Department of Optometry and Visual Science, City University London, Northampton Square, London, UK.
Br J Ophthalmol. 2012 Sep;96(9):1185-9. doi: 10.1136/bjophthalmol-2012-301827. Epub 2012 Jul 14.
BACKGROUND/AIMS: To assess whether mean deviation (MD) from automated perimetry is related to the visual field (VF) component for legal fitness to drive (LFTD) in glaucoma patients.
Monocular 24-2 VFs of 2604 patients with bilateral VF damage were retrospectively investigated. Integrated visual fields were calculated and used as a surrogate to assess LFTD according to current UK driving licence criteria. The better eye MD (BEMD), worse eye MD (WEMD) and a measure utilising MD of both eyes were compared, to assess respective diagnostic capabilities to predict LFTD (using the integrated visual field surrogate test as the gold standard) and a 'Probability of Failure' (PoF) for various defect levels was calculated.
BEMD appears to be a good predictor of the VF component for a patient's LFTD (receiver operating characteristic area under the curve: 96.2%); MDs from both eyes offered no significant extra diagnostic power (area under the curve: 96.4%). PoF for BEMD thresholds of ≤-10 dB and ≤-14 dB were 70 (95% CI 66% to 74%) and 92% (87% to 95%), respectively.
There is a strong relationship between BEMD and a patient's LFTD. PoF values for LFTD associated with readily available MD values provide practical landmarks for VF disability in glaucoma.
背景/目的：评估青光眼患者的平均偏差（MD）与自动视野计的视野（VF）分量是否相关，以确定其是否适合合法驾驶。
回顾性研究了 2604 名双眼 VF 损伤患者的单眼 24-2 VFs。计算了综合视野，并将其用作替代指标，根据英国现行驾照标准评估 LFTD。比较了较好眼 MD（BEMD）、较差眼 MD（WEMD）和利用双眼 MD 的测量值，以评估各自预测 LFTD 的诊断能力（使用综合视野替代测试作为金标准）和各种缺陷水平的“故障概率”（PoF）。
BEMD 似乎是预测患者 LFTD 的 VF 分量的良好指标（受试者工作特征曲线下面积：96.2%）；双眼 MD 没有提供显著的额外诊断能力（曲线下面积：96.4%）。BEMD 阈值≤-10 dB 和≤-14 dB 的 PoF 分别为 70（95%CI 66%至 74%）和 92%（87%至 95%）。
BEMD 与患者的 LFTD 之间存在很强的关系。与易于获得的 MD 值相关的 LFTD 的 PoF 值为青光眼患者的 VF 残疾提供了实用的基准。
