目的：探究原发性开角型青光眼(POAG)患者视野损害进展的相关因素，为临床POAG患者更准确高效的随访提供思路。

方法：前瞻性病例系列研究。将POAG患者39例77眼纳入随访研究，详细询问病史后，进行眼内压(IOP)测量，视野检查及神经纤维层(RNFL)厚度测量，每3mo 1次，共连续随访7次。对患者的家族史、吸烟及饮酒史、年龄、性别、是否手术、IOP波动、基线视野缺损程度、随访期间RNFL厚度变化与视野损害进展进行相关性分析。

结果：随访期间RNFL厚度变化程度与视野损害进展呈正相关(P<0.05)。基线视野缺损程度与视野损害进展有关，中度基线视野缺损与视野损害进展相关性最大，轻度次之，重度最小。

结论：RNFL的厚度变化可能为POAG患者进展性随访提供有用信息； 轻度和重度视野缺损患者进展性的判断应结合视野外信息。

METHODS: A prospective study that includes thirty-nine patients(77 eyes)with POAG who were followed up every three months for 7 consecutive times. After inquiring the history in detail, intraocular pressure(IOP), visual field examination and nerve fiber layer(RNFL)thickness were measured. During follow-up the family history, smoking and drinking history, age, gender, surgery, IOP fluctuation, baseline visual field defect and RNFL thickness change were analyzed.

RESULTS: During the follow-up period, the degree of RNFL thinning was positively correlated with visual field progression(P<0.05). The baseline visual field defect was associated with visual field progression. Moderate baseline visual field defect has the greatest correlation with the progression of visual field damage, the second is mild, and the least is severe.

CONCLUSION: Changes in RNFL thickness may provide useful information and progressive judgment of patients with mild and severe visual field defects should be combined with other information besides visual field.