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目的本文探讨晚期青光眼与早中期青光眼患者视野检测的可靠性是否存在显著性差异。方法以2002年4月至2003年12月随诊于我科的临床确诊为青光眼的患者作为研究对象,应用OCTOPUS101型视野计中G2/TOP程序对双眼进行视野检测。以每位患者有一次以上视野检查经历及裸眼视力≥0.5,瞳孔直径大于2.5mm作为入选标准。共157只眼(90位患者)入选;年龄25岁到79岁,男性29人、女性61人。结果以平均缺损指数(MD,meandefect)分组:MD≥15dB为晚期青光眼组;MD<15dB为早中期青光眼组。MD≥15dB组RF值35.73±3.69,显著高于MD<15dB组5.14±0.73(P<0.01);根据RF值进行分组:RF>15%为RF异常组;RF≤15%为RF正常组,RF异常组的MD值8.64±1.08显著高于RF正常组4.38±0.38(P<0.01)。晚期青光眼组患者假阴性率远高于早中期青光眼组。结论晚期青光眼患者视野检查的可靠性因子(RF)与早中期患者相比有显著差异,在视野损伤严重的患者,高RF值并不一定代表患者视野检查的可靠性差,相反,当青光眼损伤到一定程度,RF值随之增大,可能与损伤程度有关。高RF值来源于高的假阴性率,青光眼的加重导致假阴性率的增高。
Objective To investigate whether there is a significant difference in the reliability of visual field detection between patients with advanced glaucoma and early-middle glaucoma. Methods Patients with clinically diagnosed glaucoma who were followed up in our department from April 2002 to December 2003 were selected as the study objects. Visual field test was performed on both eyes using the G2 / TOP program of OCTOPUS101. Each patient has more than one visual field experience and uncorrected visual acuity ≥ 0.5, pupil diameter greater than 2.5mm as the inclusion criteria. A total of 157 eyes (90 patients) were enrolled; ages 25 to 79 years old, 29 males and 61 females. The results were grouped according to meandefect index (MD): MD≥15dB for advanced glaucoma group; MD <15dB for early-middle glaucoma group. The RF of MD≥15dB group was 35.73 ± 3.69, which was significantly higher than that of MD <15dB group (5.14 ± 0.73, P <0.01). According to RF group, RF> 15% was RF abnormality group; RF≤15% The MD of RF abnormal group was 8.64 ± 1.08, which was significantly higher than that of RF normal group (4.38 ± 0.38, P <0.01). False negative rates in patients with advanced glaucoma were much higher than those in early and middle glaucoma patients. Conclusions The reliability factor (RF) of visual field examination in patients with advanced glaucoma is significantly different from that of patients with early glaucoma. In patients with severe visual field injury, the high RF value does not necessarily mean that the reliability of visual field examination is poor. On the contrary, when glaucoma is damaged To a certain extent, the RF value increases, which may be related to the degree of injury. High RF values are derived from high false negative rates, and glaucomatous exacerbations lead to an increase in false negative rates.