采用绝对阈值敏感性与校正阈值敏感性的逐点线性回归分析检测视野进展。

Pointwise linear regression analysis for detection of visual field progression with absolute versus corrected threshold sensitivities.

作者信息

Manassakorn Anita, Nouri-Mahdavi Kouros, Koucheki Behrooz, Law Simon K, Caprioli Joseph

机构信息

Glaucoma Division, Jules Stein Eye Institute, University of California Los Angeles, Los Angeles, California 90095, USA.

出版信息

Invest Ophthalmol Vis Sci. 2006 Jul;47(7):2896-903. doi: 10.1167/iovs.05-1079.

DOI:10.1167/iovs.05-1079

PMID:16799031

Abstract

PURPOSE

To compare the performance of point-wise linear regression analysis (PLR) with total deviation (TD) versus corrected or pattern deviation (PD) threshold sensitivities for detection of visual field progression.

METHODS

Four hundred two eyes (402 patients) enrolled in the Advanced Glaucoma Intervention Study (AGIS) were selected. Criteria for progression according to PLR were a slope<or=-1 dB/year with P<or=0.01 with >or=2 worsening points within the same Glaucoma Hemifield Test cluster. PLR was performed on TD and PD threshold sensitivities and compared to clinical evaluation. Eyes were classified into three groups based on mean deviation (MD): mild (MD>or=-6 dB), moderately advanced (-6 dB>MD>or=-12 dB), and advanced (MD<-12 dB) glaucoma.

RESULTS

Visual field progression was observed in 154 (38%), 85 (21%), and 175 (44%) eyes, according to PLR(TD) and PLR(PD), and clinical evaluation. The pair-wise agreement between clinicians and PLR(TD) was significantly greater than that of clinicians and PLR(PD) (kappa=0.48, 95% CI: 0.44-0.52 vs. kappa=0.31, 95% CI: 0.27-0.35). Agreement between PLR(TD) and PLR(PD) decreased with increasing glaucoma severity: kappa (95% CI)=0.60 (0.52-0.67), 0.41 (0.35-0.47), and 0.33 (0.27-0.40) for mild, moderately advanced, and advanced glaucoma, respectively.

CONCLUSIONS

Point-wise linear regression analysis on TD threshold sensitivities performed better than the same analysis on PD when clinical evaluation was used as a reference. Agreement between the two methods was less in moderately advanced and advanced glaucoma.

摘要

目的

比较逐点线性回归分析（PLR）采用总偏差（TD）与校正或模式偏差（PD）阈值敏感度检测视野进展的性能。

方法

选取参加高级青光眼干预研究（AGIS）的402只眼（402例患者）。根据PLR，进展标准为斜率≤ -1 dB/年，P≤0.01，且在同一青光眼半视野检测簇内有≥2个恶化点。对TD和PD阈值敏感度进行PLR，并与临床评估进行比较。根据平均偏差（MD）将眼部分为三组：轻度青光眼（MD≥ -6 dB）、中度进展性青光眼（-6 dB＞MD≥ -12 dB）和重度青光眼（MD＜ -12 dB）。

结果

根据PLR（TD）、PLR（PD）和临床评估，分别在154只眼（38%）、85只眼（21%）和175只眼（44%）中观察到视野进展。临床医生与PLR（TD）之间的两两一致性显著高于临床医生与PLR（PD）之间的一致性（kappa = 0.48，95%CI：0.44 - 0.52 vs. kappa = 0.31，95%CI：0.27 - 0.35）。PLR（TD）与PLR（PD）之间的一致性随青光眼严重程度增加而降低：轻度、中度进展性和重度青光眼的kappa（95%CI）分别为0.60（0.52 - 0.67）、0.41（0.35 - 0.47）和0.33（0.27 - 0.40）。