Wall M, Kutzko K E, Chauhan B C
Department of Neurology, Veterans Administration Hospital, Iowa City, Iowa, USA.
Invest Ophthalmol Vis Sci. 1997 Feb;38(2):426-35.
To test the hypothesis that variability of conventional automated perimetry can be reduced using size V stimuli for patients with glaucomatous visual field damage.
Ten patients with glaucoma and five age-matched control volunteers were tested with the Humphrey Field Analyzer program 24-2 or 30-2, after which the method of constant stimuli was used to measure frequency-of-seeing curves. This was done by controlling the perimeter with a custom program run by a personal computer. At two widely separated visual field locations on the program 24-2 or 30-2 grid, stimuli were presented in 2 dB intervals to at least 10 dB on either side of the estimated program 24-2 or 30-2 threshold. This protocol was performed for each of three stimulus sizes (Goldmann sizes I, III, and V). For the patients with glaucoma, one test location was chosen in an area of normal visual field sensitivity, the other in an area of 10 to 20 dB loss. Control subjects were tested at the (3 degrees, 3 degrees) and (-21 degrees, -9 degrees) test locations. Fifteen repetitions were performed at each intensity.
Repeated measures analysis of variance showed that variability, as measured by the standard deviation of the cumulative Gaussian function of the fitted frequency-of-seeing curves, was lowest at the abnormal sensitivity test location in the subjects with glaucoma using a size V stimulus. Differences between the results from the V to III and V to I stimuli were statistically significant (size V = 2.9 dB, III = 10.1 dB, I = 10.1 dB). The same trend in estimated standard deviations was present in tests of the area of normal sensitivity (size V = 1.1 dB, III = 1.7 dB, I = 2.0 dB) in subjects with glaucoma and for the control subjects' peripheral test locations, but not for the central location. The smaller reduction in variability between estimated standard deviations of the size I and size III stimuli was not statistically significant at any test location.
Use of size V stimuli in conventional automated perimetry reduces variability in tests of moderately damaged and normal sensitivity test locations in subjects with glaucoma.
验证对于患有青光眼性视野损害的患者，使用V尺寸刺激可降低传统自动视野计检查变异性这一假设。
对10例青光眼患者和5例年龄匹配的对照志愿者使用Humphrey视野分析仪程序24-2或30-2进行检测，之后采用恒定刺激法测量视见频率曲线。这是通过个人计算机运行的自定义程序控制视野计来完成的。在程序24-2或30-2网格上两个相距较远的视野位置，以2 dB的间隔呈现刺激，刺激强度在估计的程序24-2或30-2阈值两侧至少达到10 dB。对三种刺激尺寸（Goldmann尺寸I、III和V）分别执行此方案。对于青光眼患者，在正常视野敏感度区域选择一个测试位置，在视野敏感度损失10至20 dB的区域选择另一个测试位置。对照受试者在（3度，3度）和（-21度，-9度）测试位置进行检测。每个强度进行15次重复测量。
重复测量方差分析显示，对于青光眼患者，使用V尺寸刺激时，在异常敏感度测试位置，由拟合视见频率曲线的累积高斯函数标准差测量的变异性最低。V尺寸与III尺寸及V尺寸与I尺寸刺激结果之间的差异具有统计学意义（V尺寸 = 2.9 dB，III尺寸 = 10.1 dB，I尺寸 = 10.1 dB）。在青光眼患者正常敏感度区域测试（V尺寸 = 1.1 dB，III尺寸 = 1.7 dB，I尺寸 = 2.0 dB）以及对照受试者外周测试位置，估计标准差也呈现相同趋势，但中央位置未出现此趋势。在任何测试位置，I尺寸和III尺寸刺激估计标准差之间变异性较小的降低均无统计学意义。
在传统自动视野计检查中使用V尺寸刺激可降低青光眼患者中度受损和正常敏感度测试位置检查的变异性。
