Johnson L N, Baloh F G
Neuro-Ophthalmology Division, Penn State University, Hershey.
J Natl Med Assoc. 1991 Oct;83(10):895-8.
The accuracy of confrontation visual field testing was determined for 512 visual fields using automated static perimetry as the reference standard. The sensitivity of confrontation testing excluding patchy defects was 40% for detecting anterior visual field defects, 68.3% for posterior defects, and 50% for both anterior and posterior visual field defects combined. The sensitivity within each group varied depending on the type of visual field defect encountered. Confrontation testing had a high sensitivity (75% to 100%) for detecting altitudinal visual loss, central/centrocecal scotoma, and homonymous hemianopsia. Confrontation testing was fairly insensitive (20% to 50% sensitivity) for detecting arcuate scotoma and bitemporal hemianopsia. The specificity of confrontation testing was high at 93.4%. The high positive predictive value (72.6%) and negative predictive value (75.7%) would indicate that visual field defects identified during confrontation testing are often true visual field defects. However, the many limitations of confrontation testing should be remembered, particularly its low sensitivity for detecting visual field loss associated with parasellar tumors, glaucoma, and compressive optic neuropathies.
以自动静态视野计作为参考标准，对512个视野进行了对照视野测试的准确性评估。排除片状缺损后，对照测试检测前部视野缺损的敏感性为40%，检测后部缺损的敏感性为68.3%，检测前部和后部视野缺损合并情况的敏感性为50%。每组内的敏感性因所遇到的视野缺损类型而异。对照测试在检测高度性视力丧失、中心/中心暗点和同向性偏盲方面具有较高的敏感性（75%至100%）。对照测试在检测弓形暗点和双颞侧偏盲方面相当不敏感（敏感性为20%至50%）。对照测试的特异性较高，为93.4%。较高的阳性预测值（72.6%）和阴性预测值（75.7%）表明，在对照测试中发现的视野缺损往往是真正的视野缺损。然而，应牢记对照测试的诸多局限性，尤其是其在检测与鞍旁肿瘤、青光眼和压迫性视神经病变相关的视野缺损时敏感性较低。
