Primary open-angle glaucoma is a chronic progressive optic neuropathy. There is no symptom in the early stage of the disease, but in the middle and late stages, it is difficult to be controlled and can lead to irreversible blindness. Therefore, the early diagnosis and treatment of the disease is very important. For a long time, a visual field defect has been an important standard for its diagnosis. In recent years, however, preperimetric glaucoma (PPG) has been paid much attention, which is the very early stage of open-angle glaucoma. Although the visual field is normal, there is glaucomatous optic neuropathy in PPG eyes, which may progress to visual field defects. By expounding and analyzing the definition, mechanism, clinical evidence, diagnostic methods and therapeutic value of PPG, this article puts forward the view that facing up to the existence of PPG in clinics is helpful to find the condition of glaucoma early, and timely follow-up and accurate judgement of the treatment opportunity are key to preventing glaucomatous visual field defects.
原发性开角型青光眼（POAG）为慢性进行性视神经病变，其特征为疾病早期无症状，进入中晚期病情难以控制，可导致不可逆盲，因此早期诊疗极为重要。视野缺损是其重要的诊断标准。近年来临床针对POAG提出视野前期青光眼（PPG）概念，即临床标准全自动视野计检查结果正常，但已存在明确的青光眼视神经结构改变，病情进展可导致视野缺损，由视野无缺损阶段（临床极早期青光眼）进入功能损伤阶段（临床早、中、晚期青光眼）。本文通过阐述和分析PPG的定义、发生机制、临床证据以及诊断方法、治疗价值等，提出临床正视PPG的存在，有助于及时发现POAG病情，重视随访并准确判断和把握治疗时机，这是预防POAG视野缺损的关键。.