Department of Psychology, Columbia University, New York, New York, USA; Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Medical Center, New York, New York, USA.
Columbia Vagelos College of Physicians and Surgeons, New York, New York, USA.
Am J Ophthalmol. 2021 Mar;223:119-128. doi: 10.1016/j.ajo.2020.07.045. Epub 2020 Aug 7.
We sought to test the hypothesis that a recently proposed pattern standard deviation (PSD) metric, based upon the 24-2 visual field (VF) test, as well as the PSD of the 10-2 VF, will miss central glaucomatous damage confirmed with an objective structure-function method.
Cross-sectional study.
A glaucoma (G) group (70 eyes/patients) diagnosed with glaucoma and a 24-2 mean deviation better than -6 dB and a healthy (H) group (45 eyes/patients) had 24-2 and 10-2 VFs and optical coherence tomography (OCT) scans twice within 4 weeks. The PSD(C24-2), based upon the central 12 points of the 24-2, was compared with the PSD(10-2). To evaluate central damage (CD) in G eyes with normal PSD(C24-2) values, a post hoc analysis was combined with a CD reference standard (CD-RS), which was based upon an objective, topographic comparison between abnormal points on the 10-2 VF and OCT probability maps.
The 115 PSD(C24-2) and PSD(10-2) values were significantly correlated (Spearman correclation coefficient: rho = 0.55; P < .001) and the number of G eyes (19) identified as abnormal by the PSD(C24-2) was not significantly different from the number (22) identified by the PSD(10-2) (P = .15). However, based upon the CD-RS, 44 of 70 G eyes were classified as abnormal. The PSD(C24-2) missed 27 (61%) of these 44 eyes, and the PSD(10-2) missed 23 (52%) of these eyes. Post hoc analysis revealed clear CD in most of these eyes.
Neither the PSD(C24-2) nor the PSD(10-2) metric is good measure of early CD. Instead we recommend a topographic approach based upon OCT probability maps and a 10-2 VF.
我们旨在检验以下假说，即基于 24-2 视野（VF）测试和 10-2VF 的 PSD 提出的一种新的模式标准差（PSD）度量标准，将错过经客观结构-功能方法证实的中央青光眼损伤。
横断面研究。
一组青光眼（G）患者（70 只眼/患者）被诊断为青光眼，24-2 平均偏差优于-6dB，一组健康（H）患者（45 只眼/患者）在 4 周内进行了 24-2 和 10-2VF 及光学相干断层扫描（OCT）两次扫描。基于 24-2 的中央 12 个点的 PSD（C24-2）与 PSD（10-2）进行了比较。为了评估具有正常 PSD（C24-2）值的 G 眼中的中央损伤（CD），进行了一项事后分析，并结合了基于异常 10-2VF 和 OCT 概率图之间的客观拓扑比较的 CD 参考标准（CD-RS）。
115 个 PSD（C24-2）和 PSD（10-2）值显著相关（Spearman 相关系数：rho=0.55；P<.001），并且 PSD（C24-2）识别为异常的 G 眼数量（19 只）与 PSD（10-2）识别为异常的数量（22 只）无显著差异（P=0.15）。然而，根据 CD-RS，70 只 G 眼中的 44 只被归类为异常。PSD（C24-2）漏诊了这些 44 只眼中的 27 只（61%），而 PSD（10-2）漏诊了这些眼中的 23 只（52%）。事后分析显示，这些眼中的大多数都有明显的 CD。
PSD（C24-2）和 PSD（10-2）度量均不是早期 CD 的良好指标。相反，我们建议基于 OCT 概率图和 10-2VF 的拓扑方法。
