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要約 目的:10年以上にわたる正常眼圧緑内障の視力と視野の経過報告と,視野進行に関係する因子の検討。対象と方法:10年以上の経過を追った正常眼圧緑内障64例64眼を対象とした。男性37例,女性27例で,年齢は53~85歳(平均69歳)である。眼圧,屈折,点眼スコア,手術歴,角膜厚,家族歴,Humphrey視野計による視野,logMAR視力などを検索した。結果:初診時から2段階以上の視力低下が64眼中13眼(20%)にあり,うち3眼では緑内障進行による中心視野障害によると判断された。信頼性がある視野追跡ができた51眼では,MD(mean deviation)の平均スロープは-0.14dB/年であり,19眼(37%)ではスロープ平均が-0.42dB/年で,有意に負であった。視野進行に有意に関連する患者の背景因子はなかった。結論:10年以上の経過観察で,正常眼圧緑内障の視力と視野の進行悪化に関連する因子は特定できなかった。
Abstract. Purpose:To report the course of visual acuity and field in patients of normal-tension glaucoma(NTG)and to discuss factors related to progression of visual field defect. Cases and Method:This retrospective study was made on 64 eyes of 64 patients who were diagnosed with NTG and who were followed up for 10 years or longer. The series comprised 37 males and 27 females. The age ranged from 53 to 85 years,average 69 years. Following factors were evaluated:intraocular pressure,refraction,medication score,history of surgery,corneal thickness,family history,visual field measured by Humphrey perimeter,and visual acuity expressed as logMAR. Results:Visual acuity decreased by 2 lines or more in 13 eyes(20%). Impaired central visual field appeared to be the cause in 3 out of the 13 eyes. Visual field could be followed up in 51 eyes. Mean deviation(MD)of the slope averaged -0.14 dB per year. In 19 eyes(37%),it was significantly greater by an average of -0.42 dB. No background factor was identified that was significantly correlated with progression of visual field defect. Conclusion:Follow-up for 10 years or longer has shown no factor related to progression of visual acuity or field in NTG.
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