La visión binocular en el glaucoma

Résumé

Objective: To describe the possible impairment of binocular vision in primary open angle glaucoma (POAG) patients. Method: A cross-sectional study was conducted on 58 glaucoma patients, 76 ocular hypertensives and 82 normal subjects. They were examined with a battery of binocular tests consisting of the measurement of phoria angles, amplitudes of fusion (AF), near point of convergence (NPC) assessment, an evaluation of suppression (Worth test), stereoacuity according to Titmus, and TNO tests. Results: The patients with glaucoma showed significantly increased phoria angles, especially in near vision, compared with the ocular hypertensives and controls (P=.000). AF were reduced mainly in near distances compared to hypertensives and controls (P=.000). The NPC of glaucoma was higher than the other two groups (P=.000). No differences were found in the near-distance suppression test between the three groups (P=.682), but there were differences in the distance vision of patients with glaucoma compared to hypertensives (OR=3.867, 95% CI; 1.260-11.862; P=.008) and controls (OR= 5.831, 95% CI; 2.229-15.252; P=.000). The stereoacuity of patients with glaucoma was reduced in both tests (P=.001). Conclusions: POAG is mostly associated with, an increased exophoria in near vision, a decreased AF in near vision, a far-distance NPC, central suppression in far-vision, and a loss of stereoacuity. These changes do not seem to appear early as they were not observed in hypertensive patients versus controls.