Schiefer U, Ulrich W D, Ulrich C, Wilhelm H, Aulhorn E
Abteilung für Pathophysiologie des Sehens und Neuroophthalmologie, Universitäts-Augenklinik Tübingen.
Ophthalmologe. 1992 Dec;89(6):477-88.
A total of 173 eyes (visual field defect stages O-V) of 99 glaucoma patients were investigated by means of conventional threshold-oriented suprathreshold automated test point perimetry using the Tübingen Automatic Perimeter (TAP) and by means of white-noise-field campimetry (flickering random dot pattern) using the Tübingen Electronic Campimeter (TEC). Most eyes were affected by primary open-angle glaucoma (119) or low tension glaucoma (35). The concordance between the two methods was good in 65 eyes (37.6%). Sufficient in 32 (18.5%) eyes, poor in 32 cases (18.5%) and inadequate in 44 eyes (25.4%). Among the last group of 44 eyes, 32 perceived a scotoma in the noise field (NF) but did not show any pathologic defect in conventional automated test point perimetry: the opposite constellation was found in only 12 eyes. In most cases, scotoma in the NF showed a change in both brightness and motion (noise) perception. No clear relationship between the type of glaucoma and a certain constellation of the aforementioned NF specifications could be found. Complete lack of noise perception in the scotoma occurred more frequently in advanced glaucoma (stage > or = IV). In 110 eyes of 63 of the glaucoma patients, white-noise-field campimetry was carried out during artificial IOP elevation achieved by suction-cup oculopression: during steplike increases of the negative pressure in the suction-cup up to maximum of 375 mmHg the following stages could be seen (the percentage of eyes that perceived each phenomena over the negative pressure range is shown in brackets): change in NF perception compared with initial findings (96.4%); impairment of central noise-field perception (78.2%); concentric constriction of NF (61.8%); complete breakdown of noise (field) perception (42.7%). A further, quantitative classification of these eyes was possible by evaluation of the negative pressure in the suction-cup that led to any one of these NF phenomena. The results demonstrate the usefulness of white-noise-field campimetry as a very fast screening method for detecting glaucomatous visual field defects. It can also be performed as a pressure tolerance test and thus be used to classify glaucomatous risk stages.
采用图宾根自动视野计（TAP），通过传统的基于阈值的超阈值自动测试点视野检查法，以及采用图宾根电子视野计（TEC），通过白噪声视野检查法（闪烁随机点图案），对99例青光眼患者的总共173只眼（视野缺损分期为O - V期）进行了研究。大多数眼睛受原发性开角型青光眼（119只）或低眼压性青光眼（35只）影响。两种方法之间的一致性在65只眼中良好（37.6%），在32只眼中充分（18.5%），在32例中较差（18.5%），在44只眼中不足（25.4%）。在最后一组44只眼中，32只在噪声视野（NF）中察觉到暗点，但在传统自动测试点视野检查中未显示任何病理性缺损：仅在12只眼中发现了相反的情况。在大多数情况下，NF中的暗点在亮度和运动（噪声）感知方面均有变化。未发现青光眼类型与上述NF特征的特定组合之间存在明确关系。暗点中完全缺乏噪声感知在晚期青光眼（分期≥IV期）中更常见。在63例青光眼患者的110只眼中，通过吸盘眼压法人工升高眼压期间进行了白噪声视野检查：在吸盘负压逐步增加至最大375 mmHg的过程中，可以观察到以下阶段（括号内显示在负压范围内察觉到每种现象的眼睛百分比）：与初始结果相比，NF感知变化（96.4%）；中央噪声视野感知受损（78.2%）；NF同心性收缩（61.8%）；噪声（视野）感知完全丧失（42.7%）。通过评估导致这些NF现象中任何一种的吸盘负压，对这些眼睛进行进一步的定量分类是可能的。结果表明，白噪声视野检查法作为一种检测青光眼性视野缺损的非常快速的筛查方法是有用的。它也可以作为一种压力耐受性测试进行，从而用于对青光眼风险阶段进行分类。
