Turkiye Klinikleri Journal of Ophthalmology

Primer Açık Açılı Glokomlu ve Normotansif Glokomlu Hastalarda Kısa Dalga Boyu Perimetrinin Tekrarlanabilirliği ve Tanısal Önemi
Diagnostic Significance And Reproducibility Of Short-Wave Perimetry In Primary Open Angle Glaucoma
Nuray AKYOL*, Yusuf KİBAR**
* Doç., Fırat Üniversitesi Tıp Fakültesi Göz Hastalıkları AD** Araş.Gör., Fırat Üniversitesi Tıp Fakültesi Göz Hastalıkları AD, ELAZIĞ
Turkiye Klinikleri J Ophthalmol. 2004;13(1):8-12
Article Language: TR
Full Text
ÖZET
 Amaç: Glokomlu ve normal olgularda kısa dalga boyu perimetrinin (KDP) tekrarlanabilirliğini belirlemek ve bu grupları global indeksleri açısından karşılaştırmak. Gereç ve Yöntemler: Primer açık açılı glokomlu(PAAG) 16 hastanın 32 gözü (grup 1), normotansif glokomlu(NTG) 17 hastanın 32 gözü (grup 2) ve bu hastalarla benzer yaşta 16 sağlam olgunun 32 gözü(kontrol) çalışma gruplarını oluşturdu. Çalışmaya dahil edilecek olgularda glokomlu olgular için 0.7, kontrol olgularında 0.8 ve üzerinde görme düzeyi, gözün kırıcı ortamlarının şeffaflığı, başka oküler patolojinin mevcut olmaması şartları arandı. Glokom olgularının daha önce standart perimetri(SP) deneyimleri vardı; kontrollere öğrenme etkisini ortadan kaldırmak için aynı gün içinde SP ile 2 deneme testi yapıldı. Daha sonra tüm olgulara Octopus 101 perimetre ile aynı hafta içinde birer kez SP ve ikişer kez KDP yapıldı. Her iki test için ortalama defekt(MD), ortalama duyarlılık(MS) ve kayıp varyansı(LV) değerleri kaydedildi. Çalışmanın sonuçları spss v. 10.0 programında, bağımlı değişkenler için paired-t testiyle analiz edildi ve p<0.05 olduğunda sonuçlar anlamlı kabul edildi. Bulgular: Çalışma grupları yaş, görme keskinlikleri ve kırma kusurları açısından birbirine benzer bulundu. Test süreleri SP ve KDP-2 için sırasıyla, PAAG grubunda 6.98±1.23 ve 10.18±3.18; NTG grubunda 6.45±0.91 8.82±2.32; kontrol grubunda ise 5.98±0.62 ve 9.42±2.22 idi. Test süreleri arasındaki fark tüm gruplarda istatistiksel olarak anlamlıydı. PAAG grubunda SP ile KDP-1 arasında MD açısından anlamlı fark yokken, NTG grubunda bu indeks açısından iki test anlamlı olarak farklı bulundu. Her iki grup için, SP ve KDP-2 testleri arasında MD ve LV açısından istatistiksel olarak anlamlı fark bulunamazken, MS açısından anlamlı fark gözlendi. Kontrol grubunda SP ve KDP-1 testleri tüm indeksler açısından farklı bulundu, ancak test tekrarlandığında LV ve MD arasındaki farkların anlamsızlaştığı, MSler arasındaki farkın hala anlamlı olduğu gözlendi. KDP-1 ve KDP-2 testleri PAAG grubunda MS, NTG grubunda MS ve MD, kontrol grubunda ise MS, MD ve LV açısından farklı bulundu. Sonuç: Glokom şüphesi olan hastalarda erken tanı için yardımcı bir metot olan KDP, glokomlu hastalarda standart perimetrik muayeneye önemli bir katkı sağlamamaktadır. Testin tekrarlanabilirliği tüm gruplar için düşüktür. Glokomlu hastalarda gözlenen değişiklikler, normallerde de benzer şekilde karşımıza çıktığından ayırdedici değillerdir. Hasta ve hekim için fazladan zaman kaybına yol açan bu yöntemi glokom şüphesi olan olgulara saklamak gereklidir.

Anahtar Kelimeler: Kısa dalga boyu perimetri, Mavi- sarı perimetri, Glokom
ABSTRACT
 Objective: To determine the reproducibility of short-wave perimetry in glaucoma patients and controls, also compare these groups by means of the global indexes. Material and Methods: 32 eyes of 16 patients with primary open angle glaucoma (group 1), 32 eyes of 17 patients with low-tension glaucoma (group 2) and 32 eyes of 16 control (group 3) constituted the study groups. Inclusion criteria for the study were visual acuity more than 0.7 for glaucoma patients and more than 0.8 for the controls, clear media and no other ocular pathology. Glaucoma cases have had enough experience with the conventional automated perimetry; two trials in same day were executed for controls to eliminate the learning effect. All of the cases than undergone one conventional and two short-wave perimetry with Octopus 101 perimeter in one-week time. Mean defect (MD), mean sensitivity (MS) and loss variance (LV) were calculated for each test. All results were analysed with paired-t test for dependent variables in spss v. 10.0. Results were evaluated as significant when p<0.05. Results: The groups were similar for age, visual acuity and refractive errors. Test durations were 6.98±1.23 and 10.18±3.18 in group 1; 6.45±0.91 and 8.82±2.32 in group 2; 5.98±0.62 and 9.42±2.22 in group 3 for standard and short-wave perimetry respectively. The differences between two test durations were statistically significant in all three groups. Conventional and first short-wave perimetric tests were found statistically similar for group 1 by means of MD, but they were different in group 2. Conventional and second short-wave perimetric tests were similar for MD and LV and were significantly different for MS in these groups. The conventional and first short-wave perimetry were significantly different for all global indices in group 3, but only the difference in MS were significant when the conventional and second short-wave perimetry were compared. First and second tests with short-wave perimetry were different for MS in group 1, for MD and MS in group 2, and for all parameters in group 3. Conclusion: Short-wave perimetry has no contribution in the perimetric examination of the patients with glaucoma, while it has important value in patients with glaucoma suspect. Its reproducibility is low for all groups. The changes seen in glaucoma patients are not useful for distinguish the patients from normal as they were also seen in controls. This method needs to be used only for glaucoma suspects because of its time-consuming properties for patient and practitioner.

Keywords: Short-wave perimetry, Blue-on-yellow perimetry, Glaucoma

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