Kiser Ava K, Mladenovich Derek, Eshraghi Fariba, Bourdeau Debra, Dagnelie Gislin
Lions Vision Center, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland 21205-2020, USA.
Invest Ophthalmol Vis Sci. 2006 Jan;47(1):444-52. doi: 10.1167/iovs.04-1146.
To establish reliable vision measures allowing functional monitoring in patients with severe vision loss.
Legally blind and normally sighted subjects were enrolled in a repeated-measures study to determine the reproducibility of psychophysical vision measures under scotopic conditions. The tests included dark adaptometry, dark-adapted, full-field flash testing, and dark-adapted macular thresholds, obtained by using a perimeter with 500- and 650-nm targets. Two to five test repetitions were performed on the better eye of each subject at monthly intervals. Subject groups included retinitis pigmentosa (RP; n = 33), macular disease (MD; n = 14), optic nerve disease (ON; n = 4), diabetic retinopathy (DR; n = 5), and other retinal diseases (OR; n = 9), and normally sighted control (CTL; n = 12).
Dark adaptometry timing yielded mean coefficients of variation for subjects across all groups that averaged approximately 20% throughout the test. For dark-adapted perimetry, the coefficients of repeatability (CR(.95)) were <7 dB (CTL), <8 dB (OR), <6 dB (ON and RP), and <15 dB (MD). Full-field flash test CR(.95) by group varied from 5 to 15 dB, and most low-vision groups performed more reliably than CTL subjects.
Dark-adapted psychophysical tests can provide reproducible vision measures in subjects with severe visual impairments, and these tests would be useful in monitoring outcomes in future clinical trials to reverse, halt, or slow vision loss. The most valuable measure of remaining vision was the dark-adapted, full-field flash test, as it produced repeatable results at all levels of vision loss and for all disease states included in this study.
建立可靠的视力测量方法，以便对严重视力丧失患者进行功能监测。
招募法定失明和视力正常的受试者参与一项重复测量研究，以确定在暗视条件下心理物理学视力测量的可重复性。测试包括暗适应测量、暗适应全视野闪光测试以及通过使用带有500纳米和650纳米目标的视野计获得的暗适应黄斑阈值。对每个受试者的较好眼每月进行两到五次测试重复。受试者组包括视网膜色素变性（RP；n = 33）、黄斑疾病（MD；n = 14）、视神经疾病（ON；n = 4）、糖尿病视网膜病变（DR；n = 5）和其他视网膜疾病（OR；n = 9），以及视力正常的对照组（CTL；n = 12）。
暗适应测量时间在所有组受试者中产生的平均变异系数在整个测试过程中约为20%。对于暗适应视野检查，重复性系数（CR(.95)）为<7 dB（CTL）、<8 dB（OR）、<6 dB（ON和RP）以及<15 dB（MD）。全视野闪光测试的CR(.95)按组从5 dB到15 dB不等，大多数低视力组的表现比CTL受试者更可靠。
暗适应心理物理学测试可为严重视力损害受试者提供可重复的视力测量，这些测试将有助于监测未来旨在逆转、阻止或减缓视力丧失的临床试验结果。剩余视力最有价值的测量方法是暗适应全视野闪光测试，因为它在本研究中涵盖的所有视力丧失水平和所有疾病状态下都产生了可重复的结果。
