Senger Cassia, da Silva Marcelo Jordão Lopes, De Moraes Carlos Gustavo, Messias André, Paula Jayter Silva
Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School- University of São Paulo, Av. Bandeirantes, 3900 - 12°. Andar. Ribeirão Preto, São Paulo, Brazil.
Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, NY, USA.
Graefes Arch Clin Exp Ophthalmol. 2019 Jan;257(1):153-160. doi: 10.1007/s00417-018-4164-9. Epub 2018 Oct 27.
Visual search is a critical skill for several daily tasks and may be compromised in patients with impaired vision. The objective of this study was to study the relationships between exploratory visual search performance (EVSP) visual field (VF) sensitivity in patients with glaucoma.
Primary open-angle glaucoma patients (POAG; n = 29) and healthy (Control; n = 28) individuals with best corrected visual acuity better than 0.2 logMAR underwent a comprehensive ophthalmological examination, including Humphrey VF tests (24-2 SITA-Standard), and a monocular exploratory visual search digit-based task performed using a software that quantifies the time spent to find a targert on a random array of digits distributed on nine sequential screens. The screens were divided into five areas to topographically match with five VF sectors.
As expected, POAG eyes had worse VF mean deviation (MD) sensitivity and EVSP than Controls (MD - 8.02 ± 7.88 dB vs - 1.43 ± 1.50 dB, p < 0.0001; and total EVSP time 106.42 ± 59.64 s vs 52.75 ± 19.07 s, p < 0.0001). MD sensitivity of both groups significantly correlated with total EVSP time (POAG r = - 0.45, p = 0.01; and Control r = 0.37, p = 0.049). A significant relationship was observed between EVSP (individual time) and both visual acuity (p = 0.006) and glaucoma diagnosis (p = 0.005). The mean sensitivity of the peripheral VF areas of the POAG group showed significant correlation with the individual search time in the corresponding spatial areas, except in the peripheral superior temporal area (r = - 0.35, p = 0.06).
These data indicate that POAG patients' EVSP is impaired in topographically-correspondent VF areas with sensitivity loss. Visual search may be considered as a measure of impairment of daily activities in glaucoma patients, if further similar tests using binocular conditions corroborate our findings.
视觉搜索是多项日常任务中的一项关键技能，视力受损的患者可能会受到影响。本研究的目的是探讨青光眼患者的探索性视觉搜索表现（EVSP）与视野（VF）敏感度之间的关系。
原发性开角型青光眼患者（POAG；n = 29）和最佳矫正视力优于0.2 logMAR的健康个体（对照组；n = 28）接受了全面的眼科检查，包括Humphrey视野测试（24-2 SITA标准），以及使用一款软件进行的基于数字的单眼探索性视觉搜索任务，该软件可量化在九个连续屏幕上分布的随机数字阵列中找到目标所花费的时间。屏幕被分为五个区域，以便在地形上与五个视野扇区相匹配。
正如预期的那样，POAG组患眼的视野平均偏差（MD）敏感度和EVSP均低于对照组（MD -8.02±7.88 dB对-1.43±1.50 dB，p < 0.0001；总EVSP时间106.42±59.64秒对52.75±19.07秒，p < 0.0001）。两组的MD敏感度均与总EVSP时间显著相关（POAG组r = -0.45，p = 0.01；对照组r = 0.37，p = 0.049）。在EVSP（个体时间）与视力（p = 0.006）和青光眼诊断（p = 0.005）之间均观察到显著关系。POAG组周边视野区域的平均敏感度与相应空间区域的个体搜索时间显著相关，但周边颞上区域除外（r = -0.35，p = 0.06）。
这些数据表明，POAG患者在与敏感度丧失相对应的视野区域中，其EVSP受损。如果使用双眼条件进行的进一步类似测试证实了我们的发现，视觉搜索可被视为青光眼患者日常活动受损的一项指标。
