高度の視神経乳頭陥凹を有する緑内障の視野欠損に影響する諸要素

Factors effecting on the visual fields of advanced glaucomas

　性別，年齢，眼圧コントロール，手術歴等が，0.8以上の陥凹／乳頭径比を持つ開放隅角緑内障眼の視野欠損に影響するか否かを検討した．視野の評価はゴールドマン視野計のV-4,I-4のイソプターの面積の実測値で行った．有意に視野の保存が良かったのは，女性の群と眼圧コントロール良好群（常時20mmHg以下）であった．その他の要素には統計学的有意差はなかった．また，V-4イソプターが1／2以上保存されている群は，保存されていない群に比較して，経過観察中の最高眼圧が有意に低かったが，最低眼圧は両者の間に差は無かった．高度な乳頭陥凹を持つ症例の視野の保存には，良好な眼圧を常に維持することが重要であり，手術を施行する場合には，トラベクロトミーが適当と思われた．

It was examined how several factors such as age, sex, intraocular pressure level and past surgeries effected on the visual field defects of primary open angle glaucoma eyes whose cup-disc ratios weremore than 0.8. Visual fields were estimated as areas of I-4 and V-4 isopters of Goldmann's perimeter being measured planimetrically. Visual fields of women were statistically wider than those of men. Eyes of which intraocular pressure maintained below 20mmHg had statistically wider visual fields than the rest. Other factors did not have statistic significance. Maximal intraocular pressure of eyes with field loss less than 1/2 of V-4 isopter, was statistically lower than that of the other eyes. No difference was found between minimal intraocularpressure of these two groups. To preserve visual fields of eyes having severe glaucomatous cupping, it is important to maintain intraocular pressure at low level. When any surgical therapy is needed, a trabeculotomy will be recommended.

Rinsho Ganka (Jpn J Clin Ophthalmol) 42(4) : 369-372, 1988