Giraud J M, Fenolland J R, May F, Hammam O, Sadat A M, Boumezrag A Bey, Renard J P
Clinique d'Ophtalmologie, Hôpital d'Instruction des Armées du Val de Grâce, 74 bd de Port Royal, 75005 Paris, France.
J Fr Ophtalmol. 2010 Jan;33(1):2-9. doi: 10.1016/j.jfo.2009.11.004. Epub 2009 Dec 10.
The Visual Field Index -VFI- is a new perimetric index allowing evaluation of visual function level and progression. In this study, we analysed this new index, that provides a trend analysis of visual field loss progression in Ocular Hypertension and Glaucoma. We also compared results with event analysis.
Retrospective study on 94 eyes of 54 patients: 35 OHT(ocular hypertension), 34 early POAG (primary open angle glaucoma) (0>MD>-6 dB), 13 moderate POAG (-6>MD>-12 dB) and 12 advanced POAG (MD<-12 dB), with a mean follow-up of 6.5 years (4 to 8 years). Each subject performed a mean number of 10 standard automated perimetry visual field tests (Humphrey SITA Standard 24-2), excluding tests without reliable indices. VFI progression rate was analysed. VFI progression during the first half period of follow up was compared with that during the second half period. VFI progression was confronted with script alert messages delivered by the last GPA (Guided Progression Analysis) event analysis program.
VFI values were "stable or with low progression" in 100% of OHT patients, 88% of early POAG, 38.5% of moderate POAG, 33% of advanced POAG. Progression during the first half period (mean of 3 years) of follow-up could be extrapolated for the second half period in 97% of OHT patients, 76% of early POAG, 70% of moderate POAG, 75% of advanced POAG. Results from VFI trend analysis and GPA event analysis corresponded in 97% of OHT patients, 85% of early POAG, 85% of moderate POAG, and 87% of advanced POAG.
VFI seems to be a useful indicator for glaucoma evaluation and progression follow-up. It completes the event analysis. Some very advanced POAG cannot be analysed by GPA event analysis. VFI should be able to be used for further follow-up. All these results require validation in larger population. The purpose would be to assess if VFI is able to detect different profiles of progression to help treatment decisions.
视野指数（VFI）是一种新的视野检查指数，可用于评估视功能水平及病情进展。在本研究中，我们分析了这一能对高眼压症和青光眼患者视野缺损进展进行趋势分析的新指数。我们还将结果与事件分析进行了比较。
对54例患者的94只眼进行回顾性研究，其中35例高眼压症患者，34例早期原发性开角型青光眼（0＞平均缺损（MD）＞-6 dB），13例中度原发性开角型青光眼（-6＞MD＞-12 dB），12例晚期原发性开角型青光眼（MD＜-12 dB），平均随访6.5年（4至8年）。每位受试者平均进行10次标准自动视野计视野检查（Humphrey SITA标准24-2），排除无可靠指标的检查。分析VFI进展率。比较随访前半期与后半期的VFI进展情况。将VFI进展情况与最后一个GPA（引导性进展分析）事件分析程序发出的脚本警报信息进行对比。
100%的高眼压症患者、88%的早期原发性开角型青光眼患者、38.5%的中度原发性开角型青光眼患者、33%的晚期原发性开角型青光眼患者的VFI值“稳定或进展缓慢”。97%的高眼压症患者、76%的早期原发性开角型青光眼患者、70%的中度原发性开角型青光眼患者、75%的晚期原发性开角型青光眼患者随访前半期（平均3年）的进展情况可外推至后半期。VFI趋势分析结果与GPA事件分析结果在97%的高眼压症患者、85%的早期原发性开角型青光眼患者、85%的中度原发性开角型青光眼患者、87%的晚期原发性开角型青光眼患者中相符。
VFI似乎是青光眼评估及病情进展随访的有用指标。它完善了事件分析。一些极晚期原发性开角型青光眼无法通过GPA事件分析进行评估。VFI应能用于进一步随访。所有这些结果都需要在更大规模人群中进行验证。目的是评估VFI是否能够检测出不同的进展模式以辅助治疗决策。
