Ichhpujani Parul, Singh Tanu, Thakur Sahil, Singh Rohan Bir, Kumar Suresh
Professor, Department of Ophthalmology, Government Medical College & Hospital, Sector-32, Chandigarh 160030, India.
Department of Ophthalmology, Government Medical College & Hospital, Chandigarh, India.
Ther Adv Ophthalmol. 2020 Dec 28;12:2515841420977412. doi: 10.1177/2515841420977412. eCollection 2020 Jan-Dec.
To assess changes in the central and peripheral contrast sensitivity in severe primary open-angle glaucoma (POAG) patients using a computer-based Spaeth/Richman contrast sensitivity test (SPARCS) over a period of 24 months.
Our pilot, observational study included 15 patients (30 eyes) with severe POAG. Visual acuity, intraocular pressure, number of anti-glaucoma drugs, visual fields, and SPARCS score were recorded at first visit and at 12 and 24 months.
We observed changes in mean deviation (MD) from -19.37 ± 5.04 to -20.63 ± 4.07, mean pattern standard deviation (PSD) from 11.49 ± 2.61 to 11.35 ± 2.01, and mean SPARCS score from 54.97 ± 15.66 to 53.50 ± 16.42. We found no statistically significant difference between visual field parameters and SPARCS scores associated with the number or type of prescribed anti-glaucoma drugs. Spearman's correlation coefficient of SPARCS at baseline (SPARCS1) MD at baseline (MD1) was 0.274 ( = 0.142) and SPARCS1 PSD at baseline (PSD1) was -0.163 ( = 0.389). The correlation coefficient between SPARCS at 12 months (SPARCS2) MD (MD2) at the same time point was computed to be 0.391 ( = 0.03), whereas SPARCS2 PSD at 12 months was -0.212 ( = 0.262). Similarly, we found the coefficient to be 0.336 ( = 0.069) for SPARCS3 (SPARCS at 24 months) MD3 (MD at 24 months) and 0.242 ( = 0.197) for SPARCS3 PSD3 (PSD at 24 months). Correlation coefficients between SPARCS1/2, SPARCS1/3, MD1/2, MD1/3 PSD1/2, and PSD1/3 were 0.856, 0.865, 0.748, 0.722, 0.497, and 0.562, respectively ( < 0.001). MD changed by 9.46% ± 12.73%, PSD by 0.64% ± 14.03%, and average SPARCS by 3.31% ± 12.73% over 24 months.
The data from our study indicate the utilitarian application of SPARCS, an inexpensive and readily available tool for monitoring functional deterioration in cases with advanced glaucomatous damage, especially in resource-poor settings. Furthermore, it is a useful and reliable alternative to the imaging modalities where retinal nerve fiber layer measurement can be erroneous in advanced cases secondary to the floor effect.
使用基于计算机的斯佩思/里奇曼对比敏感度测试（SPARCS），评估重度原发性开角型青光眼（POAG）患者在24个月期间的中央和周边对比敏感度变化。
我们的初步观察性研究纳入了15例（30只眼）重度POAG患者。在首次就诊时以及12个月和24个月时记录视力、眼压、抗青光眼药物数量、视野和SPARCS评分。
我们观察到平均偏差（MD）从-19.37±5.04变为-20.63±4.07，平均模式标准偏差（PSD）从11.49±2.61变为11.35±2.01，平均SPARCS评分从54.97±15.66变为53.50±16.42。我们发现视野参数与SPARCS评分之间，与所开具的抗青光眼药物数量或类型无关，无统计学显著差异。基线时SPARCS（SPARCS1）与基线时MD（MD1）的斯皮尔曼相关系数为0.274（P = 0.142），基线时SPARCS1与基线时PSD（PSD1）的相关系数为-0.163（P = 0.389）。计算得出12个月时SPARCS（SPARCS2）与同一时间点的MD（MD2）的相关系数为0.391（P = 0.03），而12个月时SPARCS2与PSD的相关系数为-0.212（P = 0.262）。同样，我们发现24个月时SPARCS3（24个月时的SPARCS）与MD3（24个月时的MD）的系数为0.336（P = 0.069），24个月时SPARCS3与PSD3（24个月时的PSD）的系数为0.242（P = 0.197）。SPARCS1/2、SPARCS1/3、MD1/2、MD1/3、PSD1/2和PSD1/3之间的相关系数分别为0.856、0.865、0.748、0.722、0.497和0.562（P < 0.001）。在24个月期间，MD变化了9.46%±12.73%，PSD变化了0.64%±14.03%，平均SPARCS变化了3.31%±12.73%。
我们研究的数据表明SPARCS具有实用价值，它是一种廉价且易于获得的工具，可用于监测晚期青光眼性损害患者的功能恶化情况，尤其是在资源匮乏的环境中。此外，在晚期病例中，由于下限效应，视网膜神经纤维层测量可能出现错误，而SPARCS是成像方式的一种有用且可靠的替代方法。
