Simkin Samantha K, Misra Stuti L, Kasture Apurva, McGhee Charles Nj, Dai Shuan
Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Department of Ophthalmology, Auckland District Health Board, Auckland, New Zealand.
Clin Exp Optom. 2019 Jan;102(1):70-78. doi: 10.1111/cxo.12803. Epub 2018 Jun 25.
Common paediatric perimetry techniques require central fixation and subjective responses, which may be challenging for young or cognitively impaired children. The Saccadic Vector Optokinetic Perimeter (SVOP) was designed to overcome these challenges by using infra-red eye tracking to assess the visual field. This study assessed the clinical feasibility of SVOP in children without visual impairment, comparing it to current paediatric techniques, and in children with visual impairment.
Participants were recruited into two cohorts: children without visual impairment (visual acuity ≥ 6/7.5) and children with visual impairment (visual acuity ≤ 6/18). Children without visual impairment attempted the Goldmann perimeter, confrontation method, and SVOP. Children with visual impairment attempted SVOP, when clinically indicated, as part of a full ophthalmic assessment. Visual field results and test length were recorded.
Twenty-three children without visual impairment (4-14 years old) attempted all three visual field assessments. Full results were recorded for 91 per cent of children with SVOP, 87 per cent with Goldmann, and 100 per cent with confrontation SVOP was significantly faster than Goldmann (p < 0.001) and confrontation (p = 0.003). Thirty-five children with visual impairment (3-19 years old) with visual acuity ranging from 6/9.5 to worse than 6/360 (mean of 0.8 ± 0.4 logMAR) attempted SVOP, with 26 children able to complete SVOP.
This is the largest study to date of the clinical applicability of SVOP in children without visual impairment, as well as assessing the utility of SVOP in children with visual impairment. Further research is needed to assess the accuracy of SVOP in a range of paediatric ocular disorders. SVOP may potentially offer a visual field assessment method for children previously unable to complete current paediatric perimetry techniques.
常见的儿科视野检查技术需要中心注视和主观反应，这对于年幼或认知障碍儿童可能具有挑战性。扫视矢量视动视野计（SVOP）旨在通过使用红外眼动追踪来评估视野，从而克服这些挑战。本研究评估了SVOP在无视力损害儿童中的临床可行性，将其与当前儿科技术进行比较，并评估了其在视力损害儿童中的可行性。
参与者被纳入两个队列：无视力损害儿童（视力≥6/7.5）和视力损害儿童（视力≤6/18）。无视力损害儿童尝试进行Goldmann视野计检查、对照法检查和SVOP检查。视力损害儿童在临床指征明确时尝试进行SVOP检查，作为全面眼科评估的一部分。记录视野结果和检查时长。
23名无视力损害儿童（4 - 14岁）尝试了所有三种视野评估。SVOP检查中91%的儿童获得了完整结果，Goldmann视野计检查为87%，对照法检查为100%。SVOP明显比Goldmann视野计检查快（p < 0.001），也比对照法快（p = 0.003）。35名视力损害儿童（3 - 19岁），视力范围从6/9.5到差于6/360（平均0.8 ± 0.4 logMAR）尝试进行SVOP检查，其中26名儿童能够完成SVOP检查。
这是迄今为止关于SVOP在无视力损害儿童中临床适用性的最大规模研究，同时也评估了SVOP在视力损害儿童中的效用。需要进一步研究来评估SVOP在一系列儿科眼部疾病中的准确性。SVOP可能为以前无法完成当前儿科视野检查技术的儿童提供一种视野评估方法。
