From Ophthalmology Research Unit, Department of Clinical Sciences Malmö, Lund University (A.H. and B.B.); Department of Ophthalmology, Skåne University Hospital, Malmö, Sweden (A.H.).
Department of Ophthalmology (V.M.P.), University of Iowa, Iowa City, Iowa, USA.
Am J Ophthalmol. 2022 Jan;233:180-188. doi: 10.1016/j.ajo.2021.06.026. Epub 2021 Jul 18.
To analyze the relationship between rates of false positive (FP) responses and standard automated perimetry results.
Prospective multicenter cross-sectional study.
One hundred twenty-six patients with manifest or suspect glaucoma were tested with Swedish Interactive Thresholding Algorithm (SITA) Standard, SITA Fast, and SITA Faster at each of 2 visits. We calculated intervisit differences in mean deviation (MD), visual field index (VFI), and number of statistically significant test points as a function of FP rates and also as a function of general height (GH).
Increasing FP values were associated with higher MD values for all 3 algorithms, but the effects were small, 0.3 dB to 0.6 dB, for an increase of 10 percentage points of FP rate, and for VFI even smaller (0.6%-1.4%). Only small parts of intervisit differences were explained by FP (r values 0.00-0.11). The effects of FP were larger in severe glaucoma, with MD increases of 1.1 dB to 2.0 dB per 10 percentage points of FP, and r values ranging from 0.04 to 0.33. The numbers of significantly depressed total deviation points were affected only slightly, and pattern deviation probability maps were generally unaffected. GH was much more strongly related to perimetric outcomes than FP.
Across 3 different standard automated perimetry thresholding algorithms, FP rates showed only weak associations with visual field test results, except in severe glaucoma. Current recommendations regarding acceptable FP ranges may require revision. GH or other analyses may be better suited than FP rates for identifying unreliable results in patients who frequently press the response button without having perceived stimuli.
分析假阳性（FP）反应率与标准自动视野计结果之间的关系。
前瞻性多中心横断面研究。
126 例显性或可疑青光眼患者分别在 2 次就诊时接受了瑞典交互阈值算法（SITA）标准、SITA 快速和 SITA 更快检查。我们计算了平均偏差（MD）、视野指数（VFI）和统计学上显著测试点数量的随访间差异，作为 FP 率的函数，也作为一般高度（GH）的函数。
随着 FP 值的增加，所有 3 种算法的 MD 值均呈上升趋势，但增加 10 个百分点的 FP 率，其影响较小，为 0.3 dB 至 0.6 dB，而 VFI 的影响更小（0.6%-1.4%）。仅小部分随访间差异可由 FP 解释（r 值为 0.00-0.11）。FP 的影响在严重青光眼患者中较大，FP 每增加 10 个百分点，MD 增加 1.1 dB 至 2.0 dB，r 值范围为 0.04 至 0.33。明显压低的总偏差点数量受影响较小，而模式偏差概率图总体上不受影响。GH 与视野计结果的相关性远强于 FP。
在 3 种不同的标准自动视野计阈值算法中，FP 率与视野检查结果仅存在微弱关联，除了在严重青光眼患者中。目前关于可接受 FP 范围的建议可能需要修订。GH 或其他分析可能比 FP 率更适合于识别经常在没有感知刺激的情况下按反应按钮的患者中不可靠的结果。
