Macri A, Rolando M, Corallo G, Iester M, Verrastro G, Calabria G
Department of Ophthalmology, University of Genoa, Italy.
Eye (Lond). 1998;12 ( Pt 6):916-20. doi: 10.1038/eye.1998.238.
To evaluate the correlation between computerised visual field testing and optic disc morphometric parameters (rim area, rim/disc area ratio, cup/disc area ratio and optic disc surface smoothness (ODSS)) in the follow-up of a group of patients affected by primary open angle glaucoma (POAG).
Reliable automated perimetry (Humphrey 640 VFA, central 30-2 threshold program) was performed at T0 (the enrollment time), T1 (after 6 +/- 1 months; range 5-7 months), T2 (12 +/- 1 months), T3 (18 +/- 1 months), and T4 (the end of the follow-up period: 24 +/- 2 months) in one eye randomly chosen from each of 30 POAG patients. Computerised optic disc analysis (IMAGEnet X Rev-3-51b, Topcon Europe, The Netherlands) was performed at T0 and T4. To evaluate the correlation between morphometric parameters and computerised visual field testing, the stability or worsening of visual field test was evaluated by means of 'Mean Deviation linear regression analysis' (STATPAC 2 software); that of morphometric parameters was studied using their coefficients of variation. A rank of '0' was assigned to stability and a rank of '1' to worsening. The Spearman rank correlation coefficient was used to evaluate statistically the correlations between visual field analysis and morphometric parameters. Furthermore kappa statistic was used to evaluate the agreement of morphometric parameter changes with visual field progression analysis.
According to the MD slope regression analysis, in 18 patients the visual fields were stable while in 12 they were worsening during the follow-up period. In 86.65% of patients (n = 26) the morphometric parameter ODSS and visual field analysis were concordant (p < 0.0001). In 80% of patients (n = 24) the cup/disc area ratio and visual field analysis were concordant (p < 0.001). The other morphometric parameters (rim area, rim/dics area ratio) were less correlated with visual field analysis than ODSS (p < 0.05). The agreement of visual field analysis with all the morphometric parameters was good (kappa = 0.690, 95% confidence interval (CI) of kappa = 0.589-0.790). The agreement of visual field analysis with ODSS and cup/disc area (kappa = 0.688; 95% CI = 0.511-0.864) was better than the agreement of visual field analysis with rim area and rim/disc area ratio (kappa = 0.438; 95% CI = 0.260-0.655).
Analysis of the progression of visual field damage and optic nerve head morphometric parameters should both be taken into account in glaucoma follow-up. Among the morphometric parameters evaluated by means of Topcon IMAGEnet, ODSS and (to a lesser extent) the cup/disc ratio should have the greatest weight.
评估在一组原发性开角型青光眼（POAG）患者的随访中，计算机视野检测与视盘形态学参数（边缘面积、边缘/视盘面积比、杯/盘面积比和视盘表面平滑度（ODSS））之间的相关性。
对30例POAG患者的每例患者随机选取一只眼睛，在T0（入组时间）、T1（6±1个月后；范围5 - 7个月）、T2（12±1个月）、T3（18±1个月）和T4（随访期结束：24±2个月）进行可靠的自动视野检查（Humphrey 640 VFA，中央30 - 2阈值程序）。在T0和T4进行计算机视盘分析（IMAGEnet X Rev - 3 - 51b，拓普康欧洲公司，荷兰）。为评估形态学参数与计算机视野检测之间的相关性，通过“平均偏差线性回归分析”（STATPAC 2软件）评估视野测试的稳定性或恶化情况；使用形态学参数的变异系数研究其稳定性。稳定性赋值为“0”级，恶化赋值为“1”级。采用Spearman等级相关系数对视野分析与形态学参数之间的相关性进行统计学评估。此外，使用kappa统计量评估形态学参数变化与视野进展分析的一致性。
根据平均偏差斜率回归分析，随访期间18例患者视野稳定，12例患者视野恶化。86.65%的患者（n = 26）形态学参数ODSS与视野分析结果一致（p < 0.0001）。80%的患者（n = 24）杯/盘面积比与视野分析结果一致（p < 0.001）。其他形态学参数（边缘面积、边缘/视盘面积比）与视野分析的相关性低于ODSS（p < 0.05）。视野分析与所有形态学参数的一致性良好（kappa = 0.690，kappa的95%置信区间（CI）= 0.589 - 0.790）。视野分析与ODSS和杯/盘面积的一致性（kappa = 0.688；95% CI = 0.511 - 0.864）优于视野分析与边缘面积和边缘/视盘面积比的一致性（kappa = 0.438；95% CI = 0.260 - 0.655）。
青光眼随访中应同时考虑视野损害进展分析和视神经乳头形态学参数。在通过拓普康IMAGEnet评估的形态学参数中，ODSS以及（程度稍轻的）杯/盘比应具有最大权重。
