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青光眼的快速视敏度检测——与标准视野计和 OCT 的对比。

Rapid Campimetry in glaucoma - correspondence with standard perimetry and OCT.

机构信息

Ophthalmic Department, Faculty of Medicine, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany.

H & M Medical Solutions GmbH, 14195, Berlin, Germany.

出版信息

Sci Rep. 2024 Oct 25;14(1):25400. doi: 10.1038/s41598-024-75037-5.

Abstract

The Rapid Campimetry (RC), a kinetic visual field test proved to reliably detect visual field defects within the central 10° degrees, the most crucial part for visual acuity and quality of life, affected even at very early stages of glaucoma, within a short measurement epoch, ~ 1 min. This study aims to further investigate RC correspondence with standard tests in glaucoma, namely standard automated perimetry (SAP) and optical coherence tomography (OCT) within 10° of visual field (VF). For this purpose, we included 41 participants, [21 glaucoma (GLA, mean age: 65.9 ± 12.4; 12 preperimetric eyes and 11 with VF defects) and 20 healthy controls (HC; mean age: 65.0 ± 10.3); 20 eyes]. At first, we compared the rate of detection/exclusion of VF defects in RC vs. SAP. Then, for those with VF defects (11 eyes), we investigated the 68-pointwise correspondence of 10 - 2 layout of RC and SAP. For functional and structural (SF) correspondence, pointwise correspondence of RC, SAP vs. OCT [ macular ganglion cell thickness (GCL)] was also performed. Further, we compared sector-based correspondence of RC, SAP vs. OCT accounting for GCL displacement at the fovea as well as sector-based correspondence with OCT [peripapillary retinal nerve fiber layer thickness (pRNFL)]. Agreement estimates were reported along with Cohen Kappa ([Formula: see text]) statistic. For overall performance, RC and SAP showed 100% agreement ([Formula: see text]) for the exclusion of VF defects (HC and preperimetric GLA) and for detection of VF defects [11 eyes of 9 GLA, ([Formula: see text]]. Further, RC outperformed SAP in detection of arcuate scotomas, 7 vs. 5, respectively. Pointwise correspondence of VF defects (11 eyes), RC-SAP agreement reached 90% accuracy ([Formula: see text]). For SF correspondence, RC [SAP] showed 62% [69%] pointwise agreement with OCT, ([Formula: see text]). For macular sector-based correspondence, SF correspondence improved and reached 83% [83%] agreement, ([Formula: see text]). For OCT sector-based analysis, SF correspondence was highest, 100% [100%] agreement, ([Formula: see text]). Rapid Campimetry gave reproducible results in comparison to SAP and OCT with high potential as a screening VF method given its short testing duration, ~ 1 min in screening mode, and compatibility with telemedicine technologies upon future optimization and automation.

摘要

快速视野计(RC)是一种动态视野检查,已被证明能够可靠地检测中央 10 度范围内的视野缺陷,这是视力和生活质量最关键的部分,即使在青光眼的早期阶段也能检测到,测量时间很短,约为 1 分钟。本研究旨在进一步探讨 RC 在青光眼标准测试中的对应关系,即在视野 10 度内的标准自动视野计(SAP)和光学相干断层扫描(OCT)。为此,我们纳入了 41 名参与者,[21 名青光眼(GLA,平均年龄:65.9±12.4;12 只前期眼和 11 只视野缺陷眼)和 20 名健康对照组(HC;平均年龄:65.0±10.3;20 只眼)]。首先,我们比较了 RC 与 SAP 在检测/排除视野缺陷方面的差异。然后,对于那些有视野缺陷的患者(11 只眼),我们研究了 RC 和 SAP 的 68 点 10-2 布局的对应关系。为了进行功能和结构(SF)对应关系的研究,我们还对 RC、SAP 与 OCT(黄斑神经节细胞厚度(GCL))进行了逐点对应关系的研究。此外,我们还比较了 RC、SAP 与 OCT 的基于扇区的对应关系,考虑了黄斑中心凹 GCL 的位移以及基于 OCT 的基于扇区的对应关系(神经纤维层厚度(pRNFL))。报告了一致性估计值以及 Cohen Kappa([Formula: see text])统计量。对于整体性能,RC 和 SAP 在排除视野正常(HC 和前期 GLA)和检测视野缺陷[9 只 GLA 的 11 只眼,[Formula: see text]]方面具有 100%的一致性。此外,RC 在检测弓形暗点方面优于 SAP,分别为 7 比 5。对于视野缺陷(11 只眼),RC-SAP 一致性达到 90%的准确性([Formula: see text])。对于 SF 对应关系,RC [SAP] 与 OCT 的逐点对应关系达到 62%[69%]([Formula: see text])。对于黄斑区基于扇区的对应关系,SF 对应关系得到改善,达到 83%[83%]的一致性([Formula: see text])。对于 OCT 基于扇区的分析,SF 对应关系最高,达到 100%[100%]的一致性([Formula: see text])。与 SAP 和 OCT 相比,快速视野计具有重复性,并且由于其测试时间短(筛查模式下约为 1 分钟),与远程医疗技术兼容,在未来的优化和自动化后,具有作为筛查视野方法的高潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b66/11511816/c5a3226ae366/41598_2024_75037_Fig1_HTML.jpg

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