冷激发对原发性开角型青光眼患者视网膜 光敏感度的影响

目的研究原发性开角型青光眼(primary open angle glauc oma,POAG)患者在寒冷刺激时的视盘血流、视网膜光敏感度变化及二者的相互关系。方法33例眼压已控制的POAG患者的33只患眼和13个正常人 的13只眼纳入研究。用海德堡视网膜血流仪和Topcon计算机自动视野计测量POAG患者及正常人在基础状态和冷激发后的视盘血流及视网膜光敏感度的变化。结果POAG患者在冷激发后视盘平均血流量下降31.5，血管容积下降1.1，视网膜光敏感度下降0.78dB，均较其自身基础状态显著下降(P<0.05)，而正常对照组无此趋势。POAG患者冷激发前后的血流变化值与其视网膜光敏感度的变化密切相关(r=0.615,P＜0.001)。在冷激发时，有偏头痛病史的 POAG患者视盘血流下降幅度更大(P<0.001)。结论冷激发可使部分POAG患者的视盘血管痉挛，血流减少，视网膜光敏 感度下降。视网膜光敏感度下降程度与视盘血流减少量密切相关。(中华眼底病杂志, 2001,17:37-40)

The influence of cold provocation on retinal light sensitivity of patients with primary open-angle glaucoma

Objective To evaluate the effects of cold provocation on optic dise blood flow and retinal light sensitivity of primary open-angle glaucoma (POAG) patients,and explore the relationship between the changes of optic disc blood flow and retinal light sensitivity. Methods A total 33 POAG patients (33 eyes)and 13 normal controls (13 eyes) were tested by using the Heidelberg retinal flowmetry (HRF) and Topcon automatic perimeter,and the optic disc blood flow and retinal light sensitivity of POAG patients and normal controls were measured at normal conditions and after cold provocation. Results The mean optic disc blood flow,volume and the mean retinal light sensitivity of POAG patients decreased significantly (P<0.05) after cold provocation.There was a linear and significant relationship between the decrease of mean optic disc blood flow and mean retinal light sensitivity of POAG patients (r=0.615,P<0.001).The optic disc blood flow of POAG patients with a history of migraine were more likely to reduce in response to cold provocation and reduced much more than those without such history (P<0.05). Conclusion Cold provocation can significantly reduce both the optic disc blood flow and retinal light sensitivity in POAG patients.A close correlation was found between the amount of mean optic disc blood flow decrease and the volume of mean retinal light sensitivity decline.