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先进成像时代视野测试的价值:临床与心理物理学视角

The value of visual field testing in the era of advanced imaging: clinical and psychophysical perspectives.

作者信息

Phu Jack, Khuu Sieu K, Yapp Michael, Assaad Nagi, Hennessy Michael P, Kalloniatis Michael

机构信息

Centre for Eye Health, The University of New South Wales, Kensington, New South Wales, Australia.

School of Optometry and Vision Science, The University of New South Wales, Kensington, New South Wales, Australia.

出版信息

Clin Exp Optom. 2017 Jul;100(4):313-332. doi: 10.1111/cxo.12551. Epub 2017 Jun 22.

Abstract

White-on-white standard automated perimetry (SAP) is widely used in clinical and research settings for assessment of contrast sensitivity using incremental light stimuli across the visual field. It is one of the main functional measures of the effect of disease upon the visual system. SAP has evolved over the last 40 years to become an indispensable tool for comprehensive assessment of visual function. In modern clinical practice, a range of objective measurements of ocular structure, such as optical coherence tomography, have also become invaluable additions to the arsenal of the ophthalmic examination. Although structure-function correlation is a highly desirable determinant of an unambiguous clinical picture for a patient, in practice, clinicians are often faced with discordance of structural and functional results, which presents them with a challenge. The construction principles behind the development of SAP are used to discuss the interpretation of visual fields, as well as the problem of structure-function discordance. Through illustrative clinical examples, we provide useful insights to assist clinicians in combining a range of clinical results obtained from SAP and from advanced imaging techniques into a coherent picture that can help direct clinical management.

摘要

白色视标标准自动视野计(SAP)在临床和研究环境中被广泛用于通过在视野范围内递增光刺激来评估对比敏感度。它是疾病对视觉系统影响的主要功能测量方法之一。在过去40年里,SAP不断发展,已成为全面评估视觉功能不可或缺的工具。在现代临床实践中,一系列眼部结构的客观测量方法,如光学相干断层扫描,也已成为眼科检查手段中非常重要的补充。尽管结构与功能的相关性是明确患者临床情况的一个非常理想的决定因素,但在实际中,临床医生常常面临结构和功能结果不一致的情况,这给他们带来了挑战。本文利用SAP发展背后的构建原理来讨论视野的解读以及结构-功能不一致的问题。通过举例说明临床病例,我们提供了有用的见解,以帮助临床医生将从SAP和先进成像技术获得的一系列临床结果整合为一个连贯的情况,从而有助于指导临床管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66ce/5519947/0c822fb5e577/CXO-100-313-g001.jpg

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