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[摘要]
目的:研究MP-1(microperimetry-1)微视野检测、短波长/蓝黄视野(short-wavelength auto-mated perimtry/blue-on-yellow perimetry,SWAP/B-YP)检测、标准白/白( white-on-white perimetry,W-W)视野检测在青光眼的现代临床综合检测中取得的视盘形态参数与生理盲点视野变异间的相关性。
方法:随机对我科门诊39例78眼正常体检者(均为我部军人)、59例118眼早期青光眼患者、25例50眼中期青光眼患者均采用HUMPHREY Ⅱ-750全自动全视野仪检测W-W与SWAP/B-YP视野仪、MP-1眼底超微视野仪进行视盘区域视野检测与45°免散瞳照相精确定位并叠加,通过上述三种视野的综合检测进行分析。重点指标:杯盘比值(cup/disc,C/D)、平均缺损(mean deviation,MD)。
结果:(1)MP-1微视野与SWAP/B-YP视野皆有明显差异。与正常体检组比较,早期青光眼组现C/D、MD均增大,生理盲点轻度扩大,中期青光眼组三种视野均能明显发现生理盲点、MS、MD异常。(2)当MP-1视野与 SWAP/B-YP视野综合检测青光眼时,在Logistic回归分析指导下,其MD特异度、灵敏度、准确率为92.0%,95.0%,93.9%。在与C/D值综合分析后,其可超越99%。
结论:MP-1微视野与SWAP/B-YP视野的敏感性在早期青光眼的检测中较标准W-W视野高,具有较好的相关性。但对于中期青光眼则体现了标准W-W视野快捷、准确、省时优势,上述三种视野综合检测较完整地体现出免散瞳眼底45°彩色图与视野功能相结合综合分析是将形态学和功能学检查结合得到精确定位的、定量的视觉功能资料,有助于更进一步提高青光眼现代临床检测诊断效应。
[Key word]
[Abstract]
AIM:To research the correlation between the physiological blind spot visual field variation and optic disc parameters detected by microperimetry-1(MP-1), short-wavelength automated perimtry/blue-on-yellow perimetry(SWAP/B-YP), standard white-on-white perimetry(W-WP)in the modern clinical comprehensive detection of glaucoma patients.
METHODS:The optic area visual field detection in 39 cases of 78 normal physical examinees(all soldiers), 59 cases 118 eyes with early stage of glaucoma, 25 cases 50 eyes with middle stage of glaucoma was detected using HUMPHREY Ⅱ-750 automated full field perimetry, SWAP/B-YP, MP-1, and precisely positioned by 45° non-mydriatic fundus camera and superimposed. The data obtained by the three perimeters were analyzed. Key indicators included cup/disc(C/D)ratio and mean deviation(MD).
RESULTS: There was obvious difference in the MP-1 and SWAP/B-YP. Compared with the normal physical examinees, C/D, MD enlarged in patients with early stage of glaucoma, and physiological blind spot was slightly enlarged, and there were obvious variations in blind spot, MS, MD observed in patients with middle stage glaucoma by the three perimeters. When glaucoma was detected by MP-1 combined SWAP/B-YP, with the guidance of Logistic regression analysis, the specificity, sensitivity, accuracy rate of MD was 92.0%,95.0%,93.9%, respectively, and after the comprehensive analysis of C/D, the rate could surpass 99%.
CONCLUSION: The sensitivity of MP-1 and SWAP/B-Y was higher in detection of early stage of glaucoma than standard W-WP, and they had good correlation, but for the advanced glaucoma, W-WP was fast, accurate, and time-saving, The above three perimeters can fully reflect that 45° non-mydriatic fundus camera combined with the visual field function comprehensive analysis, which combines morphology and fuctionial study to get the precise and quantitative materials of visual function, can improve the clinical diagnosis effect of glaucoma.
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