水晶体嚢性緑内障の視野障害の進行原発開放隅角緑内障との比較

A comparative study of visual field loss progression in capsular and primary open angle glaucomas

　5年間経過を観察した眼圧調整良好な水晶体嚢性緑内障患者19例20眼と，原発開放隅角緑内障患者32例45眼の視野障害の進行について比較検討した。対象は年齢50歳以上，矯正視力0.1以上で，経過観察期間中の眼圧が2回連続して21mmHgを超えず，ゴールドマン視野計にて観察開始時と，1，3，5年目の計測をしており，観察開始時の視野が湖崎分類Ⅲ期以内のものとした。各観察時期のゴールドマン視野のⅤ-4とⅠ-4イソプターの視野減少率については，新しく開発した視野図処理システムを用いて面積を計算し，有意差検定を行った。その結果，水晶体嚢性緑内障の視野減少率は各観察時期において原発開放隅角緑内障よりも高く，とくにⅠ-4のイソプターにては有意差を認めた。年齢をマッチングさせた比較では有意差を認めず，年齢因子の関与が大きいことが示唆された。

We evaluated the visual field loss progression in patients with capsular glaucoma (20 eyes) and with primary open angle glaucoma (45 eyes). Intra-ocular pressure, during 5 years follow-up, were controlled within normal range (≦21mmHg) in all eyes. We compared the rate of decrease in the area of Ⅴ-4 and Ⅰ-4 isopter by Goldmann perimetry between the initial period and 1, 3, 5 years using a new visual field analysing program of computer-ized line image prossesing.

The decrease rates of visual field area in capsular glaucoma were higher than in primary open angle glaucoma in each follow-up period. A significant correlation was present in Ⅰ-4 isopter between capsular glaucoma and primary open angle glau-coma. There was no significant correlation in age-matched groups.

The prognosis of visual field loss in patients with capsular glaucoma was similar to that in aged patients with primary open angle glaucoma. These results suggested that the age was a major factor in their prognosis.