Department of Ophthalmology (JMK, EW), Hadassah-Hebrew University Medical Center, Israel; Department of Ophthalmology (ZA), Assaf Harofe Medical Center, Zerifin, Israel; Department of Ophthalmology (YA), Meir Medical Center, Kfar Saba, Israel; Department of Ophthalmology (EA), Barzilai University Medical Center, Ashkelon, Israel; Department of Ophthalmology (AB-Z, AK), Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Neuro-Ophthalmology Unit, Department of Ophthalmology (OB, HS-K, MO), Rabin Medical Center, and Sackler School of Medicine, Tel Aviv University, Israel; Department of Ophthalmology (IB-BM, RH-B, GT), Sheba Medical Center, Tel Hashomer, Israel; Department of Ophthalmology (JH), Carmel Medical Center, Haifa, Israel; Department of Ophthalmology (RH-B, HS-K), Sackler School of Medicine, Tel Aviv University, Israel; Clalit Health Organization (YI), Israel; Department of Ophthalmology (HJ-H), Baruch Padeh Medical Center, Tiberias, Israel; Maccabi Health Care Services (IK), Israel; Department of Ophthalmology (HL), Kaplan Medical Center, Rehovot, Israel; Faculty of Medicine (HL), The Hebrew University Hadassah Medical School, Jerusalem, Israel; Department of Ophthalmology (IM, MP), Wolfson Medical Center, Holon, Israel; Department of Ophthalmology (MM), Soroka University Medical Center, Beer Sheba, Israel; Department of Ophthalmology (DR), Shaare Zedek, Medical Center, Jerusalem, Israel; Department of Ophthalmology (ER), Galilee Medical Center, Nahariya, Israel; and Department of Ophthalmology and Visual Sciences (CAJ), University of Iowa, Iowa City, Iowa.
J Neuroophthalmol. 2022 Dec 1;42(4):483-488. doi: 10.1097/WNO.0000000000001622. Epub 2022 Oct 18.
A multitude of terms have been used to describe automated visual field abnormalities. To date, there is no universally accepted system of definitions or guidelines. Variability among clinicians creates the risk of miscommunication and the compromise of patient care. The purposes of this study were to 1) assess the degree of consistency among a group of neuro-ophthalmologists in the description of visual field abnormalities and 2) to create a consensus statement with standardized terminology and definitions.
In phase one of the study, all neuro-ophthalmologists in Israel were asked to complete a survey in which they described the abnormalities in 10 selected automated visual field tests. In phase 2 of the study, the authors created a national consensus statement on the terminology and definitions for visual field abnormalities using a modified Delphi method. In phase 3, the neuro-ophthalmologists were asked to repeat the initial survey of the 10 visual fields using the consensus statement to formulate their answers.
Twenty-six neuro-ophthalmologists participated in the initial survey. On average, there were 7.5 unique descriptions for each of the visual fields (SD 3.17), a description of only the location in 24.6% (SD 0.19), and an undecided response in 6.15% (SD 4.13). Twenty-two neuro-ophthalmologists participated in the creation of a consensus statement which included 24 types of abnormalities with specific definitions. Twenty-three neuro-ophthalmologists repeated the survey using the consensus statement. On average, in the repeated survey, there were 5.9 unique descriptions for each of the visual fields (SD 1.79), a description of only the location in 0.004% (SD 0.01), and an undecided response in 3.07% (SD 2.11%). Relative to the first survey, there was a significant improvement in the use of specific and decisive terminology.
The study confirmed a great degree of variability in the use of terminology to describe automated visual field abnormalities. The creation of a consensus statement was associated with improved use of specific terminology. Future efforts may be warranted to further standardize terminology and definitions.
描述自动化视野异常的术语众多。迄今为止，尚无被普遍接受的定义或指南系统。临床医生之间的差异造成了沟通不畅和患者护理质量受损的风险。本研究的目的是 1）评估一组神经眼科医生在描述视野异常方面的一致性程度，2）使用标准化术语和定义创建共识声明。
在研究的第一阶段，以色列的所有神经眼科医生都被要求完成一项调查，其中他们描述了 10 项选定的自动化视野测试中的异常情况。在研究的第二阶段，作者使用改良 Delphi 法就视野异常的术语和定义制定了国家共识声明。在第三阶段，神经眼科医生被要求使用共识声明重复最初的 10 个视野调查来制定答案。
26 名神经眼科医生参与了初步调查。平均而言，每个视野有 7.5 种独特的描述（SD 3.17），仅描述位置的占 24.6%（SD 0.19），有 6.15%（SD 4.13）的人未作决定。22 名神经眼科医生参与了共识声明的制定，其中包括 24 种具有特定定义的异常类型。23 名神经眼科医生使用共识声明重复了调查。平均而言，在重复调查中，每个视野有 5.9 种独特的描述（SD 1.79），仅描述位置的占 0.004%（SD 0.01），有 3.07%（SD 2.11）的人未作决定。与第一次调查相比，特定且果断的术语使用明显改善。
该研究证实了描述自动化视野异常的术语使用存在很大的差异。制定共识声明与更具体术语的使用有关。可能需要进一步努力来进一步标准化术语和定义。
