Szkudlarek-Wodzińska Justyna, Przeździecka-Dołyk Joanna, Fuchs Olaf, Poznański Ziemowit, Misiuk-Hojło Marta
Department of Ophthalmology, Wroclaw Medical University, Wroclaw 50-370, Poland.
Department of Optics and Photonics, University of Science and Technology, Wybrzeże Wyspiańskiego 27, Wrocław 50-370, Poland.
Int J Ophthalmol. 2020 Mar 18;13(3):417-424. doi: 10.18240/ijo.2020.03.08. eCollection 2020.
To evaluate the different visual pathways represented by the Heidelberg Engineering Perimeter flicker defined form and RareBit (magnocellular and parvocellular respectively) in different age-groups and according to the fatigue.
Totally 64 eyes of 32 healthy subjects were included in the prospective study. Each participant underwent screening-ophthalmic examination including best-corrected visual acuity, anterior and posterior segment assessment, and visual field examination with Heidelberg Edge Perimetry (HEP)-standard automated perimeter (SAP) 24-2. They were observed for 2y previously to the enrollment. This helped to define that the enrolled patients did not bear the glaucoma-developing potential. During the screening and after two years the HEP had been conducted in the standard protocol 24-2 and RareBit perimetry (RBP) in accordance with the manufacturer's description. Participants were randomly assigned to the groups: flicker defined form (FDF)-first or RBP-first. This defined from which additional visual field test the participant started. Participants were additionally subdivided to younger and older study groups. The effect of subject variables was explored with Mann-Whitney -test. Testing for the presence of correlations between parameters was performed using the Spearman Rank Order Correlations and confirmed by the parametric tests. For the influence of additional factors, the Kruskal-Wallis test was performed.
The positive correlation between mean deviation (MD) and mean hit rate (MHR) and pattern standard deviation (PSD) and standard deviation of MHR (±MHR) were found in younger study group (=0.005, =0.481 and =0.0074, =0.465), whereas in the older subgroup no correlation was observed. Additionally, the randomization protocol helped in defining the role of fatigue on the HEP-FDF results. Participant for whom the HEP-FDF was performed after RareBit had significantly worse results than those for whom the HEP-FDF was first. In the younger group, the MHR and ±MHR depend from age in that group (<0.05, =0.43 and =-0.57 respectively) while no age-dependent differences were found in HEP-related parameters. On the contrary in the older group the MD and PSD varies with age (<0.05, =0.47 and = -0.44 respectively) while the RBP parameters remained unchanged. The questionnaire showed that participants preferred RareBit over HEP-FDF in terms of a duration time, comfort, understanding of the test procedures, and ocular pain (<0.05).
The influence of patient's fatigue should be considered during HEP-FDF examination. An overlap hypothesis should be reevaluated after determining of other factors that affect HEP-FDF and RareBit results.
评估海德堡工程视野计闪烁定义形式和RareBit（分别代表大细胞和小细胞通路）在不同年龄组以及根据疲劳程度所代表的不同视觉通路。
前瞻性研究纳入了32名健康受试者的64只眼睛。每位参与者均接受了眼科筛查检查，包括最佳矫正视力、眼前节和眼后节评估，以及使用海德堡边缘视野计（HEP）-标准自动视野计（SAP）24-2进行的视野检查。在入组前对他们进行了2年的观察。这有助于确定入组患者没有青光眼发病潜力。在筛查期间以及两年后，按照标准方案24-2进行HEP检查，并根据制造商的说明进行RareBit视野计（RBP）检查。参与者被随机分配到不同组：闪烁定义形式（FDF）优先组或RBP优先组。这确定了参与者从哪项额外的视野测试开始。参与者还被进一步细分为年轻和年长研究组。使用曼-惠特尼检验探索受试者变量的影响。使用斯皮尔曼等级相关检验参数之间的相关性，并通过参数检验进行确认。对于其他因素的影响，进行了克鲁斯卡尔-沃利斯检验。
在年轻研究组中发现平均偏差（MD）与平均命中率（MHR）以及模式标准偏差（PSD）与MHR标准偏差（±MHR）之间呈正相关（分别为=0.005，=0.481和=0.0074，=0.465），而在年长亚组中未观察到相关性。此外，随机化方案有助于确定疲劳对HEP-FDF结果的影响。在RareBit之后进行HEP-FDF的参与者的结果明显比首先进行HEP-FDF的参与者差。在年轻组中，MHR和±MHR取决于该组的年龄（分别为<0.05，=0.43和=-0.57），而在与HEP相关的参数中未发现年龄依赖性差异。相反，在年长组中，MD和PSD随年龄变化（分别为<0.05，=0.47和=-0.44），而RBP参数保持不变。问卷显示，在检查持续时间、舒适度、对测试程序的理解以及眼部疼痛方面，参与者更喜欢RareBit而非HEP-FDF（<0.05）。
在HEP-FDF检查期间应考虑患者疲劳的影响。在确定影响HEP-FDF和RareBit结果的其他因素后，应重新评估重叠假说。
