中央和全球视野进展对眼患者生活质量的差异影响
Gopikasree Gunasegaran1, Sasan Moghimi1, Evan Walker1
1Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA.
American journal of ophthalmology
|May 7, 2025
概括
中央视野 (VF) 损失显著影响与视觉相关的生活质量 (VRQOL) 超过全球VF损失. 早期检测中心VF进展对于准确评估患者的结果至关重要.
科学领域:
- 眼科医生 眼科 眼科
- 临床研究 临床研究
背景情况:
- 主要开角青光眼 (POAG) 是不可逆转失明的主要原因.
- 视觉相关的生活质量 (VRQOL) 是对治疗青光眼的一个关键的以患者为中心的结果.
- 评估特定视野 (VF) 变化对VRQOL的影响对于全面的患者护理至关重要.
研究的目的:
- 调查中心视野 (VF) 与全球视野 (VF) 进展对初级开角青光眼 (POAG) 患者视觉相关生活质量 (VRQOL) 的差异影响.
主要方法:
- 追溯队列研究,包括235名POAG参与者的364只眼睛,在至少2年的随访期间至少进行了5次24-2VF测试.
- 全球平均偏差 (MD) 和中央平均总偏差 (MTD10) 的计算斜率在24-2 VF测试的中央10°内.
- 使用国家眼科视觉功能问卷 (NEI-VFQ) 的拉什校准分数量化VRQOL,使用基于VF进展值的线性混合效应模型进行分析.
主要成果:
- 与非进展者相比,MTD10进展的眼睛显示出基线24-2VFMD明显较差的眼睛.
- 快速MTD10进展 (<-0.50dB/y) 与平均基线MD的-9.71dB相关,而缓慢进展者 (P<.001) 的平均基线MD为-5.24dB.
- 中部VF进展 (MTD10) 显示对VRQOL分数产生更大的负面影响,而不是全球VF进展 (MD) 在各种门上,在较低的MTD10门上观察到类似的VRQOL损伤.
结论:
- 中央VF的变化对VRQOL的影响比POAG的全球VF变化更为深远.
- 目前仅依赖全球MD的眼评估可能低估了中央VF损失的功能影响.
- 需要采用集中的VF指标的增强进展检测策略,以更好地与VRQOL.VRQOL等患者报告的结果保持一致.
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