Katz J, Quigley H A, Sommer A
Department of International Health, Johns Hopkins University, School of Hygiene and Public Health, Baltimore, MD 21205-2103, USA.
Invest Ophthalmol Vis Sci. 1995 Jul;36(8):1658-64.
To examine the concordance of the Glaucoma Hemifield Test and other global visual field indexes between two consecutive automated visual field tests.
Normal subjects, subjects with ocular hypertension, and subjects with glaucoma had two automated visual field tests on the Humphrey Field Analyzer. The Glaucoma Hemifield Test results, mean deviation, and corrected pattern standard deviation of the two consecutive visual field tests were compared.
Forty-one normal subjects were tested within 1 and 2 years of each other. Four hundred seven subjects with ocular hypertension and 95 subjects with glaucoma were tested 1 year apart. The proportion of normal subjects who met a criterion for abnormality on two consecutive tests was 2.4%. The proportion of subjects with glaucoma with normal results of two tests was 10.5%. The specificity of automated visual field testing was improved from 80.8% to 89.9%, with a modest loss of sensitivity if two rather than one abnormal test result was required for entry into a clinical trial enrolling patients with glaucomatous field loss. Similarly, specificity increased from 84.2% to 89.5% if two normal tests were required for entry into an ocular hypertensive clinical trial. Among subjects with more closely spaced tests, the agreement between consecutive tests was similar for tests spaced 4 versus 12 months apart.
Although there is concordance of Glaucoma hemifield Test results on consecutive testing, there is enough disagreement to result in improved specificity from the use of a second test in a clinical trial setting.
研究青光眼半视野检测结果与其他整体视野指标在连续两次自动视野检测之间的一致性。
正常受试者、高眼压症患者和青光眼患者在Humphrey视野分析仪上进行两次自动视野检测。比较连续两次视野检测的青光眼半视野检测结果、平均偏差和校正模式标准差。
41名正常受试者在彼此相隔1至2年的时间内接受检测。407名高眼压症患者和95名青光眼患者相隔1年接受检测。连续两次检测均符合异常标准的正常受试者比例为2.4%。两次检测结果均正常的青光眼患者比例为10.5%。自动视野检测的特异性从80.8%提高到89.9%，如果进入青光眼性视野缺损患者的临床试验需要两个而非一个异常检测结果，则敏感性会有适度下降。同样，如果进入高眼压症临床试验需要两次正常检测，则特异性从84.2%提高到89.5%。在检测间隔更近的受试者中，间隔4个月与12个月的连续检测之间的一致性相似。
尽管连续检测时青光眼半视野检测结果存在一致性，但仍有足够的不一致性，使得在临床试验中使用第二次检测能提高特异性。
