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目的研究老年原发性青光眼低对比度视力的变化特点及与海德堡视网膜断层成像仪Ⅱ型(HRT-Ⅱ)颞侧盘沿参数的相关性。方法选择老年原发性青光眼患者45例(83眼),根据视野结果分为早期组21例(40眼)和中晚期组24例(43眼);正常对照组23例(40眼)。对3组受试者行屈光矫正后,采用多功能视力测量仪测得100%、25%、10%和5%4个对比度视力,分析比较各组低对比度视力有无统计学差异及青光眼组各低对比度视力与HRT-Ⅱ测得的颞侧盘沿面积(RA)、盘沿容积(RV)有无相关性。结果 3组间25%、10%及5%对比度视力总体比较差异有统计学意义(P<0.05);早期组与正常对照组各低对比度视力比较差异无统计学意义(P>0.05);中晚期组各低对比度视力较正常对照组和早期组均下降(P<0.05),10%、5%低对比度视力与颞侧RA呈负相关(r=-0.361;r=-0.318,P均<0.05)、与颞侧RV呈负相关(r=-0.303;r=-0.377,P均<0.05)。结论老年原发性青光眼病情进展导致低对比度视力下降,中晚期患者10%、5%低对比度视力与颞侧盘沿参数RA、RV有相关性,对比度视力检查可以对老年中晚期青光眼中心视功能的病情评估和监测提供依据。
Objective To investigate the changes of low contrast visual acuity in elderly primary glaucoma and its correlation with temporal hemodynamic parameters of HRT-II. Methods Forty-five patients (83 eyes) with primary primary glaucoma were divided into two groups according to the field of vision: 21 cases (40 eyes) in the early stage and 24 eyes (43 eyes) in the middle and late stage, and 23 eyes (40 eyes) in the normal control group. Three groups of subjects after refractive correction, the use of multi-functional visual acuity meter measured 100%, 25%, 10% and 5% of 4 contrast visual acuity, analysis and comparison of low contrast visual acuity in each group was statistically significant and glaucoma Group of low contrast visual acuity and HRT-Ⅱ measured temporal disk area (RA), disk volume (RV) whether the correlation. Results The total visual acuity of 25%, 10% and 5% of the 3 groups were significantly different (P <0.05). There was no significant difference in the low contrast visual acuity between the early group and the normal control group (P> 0.05) Compared with the normal control group and the early group, the low contrast visual acuity in the late stage group was significantly lower than that in the normal control group and the early stage group (P <0.05). The visual acuity of 10% and 5% low contrast group was negatively correlated with temporal RA (r = -0.361; r = -0.318, 0.05), but negatively correlated with temporal RV (r = -0.303; r = -0.377, all P <0.05). Conclusions The progress of senile primary glaucoma leads to the decrease of visual acuity of low contrast. The visual acuity of 10% and 5% of the middle-advanced patients is correlated with the temporoparietal parameters RA and RV. The contrast visual acuity examination can evaluate the central visual function Provide a basis for the assessment and monitoring of the condition.