Tony Kriss Visual Electrophysiology Unit, Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
College of Health and Life Sciences, Aston University, Birmingham, UK.
Eye (Lond). 2024 Jan;38(1):33-53. doi: 10.1038/s41433-023-02636-3. Epub 2023 Jul 13.
The full-field stimulus threshold (FST) is a psychophysical measure of whole-field retinal light sensitivity. It can assess residual visual function in patients with severe retinal disease and is increasingly being adopted as an endpoint in clinical trials. FST applications in routine ophthalmology clinics are also growing, but as yet there is no formalised standard guidance for measuring FST. This scoping review explored current variability in FST conduct and reporting, with an aim to inform further evidence synthesis and consensus guidance. A comprehensive electronic search and review of the literature was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews (PRISMA-ScR) checklist. Key source, participant, methodology and outcomes data from 85 included sources were qualitatively and quantitatively compared and summarised. Data from 85 sources highlight how the variability and insufficient reporting of FST methodology, including parameters such as units of flash luminance, colour, duration, test strategy and dark adaptation, can hinder comparison and interpretation of clinical significance across centres. The review also highlights an unmet need for paediatric-specific considerations for test optimisation. Further evidence synthesis, empirical research or structured panel consultation may be required to establish coherent standardised guidance on FST methodology and context or condition dependent modifications. Consistent reporting of core elements, most crucially the flash luminance equivalence to 0 dB reference level is a first step. The development of criteria for quality assurance, calibration and age-appropriate reference data generation may further strengthen rigour of measurement.
全视野刺激阈值（FST）是一种对全视野视网膜光敏感度的心理物理学测量方法。它可以评估严重视网膜疾病患者的残余视觉功能，并且越来越多地被用作临床试验的终点。FST 在常规眼科临床中的应用也在增加，但目前还没有用于测量 FST 的正式标准化指南。本范围综述探讨了 FST 实施和报告的当前变异性，旨在为进一步的证据综合和共识指南提供信息。根据系统评价和荟萃分析扩展的首选报告项目（PRISMA-ScR）清单，进行了全面的电子搜索和文献综述。定性和定量比较并总结了 85 个纳入来源的关键来源、参与者、方法和结果数据。来自 85 个来源的数据突出表明，FST 方法的变异性和报告不足，包括闪烁亮度、颜色、持续时间、测试策略和暗适应等参数，可能会阻碍中心之间的比较和临床意义的解释。该综述还强调了针对测试优化的儿科特定考虑因素的未满足需求。可能需要进一步的证据综合、实证研究或结构化小组咨询，以制定关于 FST 方法和上下文或条件依赖性修改的连贯标准化指南。一致报告核心要素，最重要的是闪烁亮度与 0 dB 参考水平等效，是第一步。质量保证、校准和适合年龄的参考数据生成标准的制定可能会进一步增强测量的严谨性。
