Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Ophthalmology and Visual Sciences, Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Br J Ophthalmol. 2022 Feb;106(2):218-222. doi: 10.1136/bjophthalmol-2020-317034. Epub 2020 Nov 20.
Glaucoma patients with peripheral vision loss have in the past subjectively described their field loss as 'blurred' or 'no vision compromise'. We developed an iPad app for patients to self-characterise perception within areas of glaucomatous visual field loss.
Twelve glaucoma patients with visual acuity ≥20/40 in each eye, stable and reliable Humphrey Visual Field (HVF) over 2 years were enrolled. An iPad app (held at 33 cm) allowed subjects to modify 'blur' or 'dimness' to match their perception of a 2×2 m wall-mounted poster at 1 m distance. Subjects fixated at the centre of the poster (spanning 45° of field from centre). The output was degree of blur/dim: normal, mild and severe noted on the iPad image at the 54 retinal loci tested by the HVF 24-2 and was compared to threshold sensitivity values at these loci. Monocular (Right eye (OD), left eye (OS)) HVF responses were used to calculate an integrated binocular (OU) visual field index (VFI). All three data sets were analysed separately.
36 HVF and iPad responses from 12 subjects (mean age 71±8.2y) were analysed. The mean VFI was 77% OD, 76% OS, 83% OU. The most common iPad response reported was normal followed by blur. No subject reported dim response. The mean HVF sensitivity threshold was significantly associated with the iPad response at the corresponding retinal loci (For OD, OS and OU, respectively (dB): normal: 23, 25, 27; mild blur: 18, 16, 22; severe blur: 9, 9, 11). On receiver operative characteristic (ROC) curve analysis, the HVF retinal sensitivity cut-off at which subjects reported blur was 23.4 OD, 23 OS and 23.3 OU (dB).
Glaucoma subjects self-pictorialised their field defects as blur; never dim or black. Our innovation allows translation of HVF data to quantitatively characterise visual perception in patients with glaucomatous field defects.
过去，周边视野丧失的青光眼患者会主观描述他们的视野缺失为“模糊”或“无视力损害”。我们为患者开发了一个 iPad 应用程序，用于自我描述青光眼视野丧失区域内的感知。
纳入 12 名双眼视力≥20/40 的青光眼患者，双眼稳定、可靠的 Humphrey 视野（HVF）至少 2 年。iPad 应用程序（保持在 33 厘米处）允许患者将“模糊”或“暗淡”调整为与他们对距离 1 米处的 2×2 米壁挂式海报的感知相匹配。患者注视在海报的中心（从中心跨越 45°的视野）。输出结果为在 HVF 24-2 测试的 54 个视网膜部位上的正常、轻度和重度模糊/暗淡程度，这些部位的阈值敏感性值与 HVF 24-2 测试的 54 个视网膜部位的阈值敏感性值进行比较。使用单眼（右眼（OD）、左眼（OS））HVF 反应计算双眼（OU）综合视野指数（VFI）。分别分析了这三个数据集。
分析了 12 名受试者（平均年龄 71±8.2 岁）的 36 个 HVF 和 iPad 反应。平均 VFI 为 OD 77%、OS 76%、OU 83%。报告的最常见 iPad 反应是正常，其次是模糊。没有受试者报告暗淡的反应。HVF 平均敏感性阈值与相应视网膜部位的 iPad 反应显著相关（分别为 OD、OS 和 OU：正常：23、25、27；轻度模糊：18、16、22；严重模糊：9、9、11）。在接收器操作特征（ROC）曲线分析中，报告模糊的 HVF 视网膜敏感性截断值为 23.4 OD、23 OS 和 23.3 OU（dB）。
青光眼患者将其视野缺陷自我描绘为模糊；从未描述为暗淡或黑色。我们的创新使 HVF 数据能够转化为定量描述青光眼视野缺损患者的视觉感知。
