Gonzalez de la Rosa Manuel, Gonzalez-Hernandez Marta, Sanchez-Garcia Mariel, Rodriguez de la Vega Ricardo, Diaz-Aleman Tinguaro, Pareja Rios Alicia
University of La Laguna, La Laguna, Spain.
Eur J Ophthalmol. 2013 May-Jun;23(3):316-23. doi: 10.5301/ejo.5000233. Epub 2013 Jan 25.
To compare diagnostic capabilities and agreement between Oculus-Spark perimetry and 3 procedures of glaucoma morphologic analysis.
A total of 102 normal eyes and 104 consecutive eyes with suspected or confirmed glaucoma (1 eye per subject) were analyzed in a prospective observational case-control study, using Spark strategy (Oculus Easyfield Perimeter), Heidelberg retinal tomograph (HRT), Zeiss laser polarimetry (GDx), and Cirrus optical coherence tomography (OCT).
Spark first phase lasted 37 seconds and all 4 phases 2:34 minutes. Specificities and sensitivities were as follows: Spark mean deviation (MD) first phase (95.1%, 85.6%), MD second and final phases (95.1%, 86.5%), GDx-nerve fiber indicator (95.1%, 57.4%), HRT-Reinhard Burk discriminant function (95.1%, 52.9%), HRT glaucoma probability score (95.1%, 71.2%), Cirrus OCT vertical cup/disc ratio (96.1%, 85.6%), and Cirrus OCT retinal nerve fiber layer thickness (95.1%, 68.0%). Diagnostic agreement between second and final Spark MD phases was kappa=0.92; between phase 1 Spark/MD and Cirrus OCT/vertical C/D ratio was kappa=0.78. Agreements between the 2 Cirrus OCT indices was kappa=0.69 and between the 2 HRT indices was kappa=0.559. The correlation coefficient between second and final MD and PSD was 0.99, and 0.98 between the number of scotomatous points. There was high concordance in scotoma position in both phases (kappa=0.86). The linear correlation coefficients between the morphologic indices were 0.48-0.78, and between morphologic and functional indices 0.51-0.76. Correlation coefficients comparing morphologic and functional indices were similar in the first and the last phase (p>0.05 in all cases).
Spark perimetry appears to show useful sensitivity and specificity, even in the first phase, and good agreement with the morphology.
比较Oculus-Spark视野检查与3种青光眼形态学分析方法的诊断能力及一致性。
在一项前瞻性观察性病例对照研究中，对102只正常眼和104只连续的疑似或确诊青光眼的眼睛（每位受试者1只眼）进行分析，使用Spark策略（Oculus Easyfield视野计）、海德堡视网膜断层扫描仪（HRT）、蔡司激光偏振仪（GDx）和Cirrus光学相干断层扫描（OCT）。
Spark第一阶段持续37秒，所有4个阶段共2分34秒。特异性和敏感性如下：Spark平均偏差（MD）第一阶段（95.1%，85.6%），MD第二阶段和最后阶段（95.1%，86.5%），GDx神经纤维指标（95.1%，57.4%），HRT-莱因哈德·伯克判别函数（95.1%，52.9%），HRT青光眼概率评分（95.1%，71.2%），Cirrus OCT垂直杯盘比（96.1%，85.6%），以及Cirrus OCT视网膜神经纤维层厚度（95.1%，68.0%）。Spark MD第二阶段和最后阶段之间的诊断一致性kappa=0.92；第一阶段Spark/MD与Cirrus OCT/垂直杯盘比之间的一致性kappa=0.78。Cirrus OCT的2个指标之间一致性kappa=0.69，HRT的2个指标之间一致性kappa=0.559。第二阶段和最后阶段的MD与PSD之间的相关系数为0.99，暗点数量之间的相关系数为0.98。两个阶段暗点位置的一致性较高（kappa=0.86）。形态学指标之间的线性相关系数为0.48 - 0.78，形态学指标与功能指标之间的线性相关系数为0.51 - 0.76。比较形态学指标与功能指标的相关系数在第一阶段和最后阶段相似（所有情况下p>0.05）。
即使在第一阶段，Spark视野检查似乎也显示出有用的敏感性和特异性，并且与形态学有良好的一致性。
