Glokomda görme alanı defektleri

Year 2012, Volume: 29 Issue: 2s, 66 - 74, 22.06.2012

Nurşen Arıtürk

Abstract

Glokom, ilerleyici, geri dönüşümü olmayan, optik disk ve retina sinir lifi tabakasındaki yapısal değişiklikler ve görme alanındaki fonksiyonel kayıplarla karakterize, birçok faktorün sorumlu olduğu bir hastalıklar grubudur. Oftalmologların birincil amacı, glokom tanısı ve takibinde sinir lifi kayıplarını belirlemek, kayıp gelişimini önlemek ve progresyonu durdurmaktır. Teşhis ve takipte kullanılan geleneksel yöntemler, göz içi basınç ölçümü, optik sinir başının subjektif incelenmesi ve görme alanı testidir. Göz içi basınç ölçümü diürnal varyasyon göstermesi, kişisel farklılıkların olması ve risk faktörlerinden sadece biri olması nedeniyle tek başına tanı koymada yeterli değildir. Optik sinir başının subjektif incelenmesi, gözlemci ve gözlemciler arası farklı değerlendirmeler ve kişisel farklılıklar olabilmesi güvenilirliğini azaltmaktadır. Görme alanı testi ise, glokomun klinik olarak takibinde vazgeçilmez değerlendirme yöntemlerinden biridir. Subjektif bir test olması, kısa ve uzun süreli değişikliklerin olması teste güvenilirliği azaltsa bile halen günümüzde tanı ve takipte, klinik olarak görme fonksiyonunu belirlemede vazgeçilmez altın standart yöntemdir. Bu makalede, glokomda görülen görme alanı kayıp tipleri, literatür verileri ışığında tartışılmıştır.


Visual field defects in glaucoma

Glaucoma, is a group of diseases caused by several factors characterized by progressive, irreversible structural changes at the optic disc and retinal nerve fiber layer, and the functional loss in the visual field. The primary purpose of the ophthalmologist is to determine the level of the loss of retinal nerve fibers during the glaucoma diagnosis and the follow-up; and to prevent and to stop the progression of nevre fiber loss. Conventional methods used for glaucoma diagnosis and follow-up are intraocular pressure measurements, subjective examination of the optic nerve head and visual field test. Intraocular pressure measurement is not enough alone for glaucoma diagnosis, because it shows diurnal variation, individual differences and it is only one of several risk factors. Subjective evaluation of the optic nerve head, the interobserver variability of the assessment and individual differences of optic disc size and type should reduce its reliability. The visual field test is one of the indispensable assessment methods. For today, it is still the gold standard method for the diagnosis and the follow-up of glaucoma, and to determine clinically the visual function. Even if it is a subjective test,and the short-and long-term fluctuations should decrease the reliability of the test.In this article, the types of visual field loss in glaucoma are discussed in the light of the current literature.

J. Exp. Clin. Med., 2012; 29:S66-S-S74

Keywords

Glokom; Görme Alanı; Optik sinir; Perimetre; Retinal sinir lifi tabakası; Görme alanı defekti (Glaucoma; Visual field; Optic nevre; Perimeter; Retinal nerve fibre layer; Visual field defect)

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