University of California San Francisco School of Medicine, San Francisco, CA.
Department of Ophthalmology, University of California San Francisco, San Francisco, CA.
J Glaucoma. 2024 Jul 1;33(7):499-504. doi: 10.1097/IJG.0000000000002406. Epub 2024 Apr 23.
Children with glaucoma had an average of 1.3 visual field tests per year. Self-reported black and multiracial patients had lower visual field testing rates, whereas older children with better visual acuity had more frequent testing.
To evaluate frequency of visual field (VF) testing in children with glaucoma and identify characteristics associated with VF frequency.
A retrospective cohort study of 82 children 6-18 years of age with glaucoma seen between August 2018 and May 2023. Patients were divided into those who had ≥1 VF test (303 VF tests of 61 children) and 0 VFs (21 children). Eyes were excluded if best corrected visual acuity (BCVA) was counting fingers or worse. Characteristics obtained included age, self-reported race and ethnicity, sex, primary language, glaucoma diagnosis, distance to provider, office visit frequency, follow-up compliance, insurance type, and BCVA. The main outcome measure was VF testing frequency.
Among children with ≥1 VF test, mean age at first VF was 11.8±2.8 years, mean number of VF/year was 1.3±0.8, and 44.9% of all VFs were reliable. Thirty nine percent of patients underwent <1 VF/year, 45.9% ≥1 to <2 VFs/year, and 14.8% ≥2 VF/year. Children who were black or multiracial had significantly lower VF testing frequency [estimated difference (ED) -1.2 (95% CI, -2.0 to -0.4, P =0.002) and ED -1.3 (95% CI, -2.2 to -0.3, P =0.008), respectively]. Better visual acuity and greater office visit frequency were significantly associated with higher VF testing frequency [ED 0.052 (95% CI, 0.001-0.103, P =0.045) and ED 0.2 (95% CI, 0.1-0.3, P <0.001), respectively].
Most children had between 1 and 2 VF/year, although less than half of all VFs were reliable. Ophthalmologists should consider barriers to care in glaucoma monitoring.
青光眼患儿每年平均进行 1.3 次视野检查。自我报告为黑人和多种族的患者进行视野检查的频率较低，而视力较好的大龄儿童进行视野检查的频率更高。
评估青光眼儿童的视野检查频率，并确定与视野检查频率相关的特征。
这是一项回顾性队列研究，纳入了 2018 年 8 月至 2023 年 5 月期间就诊的 82 名 6-18 岁的青光眼患儿。根据是否进行过≥1 次视野检查（61 名患儿的 303 次视野检查）和 0 次视野检查（21 名患儿）将患者分为两组。如果最佳矫正视力（BCVA）为手动或更差，则排除该眼。获得的特征包括年龄、自我报告的种族和民族、性别、母语、青光眼诊断、与提供者的距离、就诊频率、随访依从性、保险类型和 BCVA。主要结局指标为视野检查频率。
在进行过≥1 次视野检查的患儿中，首次视野检查时的平均年龄为 11.8±2.8 岁，平均每年进行的视野检查次数为 1.3±0.8，且 44.9%的视野检查结果可靠。39%的患儿每年进行的视野检查次数<1 次，45.9%的患儿每年进行的视野检查次数为 1 至<2 次，14.8%的患儿每年进行的视野检查次数≥2 次。黑人和多种族患儿的视野检查频率明显较低[估计差值（ED）分别为-1.2（95%CI，-2.0 至-0.4，P=0.002）和-1.3（95%CI，-2.2 至-0.3，P=0.008）]。更好的视力和更高的就诊频率与更高的视野检查频率显著相关[ED 分别为 0.052（95%CI，0.001-0.103，P=0.045）和 0.2（95%CI，0.1-0.3，P<0.001）]。
大多数患儿每年进行 1 至 2 次视野检查，尽管只有不到一半的视野检查结果可靠。眼科医生应考虑青光眼监测中的护理障碍。
