Camp Andrew S, Long Christopher P, Galor Anat, Yamane Maya, Proudfoot James A, Weinreb Robert N
Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, San Diego, CA.
Bascom Palmer Eye Institute, University of Miami, Miami, FL.
J Glaucoma. 2022 May 1;31(5):305-309. doi: 10.1097/IJG.0000000000002017. Epub 2022 Mar 18.
Tracking failure frequency (TFF) increases with dry eye symptom severity and in the left eye.
Symptoms of dry eye disease are commonly encountered in glaucoma patients and can be exacerbated by topical glaucoma medications. Dry eye disease may influence the reliability of visual field (VF) tests and impact the accurate interpretation of the results.
Patients at the Veterans Administration Medical Center San Diego completed the 5-item Dry Eye Questionnaire before VF testing between December 2018 and February 2019. VF reliability metrics were recorded for each patient. Standard reliability metrics included fixation losses, false positive, and false negative rates. Gaze tracking (GT) metrics included percent of stimuli with gaze deviations between 1 and 2 degrees, 3 and 5 degrees, 6 degrees or greater, and percent of stimuli with tracking failure (TFF). The use of glaucoma medications and artificial tears was also recorded.
A total of 494 patients completed the 5-item Dry Eye Questionnaire and VF testing. There was no association between dry eye symptom severity and standard reliability metrics or most GT metrics. However, TFF increased as dry eye symptom severity increased (P=0.015). TFF was also greater in the left eye, which was tested second (P=0.012); no other reliability metrics were related to laterality. Patients were more likely to use artificial tears with increased dry eye symptom severity (P<0.001), but there was no relationship between symptom severity and glaucoma medication use.
Dry eye symptom severity may influence the acceptable range or threshold of TFF when using GT metrics to determine VF reliability. Likewise, the acceptable range or threshold for TFF may be different between eyes.
追踪失败频率（TFF）随干眼症状严重程度增加而升高，且在左眼更为明显。
青光眼患者常出现干眼症状，局部青光眼药物可使其加重。干眼疾病可能影响视野（VF）检查的可靠性，并影响结果的准确解读。
圣地亚哥退伍军人事务医疗中心的患者于2018年12月至2019年2月期间在进行VF检查前完成了5项干眼问卷。记录每位患者的VF可靠性指标。标准可靠性指标包括固视丢失率、假阳性率和假阴性率。注视追踪（GT）指标包括注视偏差在1至2度、3至5度、6度或更大时的刺激百分比，以及追踪失败（TFF）的刺激百分比。还记录了青光眼药物和人工泪液的使用情况。
共有494名患者完成了5项干眼问卷和VF检查。干眼症状严重程度与标准可靠性指标或大多数GT指标之间无关联。然而，TFF随干眼症状严重程度增加而升高（P = 0.015）。TFF在左眼（第二个进行检查）也更高（P = 0.012）；没有其他可靠性指标与眼别有关。干眼症状严重程度增加时，患者使用人工泪液的可能性更大（P < 0.001），但症状严重程度与青光眼药物使用之间无关联。
在使用GT指标确定VF可靠性时，干眼症状严重程度可能会影响TFF的可接受范围或阈值。同样，两眼之间TFF的可接受范围或阈值可能不同。
