Bruun-Jensen Jørgen
University Hospital, Rigshospitalet, Slagelse, Denmark.
Optometry. 2011 Sep;82(9):519-27. doi: 10.1016/j.optm.2010.09.016.
The aim of this study was to develop a visual field screening system and investigate the importance of using 2 different programs for visual field screening to be used in places in which other perimeters are yet not available. The system consists of a laptop computer with instructions for the patient displayed on the screen and additional equipment to ensure central eye position, eye distance to the screen, optimal optical correction, and light intensity. This visual field screening system combines a screening program consisting of 68 test points with the highest density in areas of high prevalence of visual defects, followed by a supplementary program comprising 82 other test points in a quadratic lattice pattern.
The system was compared with Octopus 1-2-3 threshold perimetry, and the applicability of the system when operated by optometrists was evaluated.
In the glaucoma clinic at the University Hospital, Rigshospitalet, Denmark, the screening program was used to investigate 98 patients (173 eyes) and to compare the results with those of the Octopus Perimetry Program dG2. The sensitivity of the system was 100% and the specificity was 78%. Subsequently, 18 optometrists in different locations in Denmark tested 1,022 patients (2,036 eyes). Patients contacted these optometrists because of the presence of refractive error, subjective vision problems, or eye symptoms. The screening was used as a part of a routine examination. In 432 eyes (21%), visual defects were detected using the screening program. By re-examining 349 eyes, with the addition of the supplementary program consisting of 82 other test points in a quadratic lattice pattern, the visual field defects were not reproduced in 263 eyes, a reduction of primary positive visual field defects by 75%. The additional supplementary program was not conducted with 38 eyes (2%) because of large visual field defects, high intraocular pressures, cataract, positive family history of glaucoma, lack of time, or poor patient cooperation. In 56 eyes (3%) examined with the additional supplementary program, the defects found in the screening program were reproduced. In total, 59 (5.8%) patients (38 + 56 eyes) were recommended to pursue an ophthalmologic eye examination by a local ophthalmologist.
Confrontation visual field testing in many places is the only method used for examining the visual field. A laptop computer system for visual field screening could be a better method for visual field screening in the primary eye care setting. For clinical relevance, it is necessary to perform the method with 2 different screening programs. The method can be useful as an important part of a routine examination and for directing further examinations.
本研究的目的是开发一种视野筛查系统，并调查在尚无其他视野计的地方使用两种不同程序进行视野筛查的重要性。该系统由一台笔记本电脑组成，屏幕上显示给患者的指导说明，以及用于确保眼睛处于中心位置、眼睛与屏幕的距离、最佳光学矫正和光强度的附加设备。这种视野筛查系统将一个由68个测试点组成的筛查程序与一个在视觉缺陷高发区域具有最高密度的程序相结合，随后是一个由82个其他测试点组成的补充程序，呈二次点阵模式。
将该系统与Octopus 1-2-3阈值视野计进行比较，并评估验光师操作该系统时的适用性。
在丹麦里格霍斯皮塔尔大学医院的青光眼诊所，使用筛查程序对98例患者（173只眼）进行了检查，并将结果与Octopus视野计程序dG2的结果进行了比较。该系统的敏感性为100%，特异性为78%。随后，丹麦不同地点的18名验光师对1022例患者（2036只眼）进行了测试。患者因屈光不正、主观视力问题或眼部症状而联系这些验光师。筛查被用作常规检查的一部分。使用筛查程序在432只眼（21%）中检测到视觉缺陷。通过重新检查349只眼，加上由82个其他测试点组成的呈二次点阵模式的补充程序，在263只眼中未重现视野缺陷，原发性阳性视野缺陷减少了75%。由于视野缺损大、眼压高、白内障、青光眼家族史阳性、时间不足或患者合作不佳，38只眼（2%）未进行额外的补充程序。在使用额外补充程序检查的56只眼（3%）中，重现了筛查程序中发现的缺陷。总共59例（5.8%）患者（38只眼+56只眼）被建议由当地眼科医生进行眼科检查。
在许多地方，面对面视野测试是检查视野的唯一方法。用于视野筛查的笔记本电脑系统可能是初级眼科护理中更好的视野筛查方法。为了具有临床相关性，有必要使用两种不同的筛查程序进行该方法。该方法可作为常规检查的重要组成部分，并用于指导进一步检查。
