Departments of Ophthalmology.
Neurology, University of Iowa, College of Medicine, Veterans Administration Hospital.
J Glaucoma. 2019 Nov;28(11):997-1005. doi: 10.1097/IJG.0000000000001372.
The authors used the Open Perimetry Interface to design a static automated perimetry test of the full field. Abnormal test locations in the nasal midperiphery and temporal inferior sector area best separated glaucomas from normals.
The peripheral visual field in glaucoma outside 30 degrees is largely unexplored with static perimetry. Their goal was to use threshold static automated perimetry to characterize the visual loss in glaucoma of the central 30 degrees and the far periphery.
The authors administered the 30-2 perimetric test to 27 patients with early stage glaucoma (with mean deviation better than -4 dB) with the Goldmann III and V stimulus sizes and a custom test from 30 to up to 87 degrees with the size V stimulus twice within a month. The authors quantified (1) the retest variability, (2) the proportion of patients flagged as abnormal (at level 0.05) on the basis of pointwise probability distributions obtained from 63 ocular healthy observers, (3) the pointwise statistical distance using the Kullback-Leibler divergence between normal and glaucoma eyes, and (4) the effect of eccentricity on visual loss.
Size V 30-2 testing identified significantly more abnormal test locations (36%) than size III 30-2 (30%; P=0.004). Kullback-Leibler divergence between healthy and glaucoma distributions was greatest for the nasal midperipheral test locations and the inferior temporal sector area. A more pronounced decrease was found in visual sensitivity with eccentricity in the patients with glaucoma compared with the ocular healthy participants across the full visual field (P<0.001).
Patients with glaucoma demonstrate a systematic decrease in sensitivity with eccentricity across the full visual field. Goldmann size V stimuli better detected visual loss in patients with glaucoma with mild loss than size III.
作者使用开放视野接口设计了一种全场静态自动视野检查。鼻侧周边和颞下区异常测试位置最能区分青光眼和正常眼。
青光眼的 30 度以外的周边视野在静态视野检查中很大程度上尚未被探索。他们的目的是使用阈值静态自动视野检查来描述 30 度以内和远周边的青光眼的视力丧失。
作者对 27 例早期青光眼患者（平均偏差大于-4dB）进行了 30-2 视野检查，使用 Goldmann III 和 V 刺激大小，以及在一个月内使用 V 刺激大小两次从 30 度到高达 87 度的自定义测试。作者量化了（1）复测的可变性，（2）基于从 63 名眼部健康观察者获得的逐点概率分布，根据逐点概率分布将患者标记为异常的比例（在 0.05 水平），（3）使用正常眼和青光眼眼之间的 Kullback-Leibler 距离的逐点统计距离，以及（4）离中心对视力丧失的影响。
V 刺激大小 30-2 测试比 III 刺激大小 30-2 测试（36%比 30%；P=0.004）识别出更多的异常测试位置。健康和青光眼分布之间的 Kullback-Leibler 距离在鼻侧周边测试位置和颞下区最大。与眼部健康参与者相比，青光眼患者在整个视野中随着离中心距离的增加，视力敏感度的下降更为明显（P<0.001）。
青光眼患者在整个视野中随着离中心距离的增加，敏感性呈系统性下降。与 III 刺激大小相比，V 刺激大小能更好地检测出轻度损失的青光眼患者的视力丧失。
