Trible J R, Schultz R O, Robinson J C, Rothe T L
Eye Institute, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Am J Ophthalmol. 2000 Jun;129(6):740-5. doi: 10.1016/s0002-9394(00)00354-8.
To determine the accuracy of glaucoma detection by frequency-doubling perimetry.
Stereoview optic nerve photographs, visual field examination, intraocular pressure measurements, medical and ocular history, and a screening and full threshold frequency-doubling perimetry examination were performed in a prospective study of consecutive subjects. Inclusion criteria included age of 45 years or older, absence of ocular disease other than glaucoma, cataract, or mild drusen, and Snellen visual acuity of 20/60 or better. A total of 125 eyes in 102 glaucoma subjects and 95 eyes of 95 normal subjects were included. Each eye was classified as "normal," "glaucoma," or "uncertain" by each of three ophthalmologists on the basis of all available clinical information with the exception of frequency-doubling perimetry results. Those in the glaucoma group were subclassified as having early (n = 51), moderate (n = 42), or severe (n = 32) glaucoma on the basis of automated Humphrey visual field criteria. In the glaucoma group, two eyes from a subject were allowed to be included (23 of 102 subjects) if they differed in level of damage because they were never analyzed within the same statistical analysis.
Several diagnostic algorithms were evaluated. Algorithms based on the most depressed single point, pair of adjacent points, and cluster of three points performed nearly identically. For the screening test, if any abnormality was identified, specificity was 95%, whereas sensitivity was 39%, 86%, and 100% for early, moderate, and severe glaucoma, respectively. For the full threshold test, with at least one point depressed to the P < 0.5% level, specificity measured 91%, whereas sensitivity was 35%, 88%, and 100% for early, moderate, and severe glaucoma, respectively. The two global indices, mean deviation and pattern standard deviation, were also evaluated and were generally less accurate.
Frequency-doubling perimetry, which is rapid and easily administered, is effective at detecting moderate and severe disease and appears well suited for glaucoma screening.
确定倍频视野检查法检测青光眼的准确性。
对连续入选的受试者进行前瞻性研究，检查项目包括立体视盘照片、视野检查、眼压测量、病史及眼科病史，以及筛查和全阈值倍频视野检查。纳入标准包括年龄45岁及以上、除青光眼、白内障或轻度玻璃膜疣外无其他眼部疾病、Snellen视力20/60或更好。共纳入102例青光眼患者的125只眼和95例正常受试者的95只眼。三位眼科医生根据所有可用临床信息（不包括倍频视野检查结果）将每只眼分类为“正常”、“青光眼”或“不确定”。青光眼组患者根据自动 Humphrey 视野标准进一步分为早期（n = 51）、中度（n = 42）或重度（n = 32）青光眼。在青光眼组中，如果同一受试者的两只眼损伤程度不同（因为它们从未在同一统计分析中进行分析），则允许纳入（102例受试者中的23例）。
评估了几种诊断算法。基于最凹陷的单点、相邻两点对和三点簇的算法表现几乎相同。对于筛查试验，如果发现任何异常，特异性为95%，而早期、中度和重度青光眼的敏感性分别为39%、86%和100%。对于全阈值试验，至少有一点凹陷至P < 0.5%水平时，特异性为91%，而早期、中度和重度青光眼的敏感性分别为35%、88%和100%。还评估了两个总体指标，即平均偏差和模式标准偏差，其准确性通常较低。
倍频视野检查法快速且易于实施，在检测中度和重度青光眼方面有效，似乎非常适合青光眼筛查。
