蓝/黄视野计与标准白色视野计检测早期青光眼的敏感性比较

目的　探讨蓝 /黄视野计 (blue on yellowperimetry ,B/Y)又称短波视野计 (short wavelengthperimetry)及自动标准白色视野计 (white on whiteperimetry ,W/W)检测早期青光眼的敏感性。方法　采用自行改装的德国Twinfield视野计 ,对 36例 (46只眼 )早期原发性开角型青光眼患者及 38例对照组正常人 (46只眼 )进行B/Y及W/W检测 ,两组的年龄及性别相匹配。视野检查采用 2 4 2程序 ,将中心 2 5°内全视网膜光敏感度均值及各象限光敏感度均值 (dB值 )进行组间比较和分析。结果　两种视野计检测正常人 ,B/Y较W/W检测全视网膜光敏感度均值低 ,差异有显著意义 (t=3 57,P <0 0 0 1 ) ,但两者仅相差 1 63dB ;两种视野计检测的各对应象限间视网膜光敏感度均值比较 ,差异均有显著意义 (t=3 45 ,P <0 0 0 1 ) ,W/W检测的各象限视网膜光敏感度均值 >与之相对应象限的B/Y检测结果。两种视野计检测早期青光眼 ,全视网膜光敏感度均值差为 2 87dB ,差异有显著意义 (t=4 57,P <0 0 0 1 ) ;各对应象限间视网膜光敏感度均值差 >2 5dB ,差异有显著意义 (t=3 42 ,P <0 0 0 1 ) ;光敏感度均值依次为鼻下 >颞下 >鼻上 >颞上 ;以B/Y检测出的视野缺损面积大且深。按视岛 (islandofvision)矫正的偏差图 (correcteddeviation)

Short-wavelength perimetry in diagnosis of early glaucoma: comparison with standard automated perimetry

OBJECTIVE: To assess the value of short-wavelength automated perimetry in the diagnosis of early glaucoma. METHODS: Fourty-six eyes of 36 patients with early open angle glaucoma and a group of 38 normal persons (46 eyes) were examined both by the standard automated (white-on-white, W/W) perimeter and short-wavelength (blue-on-yellow, B/Y) perimeter. The age and sex in two groups were matched. The program 24 - 2 was performed on both B/Y and W/W fields in two groups. The mean light sensitivity (MS) of the central 25 degrees and in each quadrant from two perimetries was calculated and analyzed statistically by Student t-test and ASNOV. RESULTS: The difference of MS in central 25 degrees between two perimetries in normal group was 1.63 dB which showed a statistical significance of difference (t = 3.57, P < 0.001). MS was significantly higher in W/W than that in B/Y either in central 25 degrees or in each corresponding quadrant (t = 3.45, P < 0.001). The MS difference between them was more than 2.87 dB and the MS average difference of the corresponding quadrant was more than 2.5 dB (t = 4.57, 3.42, P < 0.001). MS from four quadrants were different from one other. The lowest MS was in the superior temporal, the highest MS was in inferior nasal quadrant; the superior nasal and inferior temporal were in between them. The defects in B/Y perimetry were larger and deeper than that in W/W perimetry. The result of corrected deviation points (u = 3.22, P < 0.05) was used to account the defected testing points, which showed the defected points were significantly more in B/Y perimetry than that in W/W perimetry (chi(2) = 226.72, P < 0.001). The data revealed that the defected testing points from B/Y perimetry were 2.6 times of that from W/W perimetry. In the early glaucoma group, the positive rate in the abnormal visual field from B/Y perimetry was 87% (40/46) and that from W/W perimetry, 67% (31/46). CONCLUSIONS: A good coincidence is demonstrated between B/Y and W/W perimetries both in normal and in early open angle glaucoma groups. B/Y perimetry is more sensitive than W/W perimetry in detecting early glaucomatous visual field defects. The positive rate is higher and the defects are larger and deeper in B/Y perimetry than that in W/W perimetry. Therefore, B/Y perimetry can detect glaucoma defects earlier. It is suggested that B/Y perimetry be applied in diagnosing early glaucoma.