小時(shí)眼壓檢測(cè)與青光眼的診治

1、神神經(jīng)經(jīng)節(jié)節(jié)細(xì)細(xì)胞胞死死亡亡率率眼壓閾值眼壓閾值眼眼 壓壓眼壓相關(guān)損害的眼壓相關(guān)損害的風(fēng)險(xiǎn)預(yù)測(cè)風(fēng)險(xiǎn)預(yù)測(cè)降低眼壓降低眼壓 減少了青光眼進(jìn)展的風(fēng)險(xiǎn)減少了青光眼進(jìn)展的風(fēng)險(xiǎn)0123424364860728496隨訪（月）隨訪（月）平均視野缺損值平均視野缺損值 17.5 mm HgAGIS. Am J Ophthalmol. 2000;130:429-440.-0.500.511.522.533.5012243648607284960 to 50% of visits 1850 to 75% of visits 1875 to 100% of visits 18all visits 1820.2 mm

2、Hg16.9 mm Hg14.7 mm Hg12.3 mm HgAGIS. Am J Ophthalmol. 2000;130:429-440.隨訪期（月）平均眼壓平均缺損值Brubaker RF. Am J Ophthalmol. 1996;121:473-483. 眼壓眼壓神神經(jīng)經(jīng)節(jié)節(jié)細(xì)細(xì)胞胞死死亡亡率率眼壓閾值眼壓閾值眼壓水平與視野損害的關(guān)系眼壓水平與視野損害的關(guān)系眼壓眼壓 青光眼患者青光眼患者正常個(gè)體正常個(gè)體不同波動(dòng)幅度的患者日間眼壓曲線不同波動(dòng)幅度的患者日間眼壓曲線（家庭眼壓檢測(cè)）061218240510152025Time of Day hourIOP mmHgAsrani, et

3、 al, J Glaucoma, 2000, 9, 134-142061218240510152025Time of Day hourIOP mmHg波動(dòng)13波動(dòng) 6 1711Asrani S, et al. J Glaucoma. 2000;9:134-142 五年內(nèi)病情進(jìn)展的相對(duì)危險(xiǎn)五年內(nèi)病情進(jìn)展的相對(duì)危險(xiǎn)01234561.005.76日間眼壓波動(dòng)日間眼壓波動(dòng)3.1 mm Hg日間眼壓波動(dòng)日間眼壓波動(dòng)5.4 mm Hg相相對(duì)對(duì)危危險(xiǎn)險(xiǎn)Asrani et al J Glaucoma 2000;9:134-142（眼壓波動(dòng)（眼壓波動(dòng)6mmHg 56%時(shí)間時(shí)間眼眼壓壓眼壓平均值12.6mmHg壓

4、差6mmHg 30%蘇為坦替代治療蘇為坦替代治療12周治療前后眼壓降幅周治療前后眼壓降幅 (mmHg)注：療前眼壓注：療前眼壓36mmHg病例已刪除病例已刪除 例數(shù)例數(shù)療前療前4周周療前療前12周周均數(shù)均數(shù)標(biāo)準(zhǔn)差標(biāo)準(zhǔn)差均數(shù)均數(shù)標(biāo)準(zhǔn)差標(biāo)準(zhǔn)差未用藥的新病例未用藥的新病例5917.224.7408.394.000受體激動(dòng)劑受體激動(dòng)劑686.913.9697.514.290非選擇性非選擇性4165.464.6546.283.970受體阻滯劑受體阻滯劑1355.695.1907.694.589貝特舒貝特舒1146.874.6477.754.185派立明派立明785.944.9997.964.875適利達(dá)

5、適利達(dá)1853.125.4734.314.573復(fù)合用藥復(fù)合用藥5995.055.2405.954.765IOP 216441.723.4252.802.814IOP2115427.454.6908.554.004-7.4 mm Hg,p.0001-7.2 mm Hg,p.0001-7.5 mm Hg,p.0001-6.9 mm Hg,p.0001-6.2 mm Hg,p.0001-5.4 mm Hg,p.0001-7.7 mm Hg,p.0001-5.7 mm Hg,p.0001-7.7 mm Hg,p.0001-6.8 mm Hg,p.0001-7.9 mm Hg,p.0001-5.9 mm Hg,p.0001-4.3 mm Hg,p.0001-3.1 mm H