   

8.
目的:探讨原发性开角型青光眼(POAG)非对称性视野损害的相关因素,并了解非对称性视野损害者双眼间眼部参数的差异。方法:横断面研究。收集2014年1月至2018年12月温州青光眼进展研究 (WGPS)中确诊的POAG患者,分析双眼眼部参数,包括眼压、眼轴长度(AL)、中央角膜厚度(CCT)、 前房深度(ACD)、晶状体厚度(LT)、视野平均偏差(MD)、视网膜神经纤维层厚度(RNFLT)、盘沿 面积、视盘面积、杯盘比、视杯容积。非对称性视野损害定义为双眼视野MD的绝对差值≥5 dB, 根据此标准将受检者分为对称组和非对称组,分析2组眼部参数与非对称性视野损害的关系。非对称组进一步行双眼间眼部参数的比较。采用独立样本t检验、Mann-Whitney U检验、配对t检验、 Wilcoxon检验、Logistic回归分析对数据进行分析。结果:共纳入POAG患者142例(284眼),对称组 92例(64.8%),男39例(42.4%),年龄(65.3±1.0)岁;非对称组50例(35.2%),男32例(64.0%),年 龄(67.6±9.1)岁。男性[OR=4.52,95%可信区间(CI):1.90~10.73,P=0.001]、较差眼的CCT较薄 (OR=0.97,95%CI:0.95~0.99,P=0.003)、双眼平均RNFLT差值增大(OR=1.10,95%CI:1.04~1.15, P<0.001)为非对称性视野损害的危险因素。非对称组中,视野损害较重眼相比对侧眼,其平均 RNFLT较薄(Z=-7.80,P<0.001),盘沿较窄(t=-4.97,P<0.001),视盘面积较大(t=2.38,P=0.02), 平均杯盘比(Z=-4.51,P<0.001)和垂直杯盘比(Z=5.16,P<0.001)均较大,视杯容积较大(Z=-3.31, P<0.001),但双眼间眼压、等效球镜度(SE)、AL、CCT、LT和ACD的差异均无统计学意义。结论:男性、CCT较薄、双眼平均RNFLT差值增大为POAG非对称性视野损害的独立危险因素,而非对称性视野损害者其双眼中的较大视盘眼,更容易发生视神经损害。  相似文献   

9.
10.
Background: To describe the long‐term outcomes of trabeculectomies performed at Dunedin Hospital and followed in the Otago Glaucoma Surgery Outcome Study. Methods: Prospective non‐comparative case series of 841 eyes of 607 patients who had first trabeculectomies for primary open‐ or closed‐angle glaucoma at Dunedin Hospital between 1976 and 2005 and followed for a mean of 7.5 years (standard deviation 6.0). Results: The probability of a trabeculectomy controlling the intraocular pressure at 21 mmHg or less at 1, 10 and 20 years was 0.96 (95% confidence interval [CI] 0.95, 0.97), 0.86 (95% CI 0.83, 0.89) and 0.79 (95% CI 0.74, 0.83), respectively. Visual acuity was maintained or improved between preoperative assessment and final follow up in 68% of cases. The probability of not being blind following trabeculectomy at 1, 10 and 20 years was 0.98 (95% CI 0.96, 0.98), 0.83 (95% CI 0.80, 0.87) and 0.70 (95% CI 0.64, 0.76), respectively. The proportion of those with glaucomatous field loss increased during follow up from 16% (44/283) at 0–5 years to 50% (10/20) for those with 21 or more years of follow up. A repeat drainage procedure was required in 65 eyes (8%) (56 Molteno implant insertions and 9 repeat trabeculectomies). Conclusions: Intraocular pressure was well controlled by trabeculectomy; however, a steady decline in intraocular pressure control, visual acuity and visual field occurred during follow up.  相似文献   

11.
Purpose: Alcohol intake reduces intraocular pressure, a risk factor for primary open-angle glaucoma (POAG). We investigated whether alcohol consumption is associated with a reduced risk of POAG. Methods: We followed female nurses from 1980 and male health professionals from 1986 to 2002. Eligible participants were 40+ years old, did not have POAG, and reported receiving eye examinations during follow-up. Information on alcohol consumption, potential confounders and POAG diagnoses were updated by using biennial questionnaires. We identified 856 self-reported POAG cases that were confirmed with medical record review. Cohort-specific and pooled analyses across cohorts were conducted to calculate multivariable rate ratios (RR) of POAG. Results: Alcohol consumption < 30 g/day did not influence POAG risk: compared with non-drinkers, the pooled RRs were 0.99 (95% Confidence Interval [CI]: 0.83–1.19) for drinking < 10 g/day, 0.96 (95% CI: 0.76–1.22) for 10–19 g/day, and 0.95 (95% CI: 0.68–1.33) for 20–29 g/day. Although there were suggestive inverse associations with drinking > 30 g/day (RR = 0.71), this was not significant (95% CI: 0.49–1.04), and no significant linear associations were detected. Risks of POAG did not differ by type of alcoholic beverage consumed. To evaluate the potential for detection bias, we controlled for additional factors, such as frequency of eye exams, but results were similar. Conclusion: In this large prospective study of men and women, alcohol consumption did not influence the risk of POAG.  相似文献   

12.
青睫综合征与原发性开角型青光眼   总被引:5,自引:0,他引:5  
报告29例青睫综合征患者,全部作角膜内皮、前房角、视野、杯盘比、视网膜神经纤维层检查,其中25例亦作VEP检查。结果表明:青睫综合征并不是一种预后良好的自愈性疾病,而是一种可造成青光眼性视功能损害的疾病。它是否与原发性开角型青光眼有联系有待研究。  相似文献   

13.
Zehong  Wang  Lezheng  Wu 《眼科学报》1997,13(3):128-132
Purpose: To objectively evaluate the clinical application of color pattern reversal visual e-voked potential (CPR-VEP) on primary open angle glaucoma (POAG). Methods: CPR-VEP and FM 100-hue test were performed in 31 eyes with POAG and 33 normal eyes. Color pattern stimulation was presented by color monitor controlled by computer program. The reversal rate of the stimulating pattern was 2 Hz and the spatial frequency of the stimulating was 0.53 cycle/degree. The color stimulating pattern include White /Black , Red/Black , Green/Black , Blue/Black , Yellow /Black , Red/Green and Blue /Yellow . Results : CPR-VEP P1 latencies were obviously prolonged in POAG group in comparison with normal control group in equiluminance. All CPR-VEP P1 amplitudes, except Blue/Black P1 amplitude, show no differences between POAG group and normal control group . Conclusion: P1 latencies of all CPR-VEP and P1 amplitude of Blue/Black CPR-VEP were parameters for identifing acquired dyschromatopsia caused by POAG. The results sho  相似文献   

14.
Background: Glaucoma is a sight‐threatening disease affecting 3% of the population over the age of 50. Glaucoma is treatable, and severe vision loss can usually be prevented if diagnosis is made at an early stage. Genetic factors play a major role in the pathogenesis of the condition, and therefore, genetic testing to identify asymptomatic at‐risk individuals is a promising strategy to reduce the prevalence of glaucoma blindness. Furthermore, unravelling genetic risk factors for glaucoma would also allow a better understanding of the pathogenesis of the condition and the development of new treatments. Design: The Australian and New Zealand Registry of Advanced Glaucoma is a prospective study that aims to develop a large cohort of glaucoma cases with severe visual field loss to identify novel genetic risk factors for glaucoma blindness. Methods: Clinical information and blood are collected from participants after referral by eye practitioners. Samples are collected across Australia and New Zealand using postage kits. Participants: Our registry has recruited just over 2000 participants with advanced glaucoma, as well as secondary and developmental glaucomas. Results: A positive family history of glaucoma is present in more than half of the advanced glaucoma cases and the age at diagnosis is significantly younger for participants with affected relatives, which reinforces the involvement of genetic factors in glaucoma. Conclusions: With the collection of glaucoma cases recruited so far, our registry aims to identify novel glaucoma genetic risk factors to establish risk profiling of the population and protocols for genetic testing.  相似文献   

15.
开角型与闭角型青光眼色觉异常的对比研究   总被引:2,自引:0,他引:2  
采用FM100-色彩有试验,对开角型与闭角型青光眼色觉损害的情况进行了对比观察,结果发现,两类青光眼色彩分辨力的损害,无论在波长区域或程度上,均无明显差异,认为眼压升高是引起色觉异常的始发因素,据此可以对两类青光眼色觉损害的相似性作出较为满意的解释。  相似文献   

16.
目的:探讨多焦视网膜电图(mfERG)技术用于诊断原发性开角型青光眼(POAG)的准确性及实效性。方法:系列病例研究。于2014 年10 月至2016 年3 月在云南省第一人民医院门诊就诊并确诊的POAG患者中随机选取60例(86眼)作为青光眼组,其中早、中、晚期组分别为20例(27眼)、20例(29眼)、20 例(30 眼)。同时随机选取同期健康体检者60 例(120 眼)作为对照组。各组研究对象分别通过mfERG进行技术诊断,观察比较mfERG二阶反应各环与各象限的P1 波反应密度值及潜伏期。组间数据比较采用单因素方差分析和 χ2检验。结果:与对照组相比,早期青光眼组1~5环的P1波反应密度值无明显变化,差异无统计学意义,但颞下、颞上象限P1波反应密度值下降明显,差异有统计学意义(P < 0.05)。中期青光眼组2~5环及4个象限P1波反应密度值较对照组下降明显,差异均有统计学意义(P < 0.05)。晚期青光眼组1~5环及4个象限P1波反应密度值较对照组明显下降,差异均有统计学意义(P < 0.05)。早、中、晚期青光眼组1~5环及4个象限P1波的潜伏期均较对照组延长,差异均有统计学意义(P < 0.05)。各期青光眼组中,晚期青光眼组较早期青光眼组潜伏期延长更明显,差异有统计学意义(P < 0.05)。结论:mfERG 1~5 环P1波潜伏期和密度值的变化可在一定程度上反映青光眼视网膜的损害程度,对诊断早期POAG有一定的临床价值。  相似文献   

17.
原发性开角型青光眼和正常眼压性青光眼危险因素的研究   总被引:4,自引:1,他引:3  
目的:探讨原发开角型青光眼(POAG)和正常眼压性青光眼(NTG)发病相关的危险因素。方法:对592例(1156眼)原发开角型青光眼和53例(100眼)正常眼压青光眼患者进行眼科常规检查,视野检查,屈光,血糖,血压检测,家庭史及药物史和全身病调查,结果:NTG组与POAG组相比较,在患病年龄的分布上有差异:POAG组以20-40岁年龄最常见,而NTG组以50-60岁年龄最常见;两组患者均有较高的近视患病率(POAG组为42.1%,NTG组为66.04%),NTG组低血压患病率67.92%),阳性家族史为20.75%,两者均明显高于POAG组,差异有显著性,结论:年龄,近视,低血压,青光眼家族史可能是POAG和NTG发病的重要因素。  相似文献   

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青光眼是一种视神经病变,是全球不可逆性失明的主要原因,其发病机制目前尚不完全清楚。近年 来,随着全基因组关联研究(GWAS)、家系研究和功能学研究的深入,人们对青光眼的分子基础和 复杂性的认识也有了较大的进展。原发性开角型青光眼(POAG)占全世界青光眼病例的70%左右, 且患病率一直在增加。POAG具有明显的遗传特征,但因其遗传方式复杂,仅有约10%的病例表现 为典型的孟德尔单基因遗传模式,其他的则可能是多个遗传因素的相互影响,或者是遗传因素和环 境因素共同作用的结果。目前已明确与青光眼直接相关基因达30余个,其编码蛋白参与了广泛的细 胞进程和生物系统,包括细胞外基质、细胞因子信号转导、脂质代谢、膜生物学、细胞分化、自噬和 眼发育的调节等生物学进程。本综述拟从内质网应激反应、肿瘤坏死因子-α信号通路与自噬调节、 TGF-β信号通路等几个重要的生物学角度来深入认识青光眼与基因之间的内在关联,进一步明确其 可能的发病机制。  相似文献   

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钟一声  叶纹  骆训达 《眼科学报》2004,20(4):213-218
目的:研究单眼视野已严重缺损的慢性青光眼患者对侧眼视野缺损情况,并分析其视野缺损的相关危险因素。方法:对47例单眼视野已严重缺损(视野缺损计分≥12分)的慢性青光眼患者[原发性慢性闭角型青光眼(primary chronic angle-closed glaucoma,PACG)23例和原发性开角型青光眼(primary openangle glaucoma,POAG)24例]的对侧眼视野进行视野缺损计分,分析对侧眼视力、最高眼压和平均眼压、年龄、屈光度、诊断、病程、性别及抗青光眼手术与否与对侧眼视野缺损计分的关系。应用Spearman相关分析分析上述因素与对侧眼视野缺损计分的相关性。结果:23例PACG患者中,对侧眼视野缺损情况为:无视野缺损者(计分为0分)4例,轻度视野缺损者(计分为1~5分)5例,中度视野缺损者(计分为6~11分)7例,严重视野缺损或终末期视野缺损者(计分为12~20分)7例。24例POAG患者中,对侧眼视野缺损情况为:轻度视野缺损者(计分为1~5分)4例,中度视野缺损者(计分为6~11分)9例,严重视野缺损或终末期视野缺损者(计分为12~20分)11例。PACG患者病程大于或等于10年...  相似文献   

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