Departments of Ophthalmology, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Korea.
Invest Ophthalmol Vis Sci. 2012 Aug 9;53(9):5410-5. doi: 10.1167/iovs.12-9905.
The purpose of the study was to investigate the diagnostic ability of the neurologic hemifield test (NHT) and retinal nerve fiber layer (RNFL) thickness measurements to detect chiasmal compression.
Thirty-seven patients with chiasmal compression, 35 patients with glaucoma, and 30 patients with glaucoma suspect were enrolled. The NHT score was established from a 30-2 visual field pattern deviation probability plot. Each test point value was calculated for a number that was inversely proportional to its pattern deviation probability. The NHT score was the absolute value of the difference in the sum of the point scores for two symmetrical regions of 16 points on either side of the vertical meridian. RNFL thickness was scored from 0 to 10 according to the pattern of RNFL loss and probability of abnormality. Solely present nasal or temporal RNFL defects were scored high, and exclusively appearing superior or nasal RNFL defects were scored low. The differences in the NHT and RNFL scores among the three groups were compared. Diagnostic ability was assessed by receiver operating characteristic (ROC) analysis.
The NHT and RNFL scores were significantly higher in patients with chiasmal compression than in patients with glaucoma and glaucoma suspect. The area under the ROC curve (AROC) was 0.734 of the NHT score and 0.613 of the RNFL score. When AROC was calculated using the NHT and RNFL scores concurrently, AROC was increased to 0.807.
The NHT score and RNFL score have diagnostic ability to detect chiasmal compression, and simultaneous assessment of NHT and RNFL scores improves the diagnostic power.
本研究旨在探讨神经视野测试（NHT）和视网膜神经纤维层（RNFL）厚度测量对视交叉受压的诊断能力。
纳入 37 例视交叉受压患者、35 例青光眼患者和 30 例青光眼疑似患者。NHT 评分基于 30-2 视野模式偏差概率图建立。每个测试点的值根据与其模式偏差概率成反比的数值计算。NHT 评分是垂直子午线两侧 16 个点对称区域的点评分总和的绝对值差异。根据 RNFL 缺失模式和异常概率将 RNFL 厚度评分从 0 到 10。单纯出现鼻侧或颞侧 RNFL 缺损者评分高，仅出现上方或鼻侧 RNFL 缺损者评分低。比较三组之间的 NHT 和 RNFL 评分差异。通过接收者操作特征（ROC）分析评估诊断能力。
视交叉受压患者的 NHT 和 RNFL 评分明显高于青光眼和青光眼疑似患者。NHT 评分的 ROC 曲线下面积（AUC）为 0.734，RNFL 评分的 AUC 为 0.613。当同时使用 NHT 和 RNFL 评分计算 AUC 时，AUC 增加到 0.807。
NHT 评分和 RNFL 评分对视交叉受压具有诊断能力，同时评估 NHT 和 RNFL 评分可提高诊断能力。
