正常眼压性青光眼中眼压与视野间的关系

目的 :探讨正常眼压性青光眼 (normalpressureglaucoma ,NPG)的眼压、视野和相互关系。方法 :分析 98例新诊断NPG患者的眼压曲线和视野状态。结果 :眼压曲线呈单峰式波动 ,双眼对称 ,总体平均水平位于 16mmHg上下 ,波动幅度 <2mmHg。患者男性眼压均值右眼为15 70± 2 5 7mmHg、左眼为 15 46± 2 %41mmHg ,女性右眼为 16 5 2± 1 97mmHg、左眼为 16 45± 2 0 1mmHg ,眼压与年龄相关不显著 (P >0 0 5 )。患者各相应年龄组的眼压均高于正常老年人 (分别P <0 0 2 ,P <0 0 1,P <0 0 0 1)。在 98例患者 196眼的视野中 ,5 2例患者为单眼损害 ,14 4眼的视野损害在损害形态和部位上与眼压升高的原发性开角型青光眼 (hp -POAG)相符合 ,但旁中心损害侵入中心固视区者约占 2 2 2 2 %。在两眼视野损害相对轻重的划分中 ,视野损害不同分级状态下眼压的平均值、最高值和波动差二者间差异不显著 (P >0 0 2 ) ,单侧视野损害患者患眼与对侧眼眼压差异不显著 (P >0 0 5 ) ,但同侧视野损害较重且眼压较高眼数的构成比最大 ,约占 5 5 1%(P <0 0 1)。结论 :NPG患者的眼压状态在单值水平、波动幅度和双眼对称性上均与一般群体生理眼压相一致 ,但平均眼压高于年龄可比的正常老年人。视野损害特征与hp -POAG相符合 ,

The relationship between intraocular pressure and visual field in normal pressure glaucoma

Objective:To explore the relationship between intraocular pressure(IOP) and visual field(VF) in normal pressure glaucoma(NPG). Methods:98 patients with newly diagnosed NPG were recruited for this study.The diurnal IOP curves and VF were examined with the different IOP indexes. Results:The overall curvilinear patterns of the diurnal IOP curves were shown to be one-hump shaped,with binocular symmetry,the average levels around 16mmHg,and fluctuating amplitudes less than 2mmHg.There was no significant correlation between IOPs and ages in the patients(P>0.05),but the IOPs were higher in the patients than that in the general age-matched elders(P<0.05).52 of the 98 patients had the monocular damages of VF.With regard to loss patterns and loss localities,the defects of visual fields in 144 eyes were typically identical to those detected in eyes with high IOP(hp)-POAG.The paracentral damages involving the central fixation areas occrred in about 22.22% of all the eyes with visual losses.The significance was not detected in the mean values,the maximums,and the fluctuating amplitudes between the different stages characterized according to the relative bilateral severity(P>0.20).The differences were also not significant between the diseased and the contralateral eyes in the patients with monocular field losses(P>0.20).For the eyes with ipsolateral worse visual fields and higher IOPs,the proportion was the largest in about 55.1%(P<0.01). Conclusions:The NPG patients had the same IOPs as the general population in the individual values,fluctuating amplitudes,and bilateral symmetries,while the average IOPs were higher than those of the normal age-matched elders.The features of visual field defects appeared similar between patients with NPG or hp-POAG.However,the central zone involved-paracentral scotomas were common and detected in the early stage of NPG.The eyes with ipsolateral worse visual fields and higher IOPs were much more common than the eyes with unilateral worse visual fields and contralateral higher IOPs.Based upon the statistical analysis,there was no definitive relationship between field loss severity differences and IOP levels.