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目的比较自动标准白色视野计(white-on-white perimetry,W/W)和蓝/黄视野计(blue-on-bellow perimetry,B/Y)检测不同阶段青光眼视野损害的敏感性。设计横断面调查。研究对象青光眼患者42例(71眼)。方法采用HumphreyⅡ-750型自动视野计对青光眼患者进行B/Y及W/W检查。根据晚期青光眼治疗研究(Advanced Glaucoma Intervention Study,AGIS)视野评分标准,将青光眼患者分早、中、晚三组,运用青光眼首选治疗研究(collaborative initial glaucoma treatment study,CIGTS)方法,对视野缺损进行评分。比较三组不同时期青光眼应用两种视野计检查,在视野平均缺损(Mean deviation,MD)、模式标准差(Pattern Standard Deviation,PSD)、CIGTS评分方面的差异。主要指标视野的平均缺损、模式标准差、CIGTS评分。结果两种视野计检查MD的均值结果在早、中期青光眼组,B/Y检测的MD(-8.65 dB±3.89dB;-14.94 dB±3.22 dB)较W/W(-3.29 dB±2.40 dB;-10.04 dB±2.73dB)低,t=-9.21,P<0.00 1及t=-4.89,P<0.001;在晚期青光眼组,B/Y检测的MD(-22.07dB±2.64 dB)较W/W(-25.20dB±5.48 dB)高,t=3.93,P<0.001。两种视野计检查PSD的均值结果,在早期青光眼组,B/Y检测的PSD(4.17dB±1.20 dB)较W/W(3.22 dB±2.90dB)高,t=2.12,P<0.05;在中、晚期青光眼组,B/Y检测的PSD较W/W低(t=-3.04,P<0.01,t=-2.96,P<0.001)。两种视野计CIGTS评分的均值结果,在早期青光眼组,B/Y的CIGTS评分(5.35±3.83)较W/W(3.36±3.12)高,t=2.67,P<0.05);在中、晚期青光眼组,B/Y的CIGTS评分较W/W低,t-4.31,P<0.05及t=-4.02,P<0.001。结论对于早期青光眼的视野检测,B/Y较W/W敏感,但对于中晚期青光眼,W/W视野较B/Y更敏感。对于早期青光眼及可疑青光眼采用B/Y视野检测较敏感,而对于中晚期青光眼患者采用W/W视野的临床策略,能较敏感发现视野损害的进展情况。
Objective To compare the sensitivity of white-on-white perimetry (W / W) and blue-on-bellow perimetry (B / Y) in detecting glaucomatous visual field damage at different stages. Design cross-sectional survey. The study included 42 patients (71 eyes) with glaucoma. Methods The B / Y and W / W examination was performed on patients with glaucoma by HumphreyⅡ-750 automatic fluoroscopy. According to the Advanced Glaucoma Intervention Study (AGIS) field scoring criteria, glaucoma patients were divided into three groups: early, middle and late glaucoma treatment study (CIGTS) . The differences of Mean deviation (MD), Pattern Standard Deviation (PSD) and CIGTS score were compared between the three groups of glaucoma using two kinds of visual field examinations. The average loss of major indicators of vision, standard deviation of the model, CIGTS score. Results In the early and middle glaucoma groups, the mean MD of the two kinds of visual field tests was higher than that of the W / W (-3.29 dB ± 2.40 dB; B / Y MD of -8.65 dB ± 3.89 dB; -14.94 dB ± 3.22 dB; -10.04 dB ± 2.73 dB), t = -9.21, P <0.00 1 and t = -4.89, P <0.001; in the late glaucoma group, MD measured by B / Y was -22.07 dB ± 2.64 dB, W (-25.20 dB ± 5.48 dB) high, t = 3.93, P <0.001. In the early glaucoma group, PSD (4.17 dB ± 1.20 dB) was higher than that of W / W (3.22 dB ± 2.90 dB), t = 2.12, P <0.05. In the early glaucoma group, In the middle and late glaucoma group, PSD of B / Y was lower than W / W (t = -3.04, P <0.01, t = -2.96, P <0.001). In the early glaucoma group, the CIGTS score of B / Y was (5.35 ± 3.83) higher than that of W / W (3.36 ± 3.12, t = 2.67, P <0.05) In the glaucoma group, B / Y had a lower CIGTS score than W / W, t-4.31, P <0.05 and t = -4.02, P <0.001. Conclusions B / Y is more sensitive than W / W for visual field detection of early glaucoma, but W / W visual field is more sensitive than B / Y for advanced glaucoma. For early glaucoma and suspicious glaucoma using B / Y visual field detection is more sensitive, and for patients with advanced glaucoma W / W visual field clinical strategies, can be more sensitive to detect the progress of visual field damage.