使用扫描激光检眼镜进行基于地标引导的眼底视野检查。
Landmark-driven fundus perimetry using the scanning laser ophthalmoscope.
作者信息
Sunness J S, Schuchard R A, Shen N, Rubin G S, Dagnelie G, Haselwood D M
机构信息
Lions Vision Center, Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
出版信息
Invest Ophthalmol Vis Sci. 1995 Aug;36(9):1863-74.
PURPOSE
To present a new method of performing scanning laser ophthalmoscope perimetry that compensates for eye movements so that the correct retinal location is tested even if fixation changes. This allows for accurate testing of patients with central scotomas and for repeating testing longitudinally at the same retinal locations even if central fixation is lost.
METHODS
The operator views the retina and selects a retinal landmark, such as a vessel bifurcation, that can be identified easily. A testing strategy is preselected, and the computer saves the landmark and stimulus coordinates. To present each stimulus, the operator positions a cursor over the retinal landmark, and the computer adjusts the site of presentation of the stimulus for any change in landmark position caused by an eye movement. At the conclusion of the testing, the results are displayed in the proper retinal location on a fundus image.
RESULTS
Sixty-seven eyes with macular disease were tested with the landmark-driven method, using the same preplanned strategy for each eye for both a bright and a dim stimulus. There was a low rate of inconsistent points (seen with dim but not bright stimuli), and virtually all of these bordered a dense scotoma. Those eyes with more inconsistent points had a significantly greater percentage of dense scotoma points and significantly lower visual acuity. The technique significantly corrected error in retinal localization resulting from large eye movement. There is no significant rotation or magnification change during the procedure, so specifying the change in location of one landmark is sufficient to describe movement of the retina. The technique is rapid and easy to administer to elderly patients and to children.
CONCLUSIONS
This technique allows for accurate and repeatable measures of retinal sensitivity in specific locations. It is useful in following change over time. It can be developed further to allow for fully automated, retinally correct testing.
目的
介绍一种进行扫描激光检眼镜视野检查的新方法，该方法可补偿眼球运动，从而即使注视发生改变，也能对正确的视网膜位置进行检测。这使得能够对中心暗点患者进行准确检测，并且即使失去中心注视，也能在相同的视网膜位置纵向重复检测。
方法
操作人员观察视网膜并选择一个易于识别的视网膜标志，如血管分支。预先选择一种测试策略，计算机保存标志和刺激坐标。为呈现每个刺激，操作人员将光标置于视网膜标志上方，计算机针对因眼球运动导致的标志位置变化调整刺激的呈现位置。测试结束时，结果显示在眼底图像上正确的视网膜位置。
结果
采用标志驱动法对67只患有黄斑疾病 的眼睛进行了检测，对每只眼睛使用相同的预先规划策略进行明、暗两种刺激。不一致点（在暗刺激下可见但明刺激下不可见）的发生率较低，并且几乎所有这些点都毗邻密集暗点。那些不一致点较多的眼睛，密集暗点的比例显著更高，视力也显著更低。该技术显著校正了因大幅度眼球运动导致的视网膜定位误差。在操作过程中没有明显的旋转或放大变化，因此指定一个标志位置的变化就足以描述视网膜的运动。该技术快速且易于应用于老年患者和儿童。
结论
该技术能够在特定位置对视网膜敏感度进行准确且可重复的测量。它对于跟踪随时间的变化很有用。可以进一步开发以实现完全自动化的、视网膜位置正确的检测。
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