低眼圧緑内障患者における視野悪化例

Deterioration of visual field in low tension glaucoma

　当科外来において低眼圧緑内障と診断された症例28例50眼を悪化例，不変例に分け，初診時の視野所見，視神経乳頭所見，眼圧などにつき検討した。28例50眼のうち，不変例は22例35眼，悪化例は13例15眼で，初回視野検査が，Ⅰ期・Ⅱ期の初期緑内障に悪化が多くみられた。視神経乳頭所見ではnotch，乳頭出血は悪化例に有意に多く，外来平均眼圧15mmHg以上で悪化例が有意に多かった。しかし，10mmHg前後の低眼圧群でも悪化例があり，基本的には視神経乳頭の局在的変化が存在し，それに眼圧が視野悪化に関与していることが示唆された。

We reviewed the clinical course of 50 eyes in 28 cases with low tension glaucoma. We paid particu-lar attention to the visual field defect, intraocular pressure (IOP) and the optic disc. The visual field remained stable in 35 eyes, 22 cases, and deteriorat-ed in 15 eyes, 13 cases. The deterioration in visual field was more frequent in early than in advanced stage. The deterioration was significantly more frequent in cases showing notch and hemorrhage of the optic disc and was significantly more manifest when the IOP was more than 15 mmHg. Still, visual field deteriorated further in 4 eyes with lower IOP level. It appeared that visual field defect depended on the IOP level and also on the individual weak-ness of the lamina cribrosa.