优势眼测量法的研究

目的:为了检查一项新的性能测试,对同以受试者用两种不同的方法进行检测和再测试,并比较和讨论这些检测方法的可靠性。方法:共179个大学生(平均年龄±标准差为19.37±1.62)a自愿参加这项由110名女性(61.5%)和69名男性(38.5%)组成的调查。优势眼由两种不同的方法检测,一个为McManus方法,一个为Gndo■an方法。利用SPSS的重测信度的可靠性分析保证该项调查的可靠性。结果:McManus方法检测128名(71.5%)参加者右眼为优势眼,无性别差异。同样利用Gndogˇan方法再检测发现110名(61.5%)参加者右眼为优势眼。两种方法的检测结果由Fisher确切概率法分析发现呈显著性相关(P<0.01),一致性数值为为κ=0.256,P<0.001。利用Mc-Manus法发现女性参加者中74名(67.3%)右眼为优势眼,36名(32.7%)左眼为优势眼。利用Gndog■an法再检测发现62名女(56.4%)右眼为优势眼,48名女(43.6%)左眼为优势眼。通过Fisher确切概率法分析发现McMa-nus和Gndo■an两种方法在女性优势眼检测方面呈显著性相关(P<0.05),一...     

Menstrual cycle-dependent differences between right and left visual hemifields in perimetry

PURPOSE: To evaluate the effect of the menstrual cycle and gender on right and left visual hemifields in healthy subjects. METHODS: One randomly selected eye from each of 42 healthy normally menstruating women and of 37 men with no systemic and ocular problems, other than refractive error, were included in the study. Subjects underwent complete ocular examination and standard acromatic perimetric (SAP) and short-wavelength automated perimetric (SWAP) analysis in both follicular (7th to 10th day of the cycle) and luteal phases (days 3 to 7 before the menstrual bleeding) of the menstrual cycle. Visual field analysis was performed using Model 750 Humphrey Field Analyzer II (Carl Zeiss Meditec, Dublin, CA, USA) with full-threshold, central 30-2 program. RESULTS: The mean age of female (n = 42) and the male subjects (n = 37) were 35.2 +/- 3.1 years and 34.8 +/- 2.9 years, respectively (p = 0.58). Neither females nor males showed any statistically significant differences in the right and left hemifield tests with SAP (both p values > 0.05). However, using SWAP, in luteal phase of female subjects, left hemifield sensitivity was significantly less than (with a mean of 0.47 dB) right hemifield. In follicular phase, there was no significant interhemifield difference (p > 0.05). Male subjects did not show any significant differences between the sensitivity of the two hemifields with SWAP tests. CONCLUSIONS: There has been a significant difference between the mean SWAP sensitivity of right and left visual hemifields in luteal phase of the menstrual cycle. In case of a suspected hemifield difference, SAP rather than SWAP may be used to confirm suspected neurological defects as SAP is not affected by the menstrual cycle.     

Nerve fiber layer thickness in glaucoma patients with asymmetric hemifield visual field loss

PURPOSE: To investigate the presence of retinal nerve fiber layer (RNFL) thinning and determine the relationship between RNFL thickness and visual field sensitivity loss in glaucoma patients with asymmetric hemifield visual field loss. PATIENTS AND METHODS: Thirty glaucoma patients with asymmetric hemifield visual field loss and 30 normal control subjects were included in the study. RNFL thickness was measured by optical coherence tomography and visual field sensitivity was measured by automated perimetry. Glaucoma patients with advanced visual field loss restricted to 1 hemifield and early or absent glaucomatous field loss in the other hemifield on the basis of the visual field data were included. Visual field sensitivity and mean deviation (MD) were averaged separately in each of the 2 hemifields. The hemifields in each eye were categorized as early (MD>or=-6 dB) and advanced (MD<-6 dB) glaucomatous hemifields. RESULTS: RNFL thickness measurements in corresponding (eg, superior peripapillary quadrant with inferior hemifield) advanced glaucomatous hemifields (59+/-16 microm) were significantly (P<0.001) lower than in corresponding early glaucomatous hemifields (90+/-25 microm). The mean RNFL thickness in corresponding advanced and early glaucomatous hemifields were significantly lower than in normal control subjects (P<0.0001). On the basis of the normative database supplied by optical coherence tomography software, 100% and 43% of eyes had abnormal RNFL thickness in corresponding advanced and early glaucomatous hemifields, respectively. A linear correlation was found between RNFL thickness and MD in the early (r=0.6; P<0.001) and advanced (r=0.5; P=0.007) glaucomatous hemifields. CONCLUSIONS: RNFL thinning was present in corresponding hemifields of glaucomatous eyes with minimal visual field defect and correlated with visual field sensitivity loss. Measurement of RNFL thickness has potential for detection of early nerve fiber loss owing to glaucoma.     

Association between ocular dominance and refraction

PURPOSE: To investigate the association between ocular dominance and refraction. METHODS: A retrospective study of the cycloplegic refraction of 2453 consecutive patients with a mean age of 46 +/- 12 years (range: 18 to 79 years) was performed. One thousand one hundred fifty-seven (47%) patients were men and 1296 (53%) were women. Patients who had previous eye surgery, ocular disease, or > 2 lines of best spectacle-corrected visual acuity (BSCVA) difference between eyes were excluded. Motor ocular dominance was determined using the hole-in-the-card test. RESULTS: The right and left eyes were dominant in 67% (1650) and 33% (803) of patients, respectively. Males had a higher right eye dominance (70%) than females (65%) (P = .0168) with a mean cycloplegic spherical equivalent refracton (SE) of -2.12 diopters (D) and -2.38 D, respectively. This higher rate of right eye dominance in males was seen at all levels of SE refractive error. Mean BSCVA was 20/19 in both right and left eyes (P>.05) with a mean SE of -2.25 +/- 3.63 D and -2.26 +/- 3.66 D in the right and left eyes, respectively. Neither mean SE difference nor BSCVA difference between eyes was found to correlate with motor eye dominance. CONCLUSIONS: Gender appears to be a factor when testing ocular dominance but not SE refractive error. The hole-in-the-card dominance test is a method that is easy to perform for both patients and clinicians.     

Inter-eye comparison of patterns of visual field loss in patients with glaucomatous optic neuropathy

PURPOSE: To compare inter-eye patterns of visual field (VF) loss on standard automated perimetry (SAP) in patients with glaucomatous optic neuropathy. DESIGN: Observational cross-sectional study. METHODS: Four-hundred-and-ninety eyes of 245 patients with glaucomatous optic neuropathy in at least one eye defined by masked stereophoto review were included. Patients had two reliable SAP visual fields within fifteen months for each eye. Patterns of visual field loss were classified independently by two graders masked to all other patient information. Patterns were described as altitudinal, arcuate, partial arcuate, paracentral, nasal step, temporal wedge, or normal based on the classification system of Keltner and associates. Superior and inferior hemifields were graded separately. RESULTS: Inter-grader agreement in visual field patterns before adjudication was 97% and 94% for the worse eye (superior and inferior hemifield) and 97% and 95% for the better eye (superior and inferior hemifield). The percentage of correspondence by hemifield location was: 53% (superior-superior), 62% (inferior-inferior), 45% (superior-inferior), and 55% (inferior-superior). The highest correspondence of individual glaucomatous VF pattern between eyes was for arcuate (superior-superior) and inferior partial arcuate (inferior-inferior) defects (24% and 26%, respectively). Smaller hemifield patterns showed lower correspondence between the eyes (nasal step, paracentral, temporal wedge, 0% to 13% correspondence). CONCLUSIONS: Patterns of visual field loss between eyes often corresponded within the same VF hemifield (superior-superior, inferior-inferior) as well as between opposite hemifields (inferior-superior), although opposite hemifield correspondence was less common. More advanced visual field defects (for example, partial arcuate) showed higher correspondence rates between the eyes than less advanced defects.     

POAG早期上下半视盘视网膜神经纤维层的不对称性变化

目的：：探讨原发性开角型青光眼( primary open angle glaucoma, POAG)早期上下半视盘周围视网膜神经纤维层( retinal nerve fiber layer, RNFL)的变化特征。方法：临床观察研究,研究对象为2012-05/2014-05在我院门诊确诊为原发性开角型青光眼早期患者30例39眼和健康成人20例40眼,使用Humphrey视野计和光学相干断层成像术( optical coherence tomography,OCT)检查,分别记录视野平均缺损( mean defect,MD)、青光眼半视野检测( glaucoma hemifield test, GHT)、眼压、C/D比值及视盘周围FNFL厚度。使用SPSS 18.0统计软件对测量值进行统计分析,计量资料组间比较采用t检验。结果：两组上半视盘各钟点位的RNFL厚度减去下半视盘相对应钟点位的RNFL厚度,两组间比较,仅上鼻-下鼻的差值具有统计学意义(t=2.526,P=0.014),其余上下半视盘相对应钟点位RNFL厚度的差值比较,两组间均无统计学意义(均为P>0.05)。结论：原发性开角型青光眼早期上下半视盘周围RNFL存在不对称性变化,上鼻部位(右眼1：00位,左眼11：00位)的RNFL较下鼻部位(右眼5：00位,左眼7：00位)的RNFL更容易受损变薄。     

Asymmetries related to cerebral dominance in returning the eyes to specified target positions in the dark

Left-handed subjects with left eye dominance and right-handed subjects with right eye dominance show differences of performance, related to their hand and eye preference, in returning the eyes to a target position in the dark, after making saccades away to the left or right. These differences are shown particularly in magnitude of error, but also in amount of undershoot and in the number of saccades made. It is suggested that the observed asymmetries of performance implicate a cortical mechanism concerned with the registration of information about saccadic eye movements.     

Bilateral attentional advantage on elementary visual tasks

We examined interactions between and within the left and right visual hemifields using elementary visual tasks. Each trial required identifying a letter at fixation and then either discriminating the orientation of (experiment 1) or detecting (experiment 2) peripheral Gabor targets. On half the trials Gabor distracters were presented between the Gabor targets, and were either restricted to one lateral hemifield (unilateral condition) or presented across the left and right hemifields (bilateral condition). Orientation discrimination and detection each exhibited bilateral superiority only when distracters were present. The results confirm bilateral superiority in attentional selection, even on these most elementary visual tasks.     

The effects on the intraocular pressure and visual field resulting from a switch in the treatment from timolol to betaxolol.

Patients with primary open-angle glaucoma (POAG) were dosed twice-daily with 0.5% timolol maleate for 2 years, followed by 2 years of twice-daily dosing with 0.5% betaxolol hydrochloride. The changes in intraocular pressure (IOP) and effects on visual field by each treatment were monitored over this 4-year period. Both the timolol and betaxolol treatments controlled IOP. The mean MD (mean deviation in visual field) values at 24 months of the timolol treatment were -6.18 dB (decibels) and -5.32 dB. Mean MD baseline values following 24 months of the timolol treatment produced 2.31 dB and 0.95 dB reductions in sensitivity in the right and left eyes, and the reduction in the right eye was statistically significant (p < 0.01). The mean MD values after 24 months of the betaxolol treatment were -3.82 dB in the right eyes, an increase of 2.36 dB, and -4.05 dB in the left eyes, up by 1.28 dB. The results from this clinical trial demonstrated that betaxolol was superior over timolol in improving mean retinal sensitivity.     

Relationship between patterns of visual field loss and retinal nerve fiber layer thickness measurements

PURPOSE: To investigate the association between patterns of visual field (VF) loss and retinal nerve fiber layer (RNFL) thickness measurements. DESIGN: Observational cross-sectional study. METHODS: One hundred twenty-one glaucoma patients and 65 healthy subjects from the Diagnostic Innovations in Glaucoma Study (DIGS) were included. All glaucoma patients had repeatable abnormal VFs and scanning laser polarimetry (SLP) RNFL thickness measurements. RNFL measurements were obtained from 16 equal parapapillary sectors. Patterns of VF loss were classified as arcuate, partial arcuate, nasal step, or paracentral in each VF hemifield. Logistic regression analysis was performed to determine which RNFL sectors were associated with each VF pattern. The ability of SLP to discriminate between eyes with different VF patterns and healthy eyes using receiver operating characteristic (ROC) curve analyses also was investigated. RESULTS: VF patterns in the superior hemifield were significantly associated with RNFL sectors in the temporal inferior hemiretina (P < .05). ROC curve areas for discrimination between eyes with different VF patterns and healthy eyes ranged from 0.85 to 0.95. VF patterns in the inferior hemifield were most strongly associated with temporal superior RNFL sectors (P < .05). ROC curve areas for discrimination between different VF patterns and healthy eyes ranged from 0.73 to 0.98. SLP could discriminate between apparently unaffected VF hemifields in glaucoma eyes and VF hemifields in healthy eyes. CONCLUSIONS: Parapapillary RNFL thickness was topographically related to patterns of VF loss. SLP can differentiate between apparently unaffected VF hemifields in glaucoma eyes and normal VF hemifields in healthy eyes.     

倍频视野计对开角型青光眼正常半侧视野的检测结果

目的　了解倍频视野计 (frequency doublingperimetry ,FDP)检测早期青光眼视野异常的能力。方法　对Humphery视野计检测结果仅为半侧视野异常的 4 9例 (49只眼 )开角型青光眼患者 ,进行FDP(C 2 0阈值程序检测 )及海德堡视网膜断层扫描仪 (Heidelbergretinaltomography ,HRT)检测。根据检测结果 ,将患者分成FDP正常组及异常组 ;再将两组的HRT检测参数进行比较分析。结果FDP检测的平均光敏感度与HRT视野检测结果的平均偏差有显著相关性 (r =0 5 83,P <0 0 0 0 )。Humphery检测的异常半侧视野 ,FDP检测显示正常的仅占 2 0 % (1/ 4 9)。而Humphery检测的正常半侧视野 ,FDP检测显示异常的为 4 0 8% (2 0 / 4 9) ,与其相对应视乳头的HRT检测参数相比 ,FDP异常组的视杯面积和杯 /盘面积比值较FDP正常组的检测值大 (t=2 36 0和 2 4 39,P <0 0 5 ) ,而盘缘面积和盘缘容积则较FDP正常组小 (t=2 32 9和 2 5 79,P <0 0 5 )。结论　FDP不仅能检测出HRT发现的视野缺损 ,而且能显示HRT尚未能检测出的早期青光眼视野异常 ;FDP检测结果与HRT检测参数显示的青光眼性视乳头变化相一致。     

A sticky situation

An 81-year-old man with bilateral progressively blurry vision and optic disc swelling was referred for evaluation. Examination and ancillary testing confirmed a diagnosis of bilateral vitreopapillary traction accompanied by unilateral tractional retinoschisis in the right eye. Pars plana vitrectomy was performed to release the traction in both the eyes. Visual acuity improved in the right eye and stabilized in the left eye. Retinoschisis in the right eye resolved. The visual field improved in both the eyes although the left eye demonstrated a persistent hemifield defect likely attributable to a prior optic neuropathy. Distinguishing vitreopapillary traction optic neuropathy from nonarteritic anterior ischemic optic neuropathy is discussed.     

Correlations between retinal nerve fiber layer and visual field in eyes with nonarteritic anterior ischemic optic neuropathy

PURPOSE: To evaluate correlations between retinal nerve fiber layer (RNFL) thickness with visual field (VF) sensitivities in eyes with nonartertic anterior ischemic optic neuropathy (NAION). DESIGN: Case-control study in an academic, institutional setting. METHODS: One eye from 21 patients with NAION and 32 healthy participants were included in this prospective study. Humphrey visual field (HVF) sensitivities were obtained from standard achromatic HVF test (24-2 SITA). RNFL was measured with scanning laser polarimetry (SLP, GDx-VCC) and optical coherence tomography (OCT, StratusOCT). Correlations were evaluated between RNFL and sensitivities from global, hemifields, and regional locations of the VF pertinent to the RNFL distribution. A total of 15 NAION eyes had inferior altitudinal HVF defects, and their global and regional RNFL was compared with that of control eyes. The main outcome measure was correlation between HVF sensitivities and RNFL. RESULTS: Correlations of global, hemifield, and sectorial HVF sensitivities with RNFL were greater when RNFL was measured with OCT than with SLP, except for nasal and inferonasal sectors. RNFL thickness was far lower in the hemiretinas corresponding to the relative unaffected hemifield in eyes with altitudinal VF defect compared with controls. CONCLUSIONS: In patients with NAION, RNFL measured by OCT provided better correlation to HVF changes than SLP did. Both instruments showed decreased RNFL in NAION eyes with altitudinal VF defects compared with control eyes, demonstrating loss of RNFL even in sectors of the optic disk that corresponded to relatively unaffected hemifield, suggesting greater damage beyond the extent estimated by VF methods.     

Retinal nerve fiber layer measurements in indian eyes using the scanning laser polarimeter, GDx

PURPOSE: To obtain retinal nerve fiber layer (RNFL) measurements in normal Indian subjects of different age groups; and to determine the differences between the right and the left eye of a subject and variations between male and female gender using the scanning laser polarimeter GDx. MATERIALS AND METHODS: Prospective cross-sectional study of 180 eyes of 94 subjects. The RNFL values were obtained with the nerve fiber analyser GDx using default quadrant positions supplied by the manufacturer. Fourteen parameters were studied. Of these 6 were average-based parameters (average thickness, superior maximum, inferior maximum, ellipse average, superior average, inferior average), 4 ratio-based parameters (symmetry, superior ratio, inferior ratio, superior/nasal), 4 "other" parameters (maximum modulation, number, ellipse modulation, superior integral). The main outcome measures were effect of age on RNFL values, comparison of males and females and the right and the left eye of a subject. RESULTS: There was a negative linear correlation with age. Three ratio-based parameters showed a statistically significant negative correlation with age. "Number" increased with age. Superior maximum, superior average, superior integral, symmetry and superior ratio were higher for the left eye. 'Number' was higher for the right eye. Superior ratio and maximum modulation were more in females than males, no difference was noted with other parameters. CONCLUSION: There was a gradual decrease of RNFL values with increasing age - the superior quadrant values were higher for the left eye than the right eye, suggesting asymmetry. No significant differences were detected between males and females.     

Retinal nerve fibre thickness measured with optical coherence tomography accurately detects confirmed glaucomatous damage

AIM: To assess the accuracy of optical coherence tomography (OCT) in detecting damage to a hemifield, patients with hemifield defects confirmed on both static automated perimetry (SAP) and multifocal visual evoked potentials (mfVEP) were studied. METHODS: Eyes of 40 patients with concomitant SAP and mfVEP glaucomatous loss and 25 controls underwent OCT retinal nerve fibre layer (RNFL), mfVEP and 24-2 SAP tests. For the mfVEP and 24-2 SAP, a hemifield was defined as abnormal based upon cluster criteria. On OCT, a hemifield was considered abnormal if one of the five clock hour sectors (3 and 9 o'clock excluded) was at <1% (red) or two were at <5% (yellow). RESULTS: Seventy seven (43%) of the hemifields were abnormal on both mfVEP and SAP tests. The OCT was abnormal for 73 (95%) of these. Only 1 (1%) of the 100 hemifields of the controls was abnormal on OCT. Sensitivity/specificity (one eye per person) was 95/98%. CONCLUSIONS: The OCT RNFL test accurately detects abnormal hemifields confirmed on both subjective and objective functional tests. Identifying abnormal hemifields with a criterion of 1 red (1%) or 2 yellow (5%) clock hours may prove useful in clinical practice.     

郑州市某区9621名高三学生视力不良检出率和近视患病率调查分析

目的　了解郑州市某区9621名高三学生视力不良检出率和近视患病率情况。方法　采取整体抽样法对9621名高三学生体检视力和近视度数结果进行分析,通过卡方检验分析不同性别、不同眼别间视力不良检出率、近视患病率的差异。结果　本研究受检者共9621人19 242眼,其中女生4720人9440眼、男生4901人9802眼;处于病理状态3眼（具体表现为角膜斑翳、人工晶状体眼和弱视）。正常视力4445眼,占受检眼的23.10%;视力不良14 797眼,占76.90%。右眼视力不良检出率高于左眼（χ²=30.024,P<0.001）,女生视力不良检出率高于男生（χ²=27.490,P<0.001）。本调查19 242受检眼中共发现12 339眼近视眼,占64.13%（其中高度近视563眼,占2.93%;中度近视6049眼,占31.44%;轻度近视5727眼,占29.76%）。右眼近视患病率高于左眼（χ²=38.533,P<0.001）,女生近视患病率高于男生（χ²=17.107,P<0.001）。结论　郑州市某区高三学生有较高的视力不良检出率和近视患病率,视力不良检出率和近视患病率中女生高于男生、右眼高于左眼。     

两种方法研究大学生群体优势眼与左／右利手间的关系

目的：评估大学生群体优势眼和左／右利手间的关系。方法：受试对象为179名大学生志愿者,平均年龄为19.4±1.6岁,其中女110名（61.5％）,男69名（38.5％）。优势眼由Gǔndogan和McManus两种方法测得,左或右利手则由Edinburgh Handedness Inventory Oldfield和McManus法确定,t检验评估实验的可信度。结果：Gǔndogan法测得受试者中110人（61.5％）为右眼优势,69人（38.5％）为左眼优势,无性别差异。McManus法重测相同受试者,则右／左眼优势分别为128人（71.5％）和51人（28.5％）。两法测得的结果相关,一致度K=0.256（P〈0.01）。女性受试者中,Gǔndogan法测得右／左眼优势分别为62人（56.4％）和48人（43.6％）,McManus法测得的结果为右／左眼优势分别为74人（67.3％）和36人（32.7％）。Fisher检验两法测得的结果相关（P〈0.05）,一致度,（=0.239（P〈0.01）。男性受试者中,Gǔndogan法测得右／左眼优势为48人（69.6％）和21人（30.3％）,McManus法检测为54人（78.3％）和15人（21.7％）。Fisher检验两法测得结果相关（P〉0.05）,一致度K=0.239（P〈0.01）。Oldfield和McManus法分别测得右利手比例为91.6％（n=164）和91.1％（n=163）,两者间有较高的一致度κ=0.753（P〈0.01）。McManus法检测出的优势眼和左或右利手间的统计学相关性具有显著性意义（Fisher检测P〈0.017;一致度评分phi=0.193（P〈0.05）。结论：大学生以右利手为主,McManus法检测发现右利手似乎与有眼优势更为相关。左或右利手和优势眼似乎是研究大脑功能不对称性和大脑偏侧型的最可靠的方法。     

Detecting early to mild glaucomatous damage: a comparison of the multifocal VEP and automated perimetry

PURPOSE: To gain better understanding of the relationship between abnormalities detected by the multifocal VEP (mfVEP) compared with those detected by static achromatic, automated perimetry in patients with glaucoma. METHODS: Fifty patients were studied who had open-angle glaucoma that met the following criteria: (1) a mean deviation (MD) of better than -8 dB in both eyes on the 24-2 Humphrey visual field (HVF) test (Carl Zeiss Meditec, Dublin, CA); and (2) glaucomatous damage in at least one eye, as defined by a glaucomatous optic disc and an abnormal 24-2 HVF test result (pattern standard deviation [PSD] <5% and/or glaucoma hemifield test [GHT] results outside normal limits). Monocular mfVEPs were obtained from each eye by using a pattern-reversal dartboard array, 44.5 degrees in diameter, which contained 60 sectors. Recording electrodes were placed at the inion (I) and I+4 cm, and also at two lateral locations up 1 cm and over 4 cm from I. Monocular and interocular mfVEP probability plots were derived by comparing the results with those of normal control subjects. For both the HVF and mfVEP probability plots, a hemifield was classified as abnormal if three or more contiguous points were significant at less than 5%, with at least one at less than 1%. RESULTS: Of the 200 hemifields tested (50 patients x two eyes x two hemifields), 75 showed significant clusters on the HVF, and 74 (monocular probability plot) and 93 (monocular or interocular plot) showed significant clusters on the mfVEP. Overall, the HVF and mfVEP results agreed on 74% of the hemifields, and 90 hemifields were normal and 58 were abnormal on both the mfVEP (interocular and/or monocular abnormal) and HVF cluster tests. Of the 52 disagreements, 35 hemifields had a significant cluster on the mfVEP, but not on the HVF, whereas the reverse was true of 17 hemifields. A case-by-case analysis indicated that misses and false-positive results occurred on both the HVF and mfVEP tests. CONCLUSIONS: As predicted from a theoretical analysis, under these conditions (i.e., the signal-to-noise level) the HVF and monocular mfVEP tests showed a comparable number of defects, and, with the addition of the interocular test, the mfVEP showed more abnormalities than the HVF. However, although there were abnormalities detected by the mfVEP that were missed by the HVF, the reverse was true as well.     

两种方法研究大学生群体优势眼与左/右利手间的关系(英文)

目的:评估大学生群体优势眼和左/右利手间的关系。方法:受试对象为179名大学生志愿者,平均年龄为19.4±1.6岁,其中女110名(61.5%),男69名(38.5%)。优势眼由Gndogˇan和McManus两种方法测得,左或右利手则由Edinburgh Handedness Inventory Oldfield和McManus法确定,t检验评估实验的可信度。结果:Gndogˇan法测得受试者中110人(61.5%)为右眼优势,69人(38.5%)为左眼优势,无性别差异。McManus法重测相同受试者,则右/左眼优势分别为128人(71.5%)和51人(28.5%)。两法测得的结果相关,一致度κ=0.256(P<0.01)。女性受试者中,Gndogˇan法测得右/左眼优势分别为62人(56.4%)和48人(43.6%),McManus法测得的结果为右/左眼优势分别为74人(67.3%)和36人(32.7%)。Fisher检验两法测得的结果相关(P<0.05),一致度κ=0.239(P<0.01)。男性受试者中,Gndogˇan法测得右/左眼优势为48人(69.6%)和21人(30.3%),Mc-Manus法检测为54人(78.3%)和15人(21.7%)。Fisher检验两法测得结果相关(P>0.05),一致度κ=0.239(P<0.01)。Oldfield和McManus法分别测得右利手比例为91.6%(n=164)和91.1%(n=163),两者间有较高的一致度κ=0.753(P<0.01)。McManus法检测出的优势眼和左或右利手间的统计学相关性具有显著性意义(Fisher检测P<0.017;一致度评分phi=0.193(P<0.05)。结论:大学生以右利手为主,McManus法检测发现右利手似乎与有眼优势更为相关。左或右利手和优势眼似乎是研究大脑功能不对称性和大脑偏侧型的最可靠的方法。     

Analysis of retinal nerve fiber layer thickness measured by optical coherence tomography in glaucomatous eyes with hemifield defect

PURPOSE: To analyze the retinal nerve fiber layer thickness(NFLT) as measured by optical coherence tomography(OCT) in glaucomatous eyes with hemifield defect and to evaluate the most effective parameter for the diagnosis of glaucoma with OCT. METHODS: One hundred eighty four(184) normal eyes(128 subjects) and 108 open-angle glaucomatous eyes(87 subjects) with superior or inferior hemifield defects verified by Humphrey field analyzer(HFA) were measured for NFLT with OCT. The correlations between NFLT and mean deviation on HFA were calculated. In combination with normal eye data, receiver operating characteristic curve(ROC curve) and AUC(area under the curve) of each NFLT in the affected hemifield were evaluated for the diagnosis of glaucoma. RESULTS: NFLT in both affected and unaffected hemifields was significantly correlated with mean deviation in HFA. An average of four 30 degrees segments close to the temporal side in the affected hemifield (parameter A120) had the highest correlation(r = 0.571) and the highest AUC(0.948) among all parameters. CONCLUSIONS: NFLT in the unaffected visual field decreases with the progression of glaucomatous damage. We suggest that the parameter A120 is the best indication in a diagnosis of glaucoma when measuring NFLT by OCT.