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目的 研究原发性开角型青光眼 (primary open- angle glaucoma,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 .78d B,均较其自身基础状态显著下降(P<0 .0 5 ) ,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 .6 15 ,P<0 .0 0 1)。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 .0 0 1)。 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。
Objective To investigate the changes of optic disc blood flow and retinal light sensitivity in patients with primary open angle glaucoma (POAG) under cold stimulation and the relationship between them. Methods Totally 33 eyes of 13 POAG patients with intraocular pressure and 13 eyes of 13 normal subjects were included in the study. Heidelberg retinal blood flow meter and Topcon computer automatic perimetry were used to measure the changes of optic disc blood flow and retinal light sensitivity in POAG patients and normal subjects after basal state and cold excitation. Results In POAG patients, the average disc blood volume dropped by 31.5, the vessel volume decreased by 1.1, and the retinal photosensitivity decreased by 0.78 d B after cold excitation, both decreased significantly compared with their basal state (P <0.05), while those in the normal control group This trend. The changes of blood flow before and after cold stimulation in POAG patients were closely related to the change of retinal light sensitivity (r = 0.61, P <0.01). During the cold challenge, POAG patients with a history of migraine had a greater decrease in optic disc blood flow (P <.001). CONCLUSIONS: Cold excitation can reduce optic disk spasm, blood flow and retinal light sensitivity in some POAG patients. Retinal light sensitivity decreased with the degree of optic disc blood flow is closely related.