Werner E B, Adelson A, Krupin T
Glaucoma Service, Scheie Eye Institute, University of Pennsylvania School of Medicine, Philadelphia.
Ophthalmology. 1988 Jun;95(6):764-7. doi: 10.1016/s0161-6420(88)33111-8.
The first four automated visual field examinations of 20 patients with clinically stable chronic open-angle glaucoma who had previously undergone manual perimetry were studied for the presence of a learning effect on mean sensitivity, number of disturbed test locations, total loss, and short-term fluctuation. A learning effect, if present, would manifest itself as an improvement in the visual field as patients become more experienced with the test. There was no apparent effect of patient experience on the mean sensitivity, total loss, or the number of disturbed test locations. There was a significant (P less than 0.0001) decrease in short-term fluctuation as measured by the root mean square between the first and second visual field examinations. These results indicate that a learning effect did not play an important role in the clinical interpretation of automated perimetry in patients with glaucoma who have previous experience with manual perimetry. In most cases, it was not necessary to obtain more than one "baseline" examination unless a patient demonstrated unusually high short-term fluctuation or had visual field defects inconsistent with the rest of the clinical examination.
对20例临床病情稳定的慢性开角型青光眼患者进行了研究，这些患者此前已接受过手工视野检查，此次对其前四次自动视野检查进行分析，以探讨在平均敏感度、受干扰测试位点数量、完全缺损以及短期波动方面是否存在学习效应。若存在学习效应，随着患者对测试更为熟悉，视野情况应会有所改善。患者经验对平均敏感度、完全缺损或受干扰测试位点数量并无明显影响。通过第一次和第二次视野检查之间的均方根测量得出，短期波动有显著下降（P小于0.0001）。这些结果表明，对于此前有手工视野检查经验的青光眼患者，学习效应在自动视野检查的临床解读中并未起到重要作用。在大多数情况下，除非患者表现出异常高的短期波动或存在与其他临床检查结果不符的视野缺损，否则无需进行超过一次的“基线”检查。
