Mills R P, Barnebey H S, Migliazzo C V, Li Y
Department of Ophthalmology, University of Washington, Seattle 98195-0001.
Ophthalmology. 1994 Sep;101(9):1596-603. doi: 10.1016/s0161-6420(94)31132-8.
To compare the clinical performance of two time-saving test strategies in detecting visual field abnormalities.
One eye of 48 healthy subjects and 87 patients with glaucoma and early visual field loss was tested with the Humphrey perimeter. After an initial 24-2 standard threshold test, three tests using the 24-2 array of test locations were performed in randomized order: standard threshold strategy, FASTPAC threshold strategy, and threshold-related suprathreshold screening strategy. The initial 24-2 test was used as the "gold standard" against which the other three tests were compared.
Mean threshold values were 0.3 decibels more sensitive using FASTPAC than the standard threshold test, whereas short-term fluctuation was 0.5 decibels larger. Measured using different criteria for abnormality, sensitivity and specificity of FASTPAC were no different than those of the standard threshold test, but they were better than the suprathreshold screening. Using a very sensitive measure of defect detection in ten different clusters within the field, the standard strategy and FASTPAC performed similarly yet significantly better than the suprathreshold test.
In healthy subjects and patients with early glaucoma, FASTPAC saves 40% of test time without a significant deterioration in defect detection, whereas 52-point suprathreshold screening is not a clinically acceptable alternative.
比较两种省时检测策略在检测视野异常方面的临床性能。
使用汉弗莱视野计对48名健康受试者以及87名患有青光眼且有早期视野缺损的患者的一只眼睛进行检测。在进行初始的24-2标准阈值测试后，按照随机顺序使用24-2测试位点阵列进行三项测试：标准阈值策略、FASTPAC阈值策略和阈值相关的超阈值筛查策略。将初始的24-2测试用作“金标准”，并与其他三项测试进行比较。
与标准阈值测试相比，使用FASTPAC时平均阈值灵敏度高0.3分贝，而短期波动大0.5分贝。根据不同的异常标准进行测量，FASTPAC的灵敏度和特异性与标准阈值测试无异，但优于超阈值筛查。使用一种对视野内十个不同区域的缺损检测非常敏感的测量方法，标准策略和FASTPAC表现相似，但明显优于超阈值测试。
在健康受试者和早期青光眼患者中，FASTPAC可节省40%的测试时间，且在缺损检测方面无显著恶化，而52点超阈值筛查在临床上不是一个可接受的替代方法。
