Song Woo Keun, Kim Ko Eun, Lee Anna, Yoon Jooyoung, Kook Michael S
Department of Ophthalmology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
Eye (Lond). 2024 Feb;38(3):545-552. doi: 10.1038/s41433-023-02726-2. Epub 2023 Sep 11.
To evaluate the clinical utility of trend-based analysis of the targeted mean total deviation (TMTD) by comparing its rates of visual field (VF) change and sensitivities of detecting VF progression with those of the mean total deviation (mTD) in the global and hemifield VF area in early to-moderate glaucoma patients.
A single eye from 139 open-angle glaucoma patients with hemifield VF defects and a minimum two year follow-up were retrospectively evaluated. The TMTD was estimated by averaging the total deviation (TD) values after excluding VF points that had a threshold sensitivity of <0 dB in three baseline tests, and the mTD by averaging the entire VF TD values. The study patients were classified as VF progressors vs. non-progressors using both event- and trend-based analysis. The rates of change and ratios of progression detection were compared between TMTD and mTD.
This study included 49 VF progressors and 90 non-progressors. Slopes for the global and VF-affected hemifield TMTD were significantly faster than those for the mTD in each subgroup and in the entire cohort (P < 0.001). Trend-based TMTD analysis detected VF progression in greater proportion than either trend-based mTD or event-based analysis (38.1% vs. 30.2% vs. 27.3%, respectively: VF affected hemifields).
The rates of change in the TMTD are significantly faster than those for the mTD globally and in the VF-affected hemifields. Trend-based TMTD analysis shows greater sensitivity for detecting VF progression than trend-based mTD or event-based analysis in early-to-moderate glaucoma patients with hemifield VF loss.
通过比较早期至中度青光眼患者全视野和半视野视野（VF）区域中基于趋势分析的目标平均总偏差（TMTD）的视野变化率和检测VF进展的敏感性与平均总偏差（mTD）的变化率和敏感性，评估基于趋势分析的TMTD的临床实用性。
回顾性评估了139例患有半视野VF缺陷且至少随访两年的开角型青光眼患者的单眼。通过排除在三次基线测试中阈值敏感度<0 dB的VF点后，对总偏差（TD）值进行平均来估计TMTD，通过对整个VF TD值进行平均来估计mTD。使用基于事件和基于趋势的分析将研究患者分为VF进展者和非进展者。比较了TMTD和mTD之间的变化率和进展检测率。
本研究包括49例VF进展者和90例非进展者。在每个亚组和整个队列中，全视野和受VF影响的半视野TMTD斜率显著快于mTD斜率（P < 0.001）。基于趋势的TMTD分析检测到VF进展的比例高于基于趋势的mTD或基于事件的分析（分别为38.1%对30.2%对27.3%：受VF影响的半视野）。
在全球范围内以及受VF影响的半视野中，TMTD的变化率显著快于mTD。在患有半视野VF丧失的早期至中度青光眼患者中，基于趋势的TMTD分析在检测VF进展方面比基于趋势的mTD或基于事件的分析具有更高的敏感性。
