Cello Kimberly E, Keltner John L, Johnson Chris A, Wall Michael
Departments of Ophthalmology and Vision Science (KEC), and Neurology and Neurological Surgery (JLK), University of California Davis, California; Department of Ophthalmology and Visual Sciences (CAJ), University of Iowa, Iowa City, Iowa; and Department of Neurology and Ophthalmology (MW), College of Medicine, University of Iowa, Iowa City, Iowa.
J Neuroophthalmol. 2016 Mar;36(1):6-12. doi: 10.1097/WNO.0000000000000327.
To determine the prevalence of visual field (VF) performance failures (PF) and treatment failures (TFs), and identify factors associated with PFs in the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT).
A total of 165 participants from 38 sites with idiopathic intracranial hypertension (IIH) and mild visual loss were randomized to either acetazolamide-plus diet or placebo-plus diet. The IIHTT Visual Field Reading Center evaluated 2950 Swedish Interactive Threshold Algorithm Standard 24-2 VFs from the enrolled participants. A TF was defined when the participant's VF mean deviation (MD) worsened ≥2 to 3 dB from the average baseline MD (range of -2 to -7 dB) with a second retest confirming the visual deterioration. A PF was determined when the participant's: 1) VF results met TF criteria but were not confirmed on retest, 2) deterioration was confirmed on retest but the IIHTT Adjudication Committee concluded a TF was clinically unlikely.
TF was detected in 7/165 (4%) of the participants and PF was detected in 35/165 (21%) of the participants on at least 1 examination. Four of the 35 PFs were adjudicated for TF, however based on clinical review by the adjudication committee and a third retest, they were judged as PFs. Of the 2,950 total IIHTT VF examinations, 2.7% met PF criteria.
PF was confirmed in 21% of subjects and in 2.7% of the total number of VF examinations and was reversible on repeat testing. We recommend retesting when perimetric worsening occurs in otherwise clinically stable or improving IIH patients.
在特发性颅内高压治疗试验（IIHTT）中，确定视野（VF）检查表现失败（PF）和治疗失败（TF）的发生率，并识别与PF相关的因素。
来自38个地点的165名患有特发性颅内高压（IIH）和轻度视力丧失的参与者被随机分为乙酰唑胺加饮食组或安慰剂加饮食组。IIHTT视野阅读中心评估了入选参与者的2950次瑞典交互式阈值算法标准24-2视野检查。当参与者的VF平均偏差（MD）较平均基线MD（范围为-2至-7 dB）恶化≥2至3 dB，且第二次重新测试确认视力恶化时，定义为TF。当参与者出现以下情况时确定为PF：1）VF结果符合TF标准，但重新测试未得到确认；2）重新测试确认有恶化，但IIHTT判定委员会得出临床不太可能发生TF的结论。
在至少1次检查中，7/165（4%）的参与者检测到TF，35/165（21%）的参与者检测到PF。35例PF中有4例被判定为TF，但根据判定委员会的临床审查和第三次重新测试，它们被判定为PF。在IIHTT总共2950次VF检查中，2.7%符合PF标准。
21%的受试者和2.7%的VF检查总数中确认存在PF，且重复测试时可逆转。我们建议，在临床稳定或病情改善的IIH患者出现视野检查恶化时进行重新测试。
