Tailor Vijay, Glaze Selina, Unwin Hilary, Bowman Richard, Thompson Graham, Dahlmann-Noor Annegret
Department of Paediatric Ophthalmology and Strabismus, NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK.
South Essex Partnership Foundation Trust, SEPT Community Health Services Bedfordshire, Enhanced Service Centre, Bedford, UK.
Br J Ophthalmol. 2016 Oct;100(10):1427-32. doi: 10.1136/bjophthalmol-2015-307208. Epub 2016 Jan 6.
BACKGROUND/AIMS: Children and adults with neurological impairments are often not able to access conventional perimetry; however, information about the visual field is valuable. A new technology, saccadic vector optokinetic perimetry (SVOP), may have improved accessibility, but its accuracy has not been evaluated. We aimed to explore accessibility, testability and accuracy of SVOP in children with neurodisability or isolated visual pathway deficits.
Cohort study; recruitment October 2013-May 2014, at children's eye clinics at a tertiary referral centre and a regional Child Development Centre; full orthoptic assessment, SVOP (central 30° of the visual field) and confrontation visual fields (CVF). Group 1: age 1-16 years, neurodisability (n=16), group 2: age 10-16 years, confirmed or suspected visual field defect (n=21); group 2 also completed Goldmann visual field testing (GVFT).
Group 1: testability with a full 40-point test protocol is 12.5%; with reduced test protocols, testability is 100%, but plots may be clinically meaningless. Children (44%) and parents/carers (62.5%) find the test easy. SVOP and CVF agree in 50%. Group 2: testability is 62% for the 40-point protocol, and 90.5% for reduced protocols. Corneal changes in childhood glaucoma interfere with SVOP testing. All children and parents/carers find SVOP easy. Overall agreement with GVFT is 64.7%.
While SVOP is highly accessible to children, many cannot complete a full 40-point test. Agreement with current standard tests is moderate to poor. Abnormal saccades cause an apparent non-specific visual field defect. In children with glaucoma or nystagmus SVOP calibration often fails.
背景/目的：患有神经功能障碍的儿童和成人通常无法进行传统的视野检查；然而，有关视野的信息很有价值。一种新技术，即扫视向量视动视野计（SVOP），可能提高了可及性，但尚未评估其准确性。我们旨在探讨SVOP在患有神经残疾或孤立性视觉通路缺陷的儿童中的可及性、可测试性和准确性。
队列研究；2013年10月至2014年5月在一家三级转诊中心的儿童眼科诊所和一个地区儿童发展中心招募；进行全面的视光学评估、SVOP（视野中央30°）和对照视野检查（CVF）。第1组：年龄1至16岁，患有神经残疾（n = 16）；第2组：年龄10至16岁，确诊或疑似视野缺损（n = 21）；第2组还完成了戈德曼视野测试（GVFT）。
第1组：采用完整的40点测试方案时可测试性为12.5%；采用简化测试方案时，可测试性为100%，但结果图可能无临床意义。儿童（44%）和家长/照顾者（62.5%）认为该测试容易。SVOP和CVF的一致性为50%。第2组：40点方案时可测试性为62%，简化方案时为90.5%。儿童青光眼的角膜变化会干扰SVOP测试。所有儿童和家长/照顾者都认为SVOP容易。与GVFT的总体一致性为64.7%。
虽然SVOP对儿童具有很高的可及性，但许多儿童无法完成完整的40点测试。与当前标准测试的一致性为中等至较差。异常扫视会导致明显的非特异性视野缺损。在患有青光眼或眼球震颤的儿童中，SVOP校准经常失败。
