临床视盘评估与早期视野缺损检测的比较

Comparison of clinical optic disc assessment with tests of early visual field loss.

作者信息

Landers John A, Goldberg Ivan, Graham Stuart L

机构信息

Eye Associates, Sydney University, Sydney, New South Wales, Australia.

出版信息

Clin Exp Ophthalmol. 2002 Oct;30(5):338-42. doi: 10.1046/j.1442-9071.2002.00552.x.

DOI:10.1046/j.1442-9071.2002.00552.x

PMID:12213157

Abstract

PURPOSE

Clinical optic disc assessment may identify glaucomatous optic neuropathy prior to a patient developing visual field abnormalities on achromatic automated peri-metry (AAP). Tests targeting axons that are selectively damaged or whose redundancy is low, such as short wavelength automated perimetry (SWAP) and frequency doubling perimetry (FDP), may detect visual field loss before it is seen on AAP. This study investigated whether patients in whom characteristic glaucomatous optic disc damage was present without AAP abnormalities had visual field abnormalities with SWAP and FDP.

METHODS

A sample of patients (n = 50) with ocular hypertension (normal AAP) were selected, who had SWAP, FDP and stereofundus photography performed. The photographs were then analysed by two glaucoma subspecialists who were masked to the assessments of the other and to the patients' SWAP and FDP results. A categorization of the optic discs was made as either normal or abnormal and this was compared with their SWAP and FDP findings.

RESULTS

On comparing SWAP and FDP with clinical optic disc assessment as the 'gold standard', the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 33%, 92%, 57% and 81%, respectively, for SWAP and 25%, 89%, 49% and 79%, respectively, for FDP.

CONCLUSION

In glaucoma suspects, the study suggests that SWAP and FDP identify subjects with early glaucomatous optic neuropathy missed by AAP.

摘要

目的

临床视盘评估可在患者出现基于消色差自动视野计（AAP）的视野异常之前识别青光眼性视神经病变。针对选择性受损或冗余度低的轴突的检测，如短波自动视野计（SWAP）和倍频视野计（FDP），可能在AAP检测到视野缺损之前就发现视野缺损。本研究调查了存在典型青光眼性视盘损害但AAP无异常的患者在SWAP和FDP检查中是否存在视野异常。