大杯盘比患者眼压和视野及电生理的分析研究

Analysis and study of intraocular pressure, visual field and P-ERG on patients with big cup/disk

摘要:

目的：分析研究大杯盘比(cup/disk， C/D)患者24h眼压、视野及电生理的变化情况。

方法：选择大C/D(C/D>0.3)患者120例240眼，并根据C/D大小将其分为两组：A组，0.3结果：对于24h眼压，三组患者眼压均值比较无显著统计学差异(P>0.05)，波动幅度比较有显著统计学差异(P<0.05)； B组患者眼压波动幅度明显高于正常对照组，差异具有统计学意义(P<0.05)。对于静态阈值视野，三组患者平均偏差(mean deviation， MD)及图样标准差(pattern standard deviation，PSD)比较有显著统计学差异(P<0.05)； 两两比较，与正常对照组相比，B组患者MD及PSD明显增加，差异具有统计学意义(P<0.05)，而A组则无显著统计学差异(P>0.05)； A，B两组相比，B组患者MD及PSD明显高于A组，差异具有统计学意义(P<0.05)。对于P-ERG检查，三组患者P50波潜伏期比较无显著统计学差异(P>0.05)，波幅比较有显著统计学差异(P<0.05)； 两两比较，与正常对照组相比，B组患者P50波振幅明显降低，差异具有统计学意义(P<0.05)，而A组则无显著统计学差异(P>0.05)； A，B两组相比，B组患者P50波振幅明显低于A组，差异具有统计学意义(P<0.05)。

结论：当C/D≥0.6时，患者24h眼压监测、静态阈值视野检查及图形视网膜电流图P50波有明显改变。对于大杯盘比患者，仅行单次眼压检查是远远不够的，应予以详细视功能检查。同时，将C/D 0.6作为可疑青光眼的筛查标准是可行的。

Abstract:

AIM: To analyze and study the changes of intraocular pressure(IOP), visual field and P-ERG on patients with big cup/disk(C/D)in 24h.

METHODS: A total of 120 cases(240 eyes)diagnosed with big C/D(C/D>0.3)were divided into group A(C/D<0.6, 67 cases, 114 eyes)and group B(C/D≥0.6, 73 cases, 126 eyes). Forty cases(80 eyes)with small C/D(C/D≤0.3)were chosen as control group. All cases underwent 24h IOP examination, vision examination of 30-2 SITA-standard static threshold and pattern electroretinogram(P-ERG)examination. The differences between the examination indexes of the three groups were analyzed.

RESULTS: There was no significant statistical difference in the 24h average IOP(P>0.05)among the three groups, while the amplitudes had significant statistical differences(P<0.05). Compared with the control group, the IOP amplitudes of group B were obviously higher, and the difference was of statistical significance(P<0.05). In terms of static threshold visual fields, the mean deviations(MD)and pattern standard deviations(PSD)of the three groups had significant statistical differences(P<0.05). Comparison between every two groups: compared with the control group, the MD and the PSD were significantly increased in group B, and the difference was of statistical significance(P<0.05); while there was no significant statistical difference in group A(P>0.05); Compared with group A, the MD and the PSD were significantly higher in group B, and the difference was of statistical significance(P<0.05). In terms of P-ERG examination, there was no significant statistical difference in P50's latent periods among the three groups(P>0.05), but there were significant statistical differences in amplitudes(P<0.05). Comparison between every two groups: compared with the control group, the P50's amplitude was significantly decreased in group B, and the difference was of statistical significance(P<0.05), while there was no significant statistical difference in group A(P>0.05); Compared with group A, the P50's amplitude of group B was significantly lower, and the difference was of statistical significance(P<0.05).

CONCLUSION: When the patients' C/D is no less than 0.6, there are obvious changes of 24h IOP, static threshold visual field and P-ERG's P50 wave. For patients with big C/D, a single IOP examination is far from sufficient, so an in-depth visual function examination should be performed. Meanwhile, it's feasible to regard C/D 0.6 as a screening criterion for suspected glaucoma.