标准自动视野计、频域技术视野计和短波长自动视野计在青光眼检测中的比较。

Comparison of standard automated perimetry, frequency-doubling technology perimetry, and short-wavelength automated perimetry for detection of glaucoma.

机构信息

Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Peoples Republic of China.

出版信息

Invest Ophthalmol Vis Sci. 2011 Sep 21;52(10):7325-31. doi: 10.1167/iovs.11-7795.

DOI:10.1167/iovs.11-7795

PMID:21810975

Abstract

PURPOSE

To compare the performance of standard automated perimetry (SAP), frequency-doubling technology (FDT) perimetry, and short-wavelength automated perimetry (SWAP) in detecting glaucoma.

METHODS

One hundred thirty-two eyes of 95 glaucoma patients and 37 normal subjects had retinal nerve fiber layer (RNFL) imaging and visual field testing by SAP, Matrix FDT perimetry, and Swedish interactive thresholding algorithm (SITA) SWAP at the same visit (all perimeters by Carl Zeiss Meditec, Inc., Dublin, CA). Visual field defects were confirmed with two or more consecutive examinations by the same types of perimetry. Glaucoma was defined with the reference to the RNFL thickness deviation map score (≥ 4, glaucomatous; ≤ 2, normal). The sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) of MD (mean deviation) and PSD (pattern standard deviation) of the perimetries were compared.

RESULTS

Taking all glaucoma patients into consideration, the sensitivity was highest for Matrix FDT perimetry (69%), followed by SAP (68%), and then SITA SWAP (59%). When the analysis included only patients with early glaucoma, the sensitivity decreased to 52%, 46%, and 34%, respectively, with a significant difference detected between Matrix FDT perimetry and SITA SWAP (P = 0.034). The specificity was ≥ 97% for all perimetries. The AUCs of MD and PSD followed a similar order, with Matrix FDT perimetry having the greatest AUC (0.89-0.94), followed by SAP (0.87-0.94), and then SITA SWAP (0.69-0.90). There were significant differences in sensitivities at 90% specificity between Matrix FDT perimetry and SITA SWAP (P ≤ 0.005 for MD; P ≤ 0.039 for PSD).

CONCLUSIONS

The performance for glaucoma detection was comparable between FDT perimetry and SAP. FDT perimetry had a higher sensitivity for detecting glaucoma than did SWAP at a comparable level of specificity.

摘要

目的

比较标准自动视野计（SAP）、频域技术（FDT）视野计和短波长自动视野计（SWAP）检测青光眼的性能。

方法

95 例青光眼患者的 132 只眼和 37 例正常对照者在同一次就诊时接受视网膜神经纤维层（RNFL）成像和 SAP、Matrix FDT 视野计和瑞典交互阈值算法（SITA）SWAP 检查（所有视野计均由德国卡尔蔡司 Meditec 公司生产）。通过同类型视野计的两次或多次连续检查来确认视野缺损。青光眼的定义是参照 RNFL 厚度偏差图评分（≥4，青光眼；≤2，正常）。比较 MD（平均偏差）和 PSD（模式标准差）的各视野计的灵敏度、特异性和受试者工作特征曲线下面积（AUC）。

结果

将所有青光眼患者纳入考虑，Matrix FDT 视野计的灵敏度最高（69%），其次是 SAP（68%），然后是 SITA SWAP（59%）。当仅分析早期青光眼患者时，灵敏度分别降至 52%、46%和 34%，Matrix FDT 视野计和 SITA SWAP 之间的差异有统计学意义（P=0.034）。所有视野计的特异性均≥97%。MD 和 PSD 的 AUC 呈相似的顺序，Matrix FDT 视野计的 AUC 最大（0.89-0.94），其次是 SAP（0.87-0.94），然后是 SITA SWAP（0.69-0.90）。在 90%特异性时，Matrix FDT 视野计和 SITA SWAP 的灵敏度差异有统计学意义（MD：P≤0.005；PSD：P≤0.039）。