Trobe J D, Acosta P C, Shuster J J, Krischer J P
Am J Ophthalmol. 1980 Nov;90(5):654-60. doi: 10.1016/s0002-9394(14)75132-3.
We assessed the accuracy of five office-based perimetric technicians in the examination of 14 patients with prechiasmal and chiasmal defects unknown to them. A pre-test followed by two days of instruction and supervised practice; the technicians were then retested on the same patients (post-test). An independent evaluator scored their results. The identification of any field defect rose significantly (P = .039) from 69% in the pre-test to 95% in the post-test. The identification of the hemianopic configuration of a defect rose from 45% in the pre-test to 84% in the post-test (P = .11); initial identification of nasal steps was 77%, falling to 67% in the post-test. Adequate definition of extent, depth, and slope of defects was rare (5%) on the pre-test, but rose significantly (P = .032) to 57% on the post-test. The monitored patient examinations were essential for correcting recurrent flaws in technique. This study shows that such teaching efforts, including emphasis on identifying hemianopic defects, are necessary to raise visual field examination to the level of a consistently reliable diagnostic determinant.
我们评估了五名在办公室工作的视野检查技术员对14例他们并不知晓的视交叉前和视交叉病变患者进行检查的准确性。进行了一次预测试，之后进行了两天的指导和监督练习；然后对这些技术员就相同患者进行重新测试（后测试）。一名独立评估人员对他们的结果进行评分。对任何视野缺损的识别率从预测试中的69%显著提高到后测试中的95%（P = 0.039）。对缺损偏盲形态的识别率从预测试中的45%提高到后测试中的84%（P = 0.11）；对鼻侧阶梯的初始识别率为77%，后测试中降至67%。在预测试中，对缺损范围、深度和斜率的充分界定很少见（5%），但在后测试中显著提高（P = 0.032）至57%。对患者检查的监测对于纠正反复出现的技术缺陷至关重要。这项研究表明，此类教学努力，包括强调识别偏盲缺损，对于将视野检查提升至始终可靠的诊断决定因素水平是必要的。
