Subhi Hikmat, Latham Keziah, Myint Joy, Crossland Michael
Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, UK.
University of Hertfordshire School of Life and Medical Sciences, Hatfield, UK.
BMJ Open. 2017 Nov 20;7(11):e018831. doi: 10.1136/bmjopen-2017-018831.
To develop an appropriate method of assessing visual field (VF) loss which reflects its functional consequences, this study aims to determine which method(s) of assessing VF best reflect mobility difficulty.
This cross-sectional observational study took place within a single primary care setting. Participants attended a single session at a University Eye Clinic, Cambridge, UK, with data collected by a single researcher (HS), a qualified optometrist.
50 adult participants with peripheral field impairment were recruited for this study. Individuals with conditions not primarily affecting peripheral visual function, such as macular degeneration, were excluded from the study.
Participants undertook three custom and one standard binocular VF tests assessing VF to 60°, and also integrated monocular threshold 24-2 visual fields (IVF). Primary VF outcomes were average mean threshold, percentage of stimuli seen and VF area. VF outcomes were compared with self-reported mobility function assessed with the Independent Mobility Questionnaire, and time taken and patient acceptability were also considered. Receiver operating characteristic (ROC) curves determined which tests best predicted difficulty with mobility tasks.
Greater VF loss was associated with greater self-reported mobility difficulty with all field paradigms (R 0.38-0.48, all P<0.001). All four binocular tests were better than the IVF at predicting difficulty with at least three mobility tasks in ROC analysis. Mean duration of the tests ranged from 1 min 26 s (±9 s) for kinetic assessment to 9 min 23 s (±24 s) for IVF.
The binocular VF tests extending to 60° eccentricity all relate similarly to self-reported mobility function, and slightly better than integrated monocular VFs. A kinetic assessment of VF area is quicker than and as effective at predicting mobility function as static threshold assessment.
为开发一种能反映视野（VF）丧失功能后果的合适评估方法，本研究旨在确定哪种评估VF的方法最能反映行动困难情况。
这项横断面观察性研究在单一初级保健机构内进行。参与者在英国剑桥大学眼科诊所参加单次就诊，数据由一名合格验光师（HS）单独收集。
招募了50名患有周边视野损害的成年参与者。主要影响非周边视觉功能的疾病患者，如黄斑变性患者，被排除在研究之外。
参与者进行了三项定制和一项标准双眼VF测试，评估至60°的视野，还进行了综合单眼阈值24-2视野（IVF）测试。主要VF结局指标为平均平均阈值、可见刺激百分比和VF面积。将VF结局与使用独立行动问卷评估的自我报告行动功能进行比较，并考虑测试所需时间和患者可接受性。通过受试者工作特征（ROC）曲线确定哪种测试最能预测行动任务困难情况。
在所有视野模式中，更大的VF丧失与更高的自我报告行动困难相关（R为0.38 - 0.48，所有P<0.001）。在ROC分析中，所有四项双眼测试在预测至少三项行动任务困难方面均优于IVF。测试的平均持续时间从动态评估的1分26秒（±9秒）到IVF的9分23秒（±24秒）不等。
延伸至60°偏心率的双眼VF测试与自我报告的行动功能的相关性相似，且略优于综合单眼VF。VF面积的动态评估在预测行动功能方面比静态阈值评估更快且同样有效。
