蓝/黄视野计与标准白色视野计在早期青光眼诊断中的意义

目的 :评价蓝 /黄视野计 (blue on yellowperimetry ,B/Y)又叫短波视野计short wavelengthperimetry与标准白色视野计 (white on whiteperimetry ,W /W )检测早期青光眼的敏感性。方法 :采用瑞士产Octopus 10 1型全自动视野计对早期原发性开角型青光眼 17例 3 4只眼 ,对照组正常人 8例 16只眼 ,进行B/Y及W /W检测 ,视野检测采用tG2 测试程序 ,将中心 3 0°视野内全视网膜光敏感度均值及各象限光敏感度均值 (dB)进行比较分析。结果 :两种视野计检测正常人B/Y较W /W检测全视网膜光敏感度均值低 ,两者相差 3 96dB ,差异有显著意义 (t =5 11,P <0 0 0 1) ,对应各象限视网膜光敏感度均值比较 ,差异均有显著意义 (P <0 0 0 1) ,早期开角型青光眼B/Y较W /W检测全视网膜光敏感度均值差为 5 3 4dB ,差异有显著意义 (t =5 87,P <0 0 0 1) ,对应各象限视网膜光敏感度均值差 5dB以上 ,差异有显著性 (P <0 0 0 1) ,视网膜光敏感度均值依次为鼻下 >颞下 >鼻上 >颞上 ,以B/Y检测出的缺损面积大且深 ,按矫正偏差图 (cor rectedprobability)计算P <2以上缺损点数 ,显示B/Y检测结果大于W /W检测结果 ,前者为后者的 2 2 3倍 ,差异有显著意义( χ2 =13 0 4,P <0 0 0 5 ) ,早期开角型青光眼组 3 4只眼B/Y检测视野     

蓝/黄视野计与标准白色视野计检测早期青光眼的敏感性比较

目的　探讨蓝 /黄视野计 (blue on yellowperimetry ,B/Y)又称短波视野计 (short wavelengthperimetry)及自动标准白色视野计 (white on whiteperimetry ,W/W)检测早期青光眼的敏感性。方法　采用自行改装的德国Twinfield视野计 ,对 36例 (46只眼 )早期原发性开角型青光眼患者及 38例对照组正常人 (46只眼 )进行B/Y及W/W检测 ,两组的年龄及性别相匹配。视野检查采用 2 4 2程序 ,将中心 2 5°内全视网膜光敏感度均值及各象限光敏感度均值 (dB值 )进行组间比较和分析。结果　两种视野计检测正常人 ,B/Y较W/W检测全视网膜光敏感度均值低 ,差异有显著意义 (t=3 57,P <0 0 0 1 ) ,但两者仅相差 1 63dB ;两种视野计检测的各对应象限间视网膜光敏感度均值比较 ,差异均有显著意义 (t=3 45 ,P <0 0 0 1 ) ,W/W检测的各象限视网膜光敏感度均值 >与之相对应象限的B/Y检测结果。两种视野计检测早期青光眼 ,全视网膜光敏感度均值差为 2 87dB ,差异有显著意义 (t=4 57,P <0 0 0 1 ) ;各对应象限间视网膜光敏感度均值差 >2 5dB ,差异有显著意义 (t=3 42 ,P <0 0 0 1 ) ;光敏感度均值依次为鼻下 >颞下 >鼻上 >颞上 ;以B/Y检测出的视野缺损面积大且深。按视岛 (islandofvision)矫正的偏差图 (correcteddeviation)     

蓝/黄视野计与标准白色视野计在早期青光眼诊断中的意义

目的　评价蓝 /黄视野计 (blue- on- yellow perimetry B/Y又叫短波视野计 short- wavelength perime-try)与标准白色视野计 (white- on- white perim etry W/W)检测早期青光眼的敏感性。方法　采用瑞士产 Octo-pus10 1型全自动视野计对早期原发性开角型青光眼 17例 (34只眼 ) ,对照组正常人 8例 (16只眼 ) ,进行 B/Y及W/W检测 ,视野检测采用 t G2 测试程序 ,将中心 30°视野内全视网膜光敏感度均值及各象限光敏感度均值 d B进行比较分析。结果　两种视野计检测正常人 B/Y较 W/W检测全视网膜光敏感度均值低 ,两者相差 3.96 d B,差异有显著意义 (t=5 .11,P <0 .0 0 1) ,对应各象限视网膜光敏感度均值比较 ,差异均有显著意义 (P <0 .0 0 1) ,早期开角型青光眼 B/Y较 W/W检测全视网膜光敏感度均值差为 5 .34d B,差异有显著意义 (t=5 .87,P <0 .0 0 1)。早期开角型青光眼组 34只眼 B/Y检测视野阳性者 2 4只眼 ,阳性率为 70 .5 9% ,W/W检测视野阳性者 14只眼 ,阳性率为 4 1.18% ,两种视野计检测结果的异常率有显著差异 (χ2 =5 .33,P <0 .0 5 )。结论　 B/Y与 W/W检测结果有良好的一致性 ,检测早期开角型青光眼的视野改变 B/Y较 W/W敏感 ,表现为早期青光眼检测阳性率高 ,检测出的视野缺损范围大而且深     

蓝色视野检测早期青光眼的临床研究

目的 探讨蓝色(蓝/白)视野检测早期青光眼的敏感性.方法 采用美国HumphreyⅡ-740型全自动视野计,对32例(32只眼)早期青光眼患者(其中早期原发性开角型青光眼患者16例(16只眼),早期原发性慢性闭角型青光眼患者16例(16只眼)及38例(38只眼)正常对照组进行蓝色(蓝/白)及白色(白/白)视野检测,两组的年龄及性别相匹配.视野检查采用全阈值C-30-2程序,将中心30°内全视网膜光敏感度均值及各象限光敏感度均值(dB值)进行组间比较和分析.结果 两种视野检测方法检测正常人,蓝色视野比白色视野全视网膜光敏感度均值低,差异有显著意义(t=43.46,P<0.001);白色视野检测各点的视网膜光敏感度均值>蓝色视野检测的各对应点,差异有非常显著意义(t=74.642,P<0.001).两种视野检测方法检测早期青光眼,白色视野检测全视网膜光敏感度均值(23.71±4.05)dB;蓝色视野检测全视网膜光敏感度均值(14.16±4.55)dB,较白色视野检测值低,差异有显著意义(t=15.81,P<0.001).两种检测结果有明显相关性(r=0.678,P<0.001).32只眼中,蓝色视野检测异常者29只眼,阳性率84%(27/32);白色视野检测异常者25只眼,阳性率63%(20/32);两种视野计检测的阳性率比较,差异有显著意义(x2=3.864,P=0.049).结论 蓝色与白色视野检测结果有良好的符合性.检测早期青光眼性视野改变,蓝色较白色敏感,表现为早期青光眼的检出率高.     

蓝-黄视野计与标准的白-白视野计对早期原发性开角型青光眼视野的对比研究

目的　评价蓝 -黄视野计 (blue- on- yellow perim etry,B/ Y)又称短波长视野计 (short- wavelength auto-mated perim etry,SWAP)与标准的白色视野计 (white- on- white perimetry,W/ W)在早期青光眼视野损害诊断中的意义。方法　利用 Hum phrey- - 75 0型全自动视野计 C- 30 - 2全阈值检测程序对 2 0例 (4 0只眼 )正常人、2 0例 (36只眼 )可疑青光眼、18例 (32只眼 )确诊的早期原发性开角型青光眼 (primary open- angle glaucoma,POAG)分别进行 W/ W与 B/ Y的视野检查。结果　正常人、可疑青光眼、早期青光眼 B/ Y检测的全视网膜光敏感度均值 (MS)低于 W/ W检测的结果 ,两者有显著性意义 (t=11.6 8,P <0 .0 1;t=14 .0 1,P <0 .0 1;t=14 .6 8,P <0 .0 1)。B/ Y检测光敏感度缺损均值 (MD)与 W/ W检测的结果 ,正常人组无显著性意义 (t=1.0 4 ,P <0 .0 1) ,其它两组有显著性意义 (t=4 .88,P <0 .0 1;t=3.378,P <0 .0 1)。W/ W检查正常人组与可疑性青光眼的 MS差别无显著意义 (t=2 .5 4 ,P >0 .0 1) ,B/ Y有显著意义 (t=5 .5 7,P <0 .0 1)。两组的 MD差别均有显著意义 (t=3.16 ,P <0 .0 1,t=6 .2 6 ,P <0 .0 1) ;W/ W与 B/ Y检查正常人组与早期青光眼组的 MS差别有显著意义 (t=6 .4 7,P <0 .0 ;t=10 .19,P     

蓝/黄视野检查法对原发性开角型 青光眼的早期诊断价值

目的探讨蓝/黄视野检查法(blue-on-yellow perimetry,B/Y PM)对青光眼的早期诊断价值。 方法利用OCTOPUS 101全自动视野计G2程序分别对16例(32只眼)正常人,25例(35只眼)白/白视野检查(white-on-white perimetry,W/W PM)异常的原发性开角型青光眼(primary open-angle glaucoma,POAG),15例(15只眼)W/W视野检查正常的早期POAG及11例 (22只眼)可疑POAG进行B/Y视野检查。结果正常人、 可疑POAG、早期、中期及晚期POAG B/Y视野检查视网膜平均敏感度分别为(23．24±1．22 )dB、(20．97±3．42)dB、(18．44±3．570dB、(11．04±1．85)dB及(8 ．55±2．29)dB。B/Y 视野检查法对检测青光眼视野损害的敏感性高于常规W/W视野检查法,敏感性为92％,特异性为 90．62％。早期和中期POAG中,B/Y视野检测出视野缺损点数明显多于W/W视野检测出的缺损点数。结论B/Y视野检查 法是检测POAG早期视野损害的敏感方法之一。(中华眼底病杂志,2001,17:125-127)     

标准白色视野与蓝／黄视野检测不同阶段青光眼视野的对比研究

目的比较自动标准白色视野计（white-on-white perimetry,啪w）和蓝／黄视野计（blue-on-bellow perimetry,B/Y）检测不同阶段青光眼视野损害的敏感性。设计横断面调查。研究对象青光眼患者42例（71眼）。方法采用HumphreyⅡ-750型自动视野计对青光眼患者进行B／Y及W｜W检查。根据晚期青光跟治疗研究（Advanced GlaucomaIntervention Study,AGlS）视野评分标准,将青光眼患者分早、中、晚三组,运用青光眼首选治疗研究（collaborative initial glaucoma treatment study,CIGTS）方法,对视野缺损进行评分。比较三组不同时期青光眼应用两种视野计检查,在视野平均缺损（Meandeviation,MD）、模式标准差（Pattern Standard Deviation,PSD）、CIGTS评分方面的差异。主要指标视野的平均缺损、模式标准差、CIGTS评分。结果两种视野计检查MD的均值结果在早、中期青光眼组,B／Y检测的MD（-8．65dB±3．89dB;-14．94dB±3．22dB）较w／W（-3．29dB±2．40dB;-10．04dB±2．73dB）低,t=9．21,P〈0．001及t=-4．89,P〈0．001;在晚期青光眼组,B／Y检测的MD（-22．07dB±2．64dB）较w／w（-25．20dB±5．48dB）高,t=3．93,P〈0．001。两种视野计检查PSD的均值结果,在早期青光眼组,B／Y检测的PSD（4．17dB±1．20dB）较W／W（3．22dB±2．90dB）高,t=2．12,P〈0．05;在中、晚期青光眼组,B／Y检测的PSD较W/W低（t=-3．04,P〈0．01,t=-2．96,P〈0．001）。两种视野计CIGTS评分的均值结果,在早期青光眼组,B／Y的CIGTS评分（5．35±3．83）较W/W（3．36±3．12）高,t=2．67,P〈0．05）;在中、晚期青光眼组,B／Y的CIGTS评分较W/W低,t-4131,P〈0．05及t=-4．02,P〈0．001。结论对于早期青光眼的视野检测,B/Y较W/W敏感,但对于中晚期青光眼,W/W视野较B／Y更敏感。对于早期青光眼及可疑青光眼采用B／Y视野检测较敏感,而对于中晚期青?     

国人蓝黄视野正常值检测

目的通过蓝黄视野检查法(blue-onyellowperimetry,B/YP)检测正常人蓝黄视野,以期确定国人蓝黄视野的正常参考值。方法应用OCTOPUS101全自动视野计(In-terzegINC,Switzerland)G2程序的Normal分程序进行B/YP视野检查,测定健康者180例360眼(10-70岁,每10岁为1个年龄段,分6个年龄段,每个年龄段男女各15例)蓝黄视野,将中心30°内全视网膜光敏感度均值(MS)及各象限光敏感度均值(dB值)分年龄段、性别及眼别分别进行比较和分析,并计算各年龄段全视网膜光敏感度均值的95%可信区间(CI)。结果B/YP检测正常人全视网膜光敏感度均值随年龄增加而降低,平均每10a降低1.2737dB。10-20岁为26.7833dB±2.7582dB(95%CI为26.0708-27.4959dB);21-30岁为25.7567dB±1.8101dB(95%CI为25.2891-26.2243dB):31-40岁为24.1133dB±2.7807dB(95%CI为23.3950-24.8317dB);41-50岁为22.7500dB±2.9662dB,(95%CI为211.9838-23.5162dB):51-60岁为21.1300(dB±2.4246dB(95%(CI为20.5037-21.7563(dB);61-70岁为20.4150dB±2.6847dB(95%(CI为19.7215-21.1085dB)。各年龄段内比较,下方视网膜光敏感度均值高于上方视网膜光敏感度均值,差异具有非常显著意义(P≤0.001)。不同性别、眼别视网膜光敏感度均值比较,差异无统计学意义。结论B/YP检测正常     

早期原发性青光眼的蓝黄视野及黄斑阈值视野检测

目的 探讨蓝黄视野及黄斑阈值视野检测在早期原发性青光眼诊断中的应用价值。 方法 采用Humphrey II 750型自动视野计，对正常人60例60只眼、早期原发性青光眼患者63 例63只眼进行标准视野（white-on-white perimetry, W/W）、蓝黄视野（blue-on-yellow perimetry, B/Y）及黄斑阈值视野（macular threshold perimetry, MTP）检查,计算比较3 种检测方法在早期原发性青光眼诊断中的敏感度及特异度，并采用B/Y及MTP并联及串联实验进行分析。 结果 比较正常组与早期原发性青光眼组W/W、B/Y、MTP的平均光敏感度，差异均有显著性的意义［t=-3.01, P=0.0054 (W/W)；t=-2.95, P=0.0063 (B/Y)；t=-2.59,P=0.0150 (MTP)］。在早期原发性青光眼诊断中，MTP的敏感度最高（83%），B/Y次之（65%），W/W最低（48%）。将B/Y与MTP联合运用时，并联试验可使敏感度提高到94%；串联试验可使特异度提高到87%。 结论 在早期原发性青光眼诊断中，B/Y、MTP及两者的联合应用均可提高诊断的敏感度与特异度，有一定的应用价值。 （中华眼底病杂志，2003，19：102-105）     

蓝黄视野与标准静态视野在原发性开角型青光眼诊断中的应用观察

目的探讨蓝黄视野和标准静态视野检测在原发性开角型青光眼诊断中的应用价值。方法分别采用OCTOPUS101全自动电脑视野分析仪中蓝黄视野和标准静态视野的G2测试程序对正常组25例(36只眼)、早期23例(35只眼)、中期13例(24只眼)和晚期14例(23只眼)青光眼患者进行蓝/黄及白/白光视野检测,将中心30°视野内视网膜光敏感度均值(MS)和缺损(MD)进行比较和分析,并对两种视野检测正常组和早期青光眼组的敏感性和特异性进行分析。结果每组青光眼蓝/黄光视野平均光敏感度明显低于白/白光视野,平均缺损高于白/白光视野,有显著性差异(P<0.001);各组与正常组相比有显著性差异(P<0.05)。早期开角型青光眼组35只眼蓝/黄光视野检测阳性者30只眼,敏感性为85.7%,白/白光视野检测阳性者17只眼,敏感性为48.6%。结论在各期原发性开角型青光眼视野检测中,蓝/黄光比白/白光敏感,蓝/黄光检测出的缺损面积大而且深。在早期青光眼诊断中蓝/黄光敏感性高于白/白光。     

HPR perimetry and Humphrey perimetry in glaucomatous children

Fifteen children aged less than 11 years, affected by congenital glaucoma, underwent visual field testing using two different methods: conventional computerized perimetry (24-2 Humphrey program) and High Pass Resolution perimetry (Ring test). The aim of the study was to discover which of the two perimetric techniques was more suitable for younger patient. Results showed that HPR perimetry is more suitable to children. Reasons include the short duration of the test (5 min), and the appearance like a pleasant game to 80% of the subjects tested. In addition it proved to be better than Humphrey test because of the minimal possibilities of memorisation with a reproducibility factor of 68% in our sample and because of the reliable results and satisfactory evaluation in 76% of the eyes examined.     

Pupil perimetry

The pupillomotor and visual sensitivity were compared at the same 76 points across the 30 degrees field. The timing and amplitude of pupillary contractions to focal light stimuli were recorded using a computerized infrared pupillometer linked to a Humphrey automated perimeter. Pupil perimetry and standard threshold perimetry showed matching defects in the visual field of patients with ischemic and compressive optic neuropathy, but not in patients with primary open-angle glaucoma. Patients with isolated occipital strokes showed matching homonymous visual and pupillary fields, suggesting a suprageniculate influence upon the pupillary light reflex. Pupil perimetry is a useful objective form of perimetry and can be used to compare the effect of disease on the visual and pupillary pathways.     

Standard perimetry

As distinguished from measuring the ability to see at the location where the eye's gaze is fixated, perimetry consists of determining the visual capabilities throughout the field of vision. Traditionally the ability to see a white object or a projected spot of white light is determined and quantified under standard conditions. Modern machines use automated methods to present spots of light in a programmed manner to determine the threshold of visual capability, and, after recording the data, these machines also apply statistical analyses of the results to assist the clinician in evaluation of the patient. New methods for testing particular aspects of visual function and analyzing the results are continuously under development.     

视野检查法

视野计已成为一种被广泛应用的主要视功能检查手段,它具有独特的临床应用价值。随着视觉理论、现代检测技术及信息技术的进步,它将不断发展和完善。近年来学者们对其进行了大量的研究;本文就此作一综述。     

视野检查法

视野计已成为一种被广泛应用的主要视功能检查手段，它具有独特的临床应用价值。随着视觉理论、现代检测技术及信息技术的进步，它将不断发展和完善。近年来学者们对其进行了大量的研究；本文就此作一综述。     

Blue-on-yellow perimetry

Laboratory based studies which employ foveal stimuli have demonstrated a selective short-wavelength sensitive (SWS) pathway deficit prior to visual field loss in glaucomatous patients. Early glaucomatous visual field loss as revealed by conventional perimetry, however, is generally accepted to occur outside the fovea. Consequently, blue-on-yellow perimetry was developed which permits the assessment of SWS function across the central visual field. This new clinical technique employs a blue stimulus to preferentially stimulate the SWS pathway and a high luminance yellow background to saturate the other receptor types. Clinical studies suggest that blue-on-yellow perimetry reveals early glaucomatous field loss before conventional perimetry which follows a pattern dictated by the anatomy of the retinal nerve fibre bundles. Blue-on-yellow perimetry is particularly prone to attenuation by the ocular media and macular pigment because of the use of a short-wavelength stimulus. Ocular media absorption (OMA) increases with increase in age (approx. a 10 dB increase in mean OMA between 20 and 70 years relative to 410 nm), exhibits a large variation between individuals of the same age (approx. 9 dB) and is exaggerated in diabetics. Both OMA and forward light scatter (LS) result in a diffuse reduction of blue-on-yellow sensitivity. Macular pigment absorption (MPA) does not vary systematically with age (P > 0.05) but exhibits a large variation between individuals (approx. 10 dB relative to 460 nm). MPA results in a symmetrical reduction of blue-on-yellow sensitivity centred on the fovea (mean foveal MPA 4 dB, P < 0.001) with 5° eccentricity. The psychophysical techniques employed to quantify OMA, forward LS and MPA are time-consuming and not suitable as routine clinical procedures. Methods of analysis which avoid the use of absolute sensitivity values need to be employed to identify abnormality in the blue-on-yellow visual field. Such an approach may rely on the identification of change in shape (i.e. pattern standard deviation) or symmetry (i.e. glaucoma hemifield test) of the visual field. Alternatively, the clustering of stimulus locations with markedly reduced sensitivity and the conformity of clusters to recognized patterns of glaucomatous nerve fibre loss should provide sensitive measures of abnormality.     

Automation of perimetry

Conclusion Automation of perimetry is quite feasible in normal subjects (3.6 % failures).It is equally feasible in patients with visual field defects not over 60 years of age (0 % failures). Automated examination ends in failure in 30 % of the patients in the older age groups seen in our clinic. This means that automated perimetry is particularly suitable for purposes of screening, i.e. to distinguish between subjects with and without visual field defects.Automated perimetry also allows performance of an accurate assessment phase, but in 16 % of the cases the examination will have to be performed by a perimetrist. To a center for perimetry, this still means a considerable lightening the work load.In general, automation of perimetry means that the possibility of examination of the visual field is made available to large groups of people.Eye Clinic of the University of Amsterdam, 104 le Helmersstraat, Amsterdam (The Netherlands).     

Clinical comparison of frequency doubling technology perimetry and Humphrey perimetry

AIM: To determine the number of missed points on frequency doubling technology (FDT) perimetry that optimise the sensitivity and specificity of the test and to determine the topographical accuracy of the test in a clinical setting. METHODS: In a prospective study, the perimetric data from 99 patients who underwent both FDT perimetry in the screening mode and Humphrey 24-2 (H24-2) were used to determine the sensitivity and specificity of the FDT perimetry compared with the full threshold H24-2 as the gold standard. RESULTS: Missed points on the FDT perimetry correlated with both the mean deviation and the corrected pattern standard deviation on the Humphrey perimetry. A score assigned to abnormal points on the FDT perimetry and the Humphrey total deviation plot showed a significant correlation for both the location and the depth of the defect. In comparing the Humphrey hemifield test with the FDT perimetry results, if at least one missed point on the frequency doubling test was considered as abnormal then the overall sensitivity of the test was 78.1% and the specificity was 89.1%. CONCLUSION: FDT perimetry in the screening mode performed in a clinical setting was highly specific, exhibited reasonable sensitivity, and accurately determined the location and depth of scotomas when compared with the full threshold Humphrey 24-2.