Department of Ophthalmology, the University of Tokyo Graduate School of medicine, Tokyo, Japan.
Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan.
Sci Rep. 2017 Aug 2;7(1):7095. doi: 10.1038/s41598-017-07714-7.
Accurate measurement of visual field (VF) is important in accessing glaucoma, however this may not be achieved in patients with dementia or mild cognitive impairment (CI). We investigated the association between CI and structure-function relationships in elderly glaucoma patients. The study included 94 eyes of 51 glaucoma patients aged ≥75 years with no diagnoses of dementia. CI was assessed using the Mini Mental State Examination (MMSE). Using the leave-one-out cross-validation, the mean deviation (MD) of the Humphrey 30-2 VF was predicted from measurements of optical coherence tomography, and the relationship between the squared prediction error and the MMSE score, together with age, fixation loss (FL), false positive (FP), and false negative (FN) percentages that were analyzed using the linear mixed model. A high prevalence of MCI or dementia was observed in the elderly population. The squared prediction error value of the MD was 17.0 ± 21.1 (mean ± standard deviation). The squared prediction error increased with decreasing MMSE total score, but age, FL, FP, and FN were not related. Careful consideration is needed when interpreting the VF results of these patients, because VF can be over- or underestimated, as suggested by the decreased structure-function relationships.
视野（VF）的准确测量在评估青光眼方面很重要，但在痴呆或轻度认知障碍（CI）患者中可能无法实现。我们研究了 CI 与老年青光眼患者结构-功能关系之间的关联。该研究纳入了 51 名年龄≥75 岁且无痴呆诊断的青光眼患者的 94 只眼。CI 采用简易精神状态检查（MMSE）进行评估。使用留一法交叉验证，从光学相干断层扫描测量值预测 Humphrey 30-2 VF 的平均偏差（MD），并使用线性混合模型分析 MMSE 评分、年龄、固视丢失（FL）、假阳性（FP）和假阴性（FN）百分比与预测误差平方之间的关系。在老年人群中观察到 MCI 或痴呆的高患病率。MD 的预测误差平方值为 17.0±21.1（平均值±标准差）。预测误差平方值随 MMSE 总分的降低而增加，但与年龄、FL、FP 和 FN 无关。在解释这些患者的 VF 结果时需要谨慎考虑，因为正如结构-功能关系降低所表明的那样，VF 可能会被高估或低估。
