Nowomiejska Katarzyna, Wrobel-Dudzinska Dominika, Ksiazek Katarzyna, Ksiazek Piotr, Rejdak Konrad, Maciejewski Ryszard, Juenemann Anselm G, Rejdak Robert
Department of General Ophthalmology, Medical University, Lublin, Poland.
Ophthalmic Physiol Opt. 2015 Mar;35(2):147-54. doi: 10.1111/opo.12183. Epub 2014 Nov 28.
To test the hypothesis whether semi-automated kinetic perimetry (SKP) provides additional information to static automated perimetry (SAP) in the assessment of the remaining visual field in end-stage glaucoma, as defined by disc appearance (cup-to-disc ratio worse than 0.9) and SAP criteria (MD worse than 20 dB).
Fifty eyes of 44 patients presenting with end-stage glaucoma were examined first with SAP within the central 30° using stimulus size III, followed by SKP within 90° using test targets III4e and V4e.
Overall, SKP provided additional information over SAP in more than half (54%) of the cases. In 16 instances (32%), SKP revealed visual field island beyond 30° that was undetected by SAP. In eight cases (16%), SKP showed both a central island and peripheral island of visual field. In three cases (6%) altitudinal scotomatous loss was found using SKP, but not in SAP. In 23 cases (46%) the central visual field island was defined both with SAP and SKP. The mean examination duration was 4 min for SAP and 9 min for SKP.
In clinical practice, SKP with III4e and V4e test targets provides more information than 30° SAP regarding the remaining peripheral VF in patients with end-stage glaucoma; however, a longer test time is required for SKP.
检验以下假设,即对于终末期青光眼患者剩余视野的评估,半自动动态视野计(SKP)相对于静态自动视野计(SAP)是否能提供更多信息。终末期青光眼的定义为视盘外观(杯盘比大于0.9)和SAP标准(平均缺损大于20 dB)。
对44例终末期青光眼患者的50只眼进行检查,首先使用刺激大小为III的视标在中央30°范围内进行SAP检查,随后使用III4e和V4e测试视标在90°范围内进行SKP检查。
总体而言,在超过半数(54%)的病例中,SKP比SAP提供了更多信息。在16例(32%)中,SKP发现了SAP未检测到的30°以外的视野岛。在8例(16%)中,SKP显示出中央视野岛和周边视野岛。在3例(6%)中,使用SKP发现了垂直性暗点性缺损,但SAP未发现。在23例(46%)中,中央视野岛通过SAP和SKP均得以明确。SAP的平均检查时间为4分钟,SKP为9分钟。
在临床实践中,使用III4e和V4e测试视标的SKP比30°的SAP能提供更多关于终末期青光眼患者剩余周边视野的信息;然而,SKP需要更长的检查时间。