Liu Shu, Yu Marco, Weinreb Robert N, Lai Gilda, Lam Dennis Shun-Chiu, Leung Christopher Kai-Shun
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, People's Republic of China.
Invest Ophthalmol Vis Sci. 2014 May 2;55(5):2862-9. doi: 10.1167/iovs.13-13225.
We compared the detection of visual field progression and its rate of change between standard automated perimetry (SAP) and Matrix frequency doubling technology perimetry (FDTP) in glaucoma.
We followed prospectively 217 eyes (179 glaucoma and 38 normal eyes) for SAP and FDTP testing at 4-month intervals for ≥36 months. Pointwise linear regression analysis was performed. A test location was considered progressing when the rate of change of visual sensitivity was ≤-1 dB/y for nonedge and ≤-2 dB/y for edge locations. Three criteria were used to define progression in an eye: ≥3 adjacent nonedge test locations (conservative), any three locations (moderate), and any two locations (liberal) progressed. The rate of change of visual sensitivity was calculated with linear mixed models.
Of the 217 eyes, 6.1% and 3.9% progressed with the conservative criteria, 14.5% and 5.6% of eyes progressed with the moderate criteria, and 20.1% and 11.7% of eyes progressed with the liberal criteria by FDTP and SAP, respectively. Taking all test locations into consideration (total, 54 × 179 locations), FDTP detected more progressing locations (176) than SAP (103, P < 0.001). The rate of change of visual field mean deviation (MD) was significantly faster for FDTP (all with P < 0.001). No eyes showed progression in the normal group using the conservative and the moderate criteria.
With a faster rate of change of visual sensitivity, FDTP detected more progressing eyes than SAP at a comparable level of specificity. Frequency doubling technology perimetry can provide a useful alternative to monitor glaucoma progression.
我们比较了标准自动视野计（SAP）和矩阵频率加倍技术视野计（FDTP）在青光眼患者中检测视野进展及其变化率的情况。
我们前瞻性地随访了217只眼（179只青光眼患眼和38只正常眼），每隔4个月进行一次SAP和FDTP检测，持续时间≥36个月。进行了逐点线性回归分析。当非边缘位置的视觉敏感度变化率≤ -1 dB/年且边缘位置≤ -2 dB/年时，认为该测试位点出现进展。使用三个标准来定义一只眼中的进展情况：≥3个相邻的非边缘测试位点进展（保守标准）、任意三个位点进展（中等标准）以及任意两个位点进展（宽松标准）。使用线性混合模型计算视觉敏感度的变化率。
在217只眼中，按照保守标准，FDTP和SAP检测到进展的眼分别为6.1%和3.9%；按照中等标准，进展的眼分别为14.5%和5.6%；按照宽松标准，进展的眼分别为20.1%和11.7%。考虑所有测试位点（共54×179个位点），FDTP检测到的进展位点（176个）比SAP（103个）更多（P < 0.001）。FDTP的视野平均偏差（MD）变化率显著更快（所有P值均< 0.001）。在正常组中，按照保守和中等标准，没有眼显示出进展。
由于视觉敏感度变化率更快，在特异性相当的水平上，FDTP检测到进展的眼比SAP更多。频率加倍技术视野计可为监测青光眼进展提供一种有用的替代方法。
