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標題: | 近視對倍頻視野檢查之影響 Influence of Myopia on the Humphrey Matrix Frequency Doubling Perimetry |
作者: | Jehn-Yu Huang 黃振宇 |
指導教授: | 賴美淑(Mei-Shu Lai) |
關鍵字: | 近視,倍頻視野檢查,球面當量,眼軸長度,平均偏差值,型態標準偏差值, myopia,frequency doubling perimetry,spherical equivalent,axial length,mean deviation,pattern standard deviation, |
出版年 : | 2007 |
學位: | 碩士 |
摘要: | 台灣高度近視者比例之高是世界上其他國家少有的,因此高度近視引起的問題對身處台灣的眼科醫師是一項特殊的挑戰。由於高度近視者的眼軸拉長、視網膜遭受拉扯特別顯著,常被認為視覺功能與正視眼或低度近視者有所差別。為了確定高度近視者即使在確定無青光眼的狀態下,是否其視野檢查的表現仍較低、中度近視者差。關於這方面的研究並不多,尤其是第二代的Humphrey Matrix倍頻視野檢查計從未被評估過。因此,本研究的目的乃為了解不同近視程度是否會對第二代倍頻視野檢查的影響。而近視程度的劃分,係依據球面當量及眼軸長度兩種方式定義之。
本研究樣本共有91位、18至40歲之健康志願者參與。所有參與者需先接受眼壓測量、電腦驗光、最佳矯正視力檢驗、細隙燈檢查、眼底照相、中心角膜厚度及眼軸長度測量、及青光眼家族史、糖尿病病史詢問。如果有眼壓高於21毫米汞柱、視神經盤凹陷與視神經盤直徑比大於0.5、兩側視神經盤凹陷與視神經盤直徑比相差大於0.2、視網膜神經纖維層具有楔形或廣泛性缺損、患有糖尿病,則該名受測者的兩眼資料均排除。如果有最佳矯正視力未達1.0、散光超過2屈光度、曾接受眼科手術、白內障、角膜病變、視網膜病變,則該眼資料排除。通過篩檢者,繼續完成對比敏感度檢查及Humphrey Matrix倍頻視野C-30-2程式的檢查。我們依據球面當量及眼軸長度兩種定義,將受測眼分為低度近視組、中度近視組、高度近視組。由於同時將同一位受測者的雙眼資料均納入分析,所以我們利用線性混合模型之隨機效用(random effect)處理同一位受測者左右眼相關性的問題。利用線性混合模型(linear mixed model)檢驗三種近視程度組間視野指標(平均偏差值與型態標準偏差值)的差異及近視指標(球面當量與眼軸長度)與視野指標(平均偏差值與型態標準偏差值)的關係。最後,共有80位、151隻眼睛的資料納入分析。 受測者之平均年齡為29.6 Purpose: Because the optic disc morphology of myopia is frequently similar to the glaucomatous disc, it is a challenge for ophthalmologists to differentiate myopia form glaucoma. Myopia-related visual dysfunction, which is considered as results of eyeball elongation or optic quality deterioration, may mimic other diseases such as glaucoma. This study is to evaluate whether high myopia patients may demonstrate poorer visual field results obtained from the Humphrey Matrix frequency doubling perimetry (FDP). Method: Ninety-one healthy volunteers between the ages of 18 to 40 were participated in this study. All subjects first received a whole panel of ophthalmic examinations including slit lamp exam, autorefraction, intraocular pressure, central corneal thickness, axial length measurement, and fundus photography. The subjects with diabetes, cataract, corneal opacity, retinal and neuro-ophthalmic pathology, cup-to-disc ratio greater than 0.5, bilateral cup-to-disc ratio asymmetry greater than 0.2, wedge or diffuse retinal nerve fibers defect, intraocular pressure greater than 21 mmHg, astigmatism greater than 2 diopters, and best corrected visual acuity less than 1.0 were excluded from the study. Eighty qualified subjects were further examined on contrast sensitivity and the Humphrey Matrix FDP full-threshold C30-2 program. Finally, onne hundred and fifty-one eyes from 80 subjects were included in data analysis. According to spherical equivalent and axial length parameters, we classified the subjects into low, intermediate and high myopia groups. Due to the correlation of right and left eye from the same subject, we used the randome effect of linear mixed model to capture the correlation. The mean deviation (MD), pattern standard deviation (PSD), and other variables obtained from the three groups were compared using linear mixed model. The association between the myopia indices (i.e. spherical equivalent and axial length) and the visual field indices (i.e. MD and PSD) were also analyzed by linear mixed model. Results: The average age of participated patients is 29.6 |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/28242 |
全文授權: | 有償授權 |
顯示於系所單位: | 流行病學與預防醫學研究所 |
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