屈光间质混浊对Humphrey视野计和倍频视野计检查结果的影响

倍频视野计可用于选择性检查视网膜神经节细胞中的大细胞系统功能 ,有效筛选早期青光眼患者[1] 。但是 ,由于老年青光眼患者多合并白内障 ,而白内障可明显影响视野检查的结果 ,故此类患者的视野检查较为困难。因此 ,我们以正常眼配戴弥散滤片模拟屈光间质混浊眼 ,比较分析屈光间质混浊对Humphrey视野计和倍频视野计检查结果的影响 ,以期为临床工作提供参考。一、资料和方法1 临床资料 :收集 8名健康成年人 ,以左眼作为试验眼。其中男 5例 ,女 3例 ;年龄 2 3～ 39岁 ,平均 31 6岁。2 仪器和方法 :Model 6 30型Humphrey视野计的背景和视标…     

非胰岛素依赖型糖尿病患者中心视野早期光敏感度分析

目的 检测无糖尿病性视网膜病变的非胰岛素依赖型糖尿病患者和正常人的中心视野光敏感度，评价视野检查在糖尿病性视网膜病变早期诊断中的作用。 方法 对40例，75只眼,年龄46～71岁，眼底正常的非胰岛素依赖型糖尿病患者及44例，76只眼,年龄45～72岁的正常人作视野检查。采用美国Dicon TKS－4000型视野分析仪，检测中心30°视野内80个点的光敏感度。 结果 正常眼底的糖尿病患者，中心视野中多个检测点显示光敏感度下降4～8 dB；有些出现了光敏感度下降偏差群；糖尿病组中心视野的三个区域内的平均光敏感度分别与正常组的平均光敏感度比较，差异均有显著性的意义(P＜0.001)。 结论 糖尿病患者在出现视网膜病变之前视网膜神经感觉功能已在一定程度上受到了损害，而且视网膜光敏感度的下降与血视网膜屏障有无渗漏并不相关。电脑视野检测在糖尿病性视网膜病变的早期诊断中有一定的临床价值。 (中华眼底病杂志, 2002, 18: 218-220)     

倍频视野计对原发性青光眼诊断效能的荟萃分析

目的以标准自动视野计的异常检测结果和（或）眼底改变为金标准,对研究倍频视野计（FDT）诊断原发性青光眼的文献进行荟萃（Meta）分析,评价FDT的临床诊断效能。方法电子检索MEDLINE、EMBASE、Cochrane Library、BIOSIS、Previews、HMIC、IPA、OVID循证医学数据库、中国期刊网专题全文数据库、中国生物医学文献数据库、维普中文科技期刊数据库、中国医学学术会议论文、中国优秀硕博士论文数据库、超星数字图书馆、书生之家数字图书馆;手工检索国内外相关教科书、杂志、会议论文等及其参考文献。根据Cochrane协作网推荐的诊断试验纳入标准筛选文献,并对纳入文献进行质量评估,提取纳入研究的特征信息。数据分析采用Meta test version0．6软件,检验异质性,并根据检验结果选择相应的效应模型进行Meta分析。对所有研究予以加权定量合并,计算敏感性、特异性及95％可信区间。绘制汇总受试者工作特征曲线（SROC）,并计算曲线下面积。最后进行敏感性分析。结果共检索到相关文献206篇,15篇英文文献（21个研究）符合纳入标准,研究对象共3172例。FDT诊断原发性青光眼的敏感性范围为0．51～1．00,特异性范围为0．58～1．00。纳入研究存在异质性。按照随机效应模型进行计算汇总,其敏感性、特异性分别为0．86（0．80～0．90）、0．87（0．81～0．91）。SROC曲线下面积为93．01％。纳入文献稳定性好。结论纳入的文献具有较高质量,汇总Meta分析显示FDT诊断原发性青光眼的效能较高,但还需要高质量的前瞻性研究作进一步分析。（中华眼科杂志,2006,42：403-408）     

屈光间质混浊对Humphrey视野计及倍频视野计检查结果的影响(英文)

目的:用弥散滤片模拟瞳孔及屈光间质的变化,以比较这些变化对Humphrey视野计(HFA)及倍频视野计(FDT)的影响。方法:测试15位23-39岁正常人的左眼: (1) Snellen视力表; (2) Pelli-Robson(P-R)对比敏感度视力表; (3)白视标白背景自动视野计检查,HFA Model630,采用30-2程序,刺激视标为III; (4) FDT检查,采用N-30程序。每一只眼均经无滤片,1, 2, 3, 4, 5个滤片进行测试,测试顺序为随机。结果:Snellen视力表: 1个滤片只对2名受试者有影响,仅丢失1行; 2个滤片对所有受试者影响甚微,对2名受试者无影响(9名丢失1行,4名丢失2行); 3个滤片对所有受试者效果一样,均丢失3行; 4个滤片可致5名受试者丢失4行,5名受试者丢失5行, 3名受试者丢失6行, 2名受试者丢失7行;5个滤片可致所有受试者丢失全部9行。P-R视力表:3个滤片便可致13名受试者看不到所有字母,2名受试者仅看到1组字母。HFA和FDT的平均偏差值(MD)均随滤片增加而降低,HFA和FDT的图形标准差值(PSD)较小且非常一致。结论:以上结果表明,由弥散滤片所致的照明降低,光散射及瞳孔缩小对HFA及FDT均有明显影响,其视野缺损比较弥散均匀,而屈光间质混浊对FDT的影响比对HFA的影响要大。各组滤片的PSD值比较小且非常一致。     

倍频视野与蓝黄视野的研究及应用新进展

视野检查是原发性开角型青光眼诊断的主要依据。传统的自动视野检查,或称白对白视野检查法,存在着检测早期青光眼视野敏感性差,检测时间长,光阈值波动大以及仅检测光敏感度等缺陷。倍频视野检查法,尤其是第二代的MatrixFDT,在不降低第一代倍频视野高敏感度的基础上改善了其检测点数少、无法检测中心30°视野的缺陷。蓝黄视野检查法,或称短波长视野检查法,通过对短波色觉通道的分离检测提高了早期诊断的敏感性,近年来通过检测程序和检测策略的改进使其更适用于检测青光眼视野损害。本文对MatrixFDT和蓝黄视野的原理、检查程序、检测策略及其在青光眼早期诊断中的应用进行综述。     

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)     

模拟屈光间质混浊对蓝/黄视野检查结果的影响

目的 探讨屈光间质混浊对蓝/黄视野检查结果的影响.方法 对21例（21眼）正常人和15例（15眼）有早期视野损害、12例（12眼）有中晚期视野损害的原发性开角型青光眼配戴透光率为75%的毛玻璃镜片,戴镜前后,应用OCTOPUS 101全自动视野计（Interzeg INC,Switzerland）G2程序的Normal分程序进行W/W和B/Y视野检查,将所得结果进行分析比较.结果 正常组所有受检眼B/YP检查,校正概率图中无暗点.戴毛玻璃镜片后21眼在校正概率图中均出现相对性暗点,暗点弥漫性分布于中心视野0～30度范围内.配戴毛玻璃镜片前后视野指数比较,视网膜光敏感度均值（MS）降低;平均缺损（MD）、缺失方差（LV）、矫正缺失方差（CLV）增大,差异具有非常显著性（P＜0.0001）.早期POAG组配戴毛玻璃镜片后与配戴毛玻璃镜片前,B/Y视野指数比较,MS降低,MD增高,均有显著差异（P＜0.0001）,LV和CLV无显著差异.计算校对概率水平小于5%的视野缺损点数,配戴毛玻璃前后B/Y检查法测得的缺损点数均明显多于W/W检查法（P＜0.0001）;配戴毛玻璃前与配戴毛玻璃后,B/YP检测的视野缺损点数之间无显著差异（P＞0.05）,暗点位置无明显变化.中晚期青光眼组配戴毛玻璃镜片后与配戴前视野指数比较,MS、LV、CLV降低,MD增高,差异均有显著性（P＜0.05）,W/W,B/Y及加毛玻璃后B/Y视野检查,视野缺损点数分别两两比较,均无显著差异（P＞0.05）,暗点位置无明显变化.结论 模拟屈光间质混浊可使B/Y视野检查平均光敏感度普遍降低,但不影响POAG患者原有暗点的发现.     

倍频视野计与Humphrey视野计在青光眼诊断的对比研究

目的：评价倍频视野计（ＦＤＴ）在青光眼的视野诊断上能否达到Ｈｕｍｐｈｒｅｙ视野计（ＨＦＡⅡ）的诊断水平。材料与方法：对１４５只受检眼（５１例青光眼、３９例可疑青光眼和５５例正常对照）进行ＦＤＴ筛查、ＦＤＴ全阈值与ＨＦＡⅡ视野的对比研究,能过对ＦＤＴ的ＭＤ、ＰＳＤ在青光眼、可疑青光眼与正常人之间的方差分析,以及ＦＤＴ的ＭＤ、ＰＳＤ与Ｈｕｍｐｈｒｅｙ的ＭＤ、ＣＰＳＤ之间的相关分析,了解ＦＤＴ与ＨＦＡⅡ     

糖尿病性白内障发病的有关因素研究

目的：探讨非胰岛素依赖型糖尿病性白内障发病的有关因素。方法：对792例非胰岛素依赖型糖尿病患者检查视力、外眼、眼前段、眼底,血液检查项目包括血溏、糖化血红蛋白A1c(G-HbA1c）、尿素氮（BUN）、肌酐（Cr)、尿酸（UA）、N－乙酰－β－D氨基葡萄糖苷酶（NAG）、β2－微球蛋白（β2－MG）和白蛋白,尿液检查项目包括尿糖、PH蛋白质、细胞、管型和酮体,白内障的诊断按Chylack等的晶体混浊分类系统Ⅱ进行。结果：白内障在本组糖尿病患者中的发生率为62．37％（494／792）,白内障的发生与性别无关,但与糖尿病的病程有关。糖尿病病程少于5年（A组）、5－10年（B组）和10年以上（C组）者的发生率分别为49．67％（228／459）、71．84％（125／174）和88．68％（141／159）。A组和B组及C组间的白内障发生率有非常显著性差异,B组和C组间的白内障发生率则无显著性差异。在血液BUN和／或Cr含量升高的糖尿病患者白内障的发生率明显高于BUN和／或Cr含量正常的糖尿病患者。结论：非胰岛素依赖型糖尿病患者病程的延长、肾功能不良及血糖控制不良可加速白内障的发展。     

倍频视野计在青光眼视野缺损评估中的应用

目的评价倍频视野计(FDP)在青光眼视野缺损评估中的作用.方法对93只受检眼(30例轻度青光眼、37例中度青光眼、26例重度青光眼、20例正常对照)进行FDP全阈值检查,将同时进行的Humphrey视野计(HFA)视野检查结果作为标准进行对照,评估其检查时间、平均偏差(MD)、图形标准偏差(PSD)与校正图形标准偏差(CPSD)间的关系.结果FDP全阈值检查的时间为轻度青光眼(4.31±0.47)min、中度青光眼(5.06±0.49)min、重度青光眼(5.50±0.63)min、正常对照(4.04±0.47)min,HFA检查时间为(16.41±1.88)min.FDP各组与HFA间的检查时间的差异均有显著性(P＜0.01).FDP全阈值结果的MD、PSD与HFA的MD、CPSD间的相关系数分别为轻度青光眼0.86(P＜0.01)和0.63(P＜0.01),中度青光眼0.95(P＜0.01)和0.72(P＜0.01),重度青光眼0.99(P＜0.01)和0.87(P＜0.01).结论FDP全阈值检查不仅可快速诊断青光眼,而且可对轻度、中度、重度青光眼视野缺损进行准确的评估,在评估指标中MD为最佳.     

Comparison of visual field test results obtained through Humphrey matrix frequency doubling technology perimetry versus standard automated perimetry in healthy children

Aims:

The aim of this study was to compare the visual field test results in healthy children obtained via the Humphrey matrix 24-2 threshold program and standard automated perimetry (SAP) using the Swedish interactive threshold algorithm (SITA)-Standard 24-2 test.

Materials and Methods:

This prospective study included 55 healthy children without ocular or systemic disorders who underwent both SAP and frequency doubling technology (FDT) perimetry visual field testing. Visual field test reliability indices, test duration, global indices (mean deviation [MD], and pattern standard deviation [PSD]) were compared between the 2 tests using the Wilcoxon signed-rank test and paired t-test. The performance of the Humphrey field analyzer (HFA) 24-2 SITA-standard and frequency-doubling technology Matrix 24-2 tests between genders were compared with Mann-Whitney U-test.

Results:

Fifty-five healthy children with a mean age of 12.2 ± 1.9 years (range from 8 years to 16 years) were included in this prospective study. The test durations of SAP and FDT were similar (5.2 ± 0.5 and 5.1 ± 0.2 min, respectively, P = 0.651). MD and the PSD values obtained via FDT Matrix were significantly higher than those obtained via SAP (P < 0.001), and fixation losses and false negative errors were significantly less with SAP (P < 0.05). A weak positive correlation between the two tests in terms of MD (r = 0.352, P = 0.008) and PSD (r = 0.329, P = 0.014) was observed.

Conclusion:

Children were able to complete both the visual test algorithms successfully within 6 min. However, SAP testing appears to be associated with less depression of the visual field indices of healthy children. FDT Matrix and SAP should not be used interchangeably in the follow-up of children.     

The effect of yellow tinted intraocular lenses on the result of frequency doubling perimetry after cataract surgery

Purpose

To investigate the effect of yellow tinted intraocular lenses (IOLs), implanted in the bag after phacoemulsification, on the result of frequency doubling technique (FDT) perimetry.

Methods

For 68 eyes of 52 patients, an IOL was implanted in the bag after phacoemulsification. The patients were categorized into three groups according to the type of implanted IOLs used. IOLs were selected randomly among two types of yellow IOLs (Acrysof SN60WF IOL, Hoya YA60BBR IOL) and a clear IOL was used as a control. A FDT Humphrey matrix was performed 2 months after the surgery. The mean deviation (MD) and pattern standard deviation (PSD) among these three groups was analyzed using Mann-Whitney U-test.

Results

Two months after the procedure, there was no significant difference between each of the three groups: the clear IOL and Hoya YA60BBR IOL (MD, p = 0.21; PSD, p = 0.27), the clear IOL and Alcon SN60WF IOL (MD, p = 0.11; PSD, p = 0.22), and the Hoya YA60BBR IOL and Alcon SN60WF IOL (MD, p = 0.33; PSD, p = 0.56).

Conclusions

When interpreting the result of the FDT after cataract surgery, the color and type of IOLs used should not be considered.     

Impact of cataract on the results of frequency-doubling technology perimetry

PURPOSE: To determine the effect of cataract on the results of frequency-doubling technology (FDT) perimetry. DESIGN: Consecutive cohort study. PARTICIPANTS: Forty-four patients with normal ophthalmic examinations, with the exception of cataract, scheduled to undergo phacoemulsification and posterior chamber lens implantation were prospectively identified and completed the study. METHODS: All subjects underwent FDT perimetry using the full-threshold C-20 strategy. Both eyes were tested within 1 month before cataract surgery and up to 3 months after surgery. The unoperated fellow eyes served as controls. MAIN OUTCOME MEASURES: Changes in visual acuity (VA), mean deviation (MD), and pattern standard deviation (PSD) were evaluated. For each subject, the change in MD and PSD in the eye that underwent cataract surgery was adjusted for change in the control eye that is thought to occur due to a learning effect. RESULTS: Among the eyes that underwent cataract surgery, the median preoperative VA was 20/60 (range, 20/30-20/800) and the mean preoperative MD was -4.00+/-3.72 decibels (dB). Postoperatively, the median VA improved to 20/30 (range, 20/20-20/70) and the mean postoperative MD was -0.26+/-3.09 dB (P<0.001). Among the control eyes, MDs were -1.74+/-3.71 dB preoperatively and -0.94+/-3.85 dB postoperatively (P = 0.019). The adjusted improvement in MD among eyes that underwent cataract surgery was 2.94+/-3.44 dB (P<0.001). There was no significant change in PSD. Preoperative VA correlated significantly with preoperative MD (r = 0.39, P = 0.01). The improvement in VA correlated significantly with the adjusted improvement in MD (r = 0.38, P = 0.01). CONCLUSIONS: Cataract has an adverse effect on the MD but not the PSD in FDT perimetry. Among eyes with visually significant cataract, the MD correlates significantly with VA. After cataract surgery, the change in VA correlates significantly with the adjusted change in MD.     

An evaluation of algorithms designed to classify the results from frequency doubling perimetry

All previously published algorithms for the interpretation of frequency doubling perimetry test results were compared in full-threshold mode in a large group of glaucoma patients (n = 452) and normal subjects (n = 237). Areas under the receiver-operating characteristic (ROC) curve ranged from 0.86 to 0.92. None of the algorithms performed substantially better than simply counting the number of defects p < 1% in the total deviation plot. For this algorithm, we found a sensitivity of 0.90 and a specificity of 0.81 at a cut-off point of >1 defect, and an area under the ROC curve of 0.92.     

青光眼中倍频视野检查与Octopus视野检查的相关性

目的 评价青光眼中倍频视野计（Frequency Doubling Technique FDT）与传统自动视野计Octopus检查结果的相关性。方法 35例正常对照，27例可疑青光眼患者，37例原发性开角型青光眼和50例正常眼压性青光眼患者进行FDT和Octopus检查。记录FDT视野检查的平均缺损（MeanDefect，MD）、图形标准偏差（Pattem Standard Deviation，PSI）），Octopus视野检查中的平均缺损、丢失方差（Loss Variance，LV）。应用线性回归分析计算回归方程及相关系数。结果 原发性开角型青光眼中，FDT-MD与Octopus-MD，FDT-PSD与Octopus-LV均显著相关（r=0．828，r=0．758，P均＜0．001）。正常眼压性青光眼中，FDT-MD与Octopus-MD，PDT-PSI）与Octopus-LV均显著相关（r=0．827，r=0．783，P均＜0．001）。结论 FDT检查的各指标无论在POAG还是NTG中均与传统自动视野计Octopus有很好的相关性。     

Frequency doubling perimetry screening mode compared to the full-threshold mode

The diagnostic performance of the frequency doubling perimetry (FDT) C20-1 screening mode was compared to that of the C20 full-threshold mode. For the number of defects p < 1% in the total deviation plot, both modes appeared to perform similarly in terms of sensitivity, specificity, and area under the receiver-operating characteristic (ROC) curve. Different cut-off points should be applied for both modes to obtain equal sensitivity and specificity values, and - related to that - for most subjects more defects were found in full-threshold mode than in screening mode. For the screening mode, we found a sensitivity of 0.91 and a specificity of 0.88 at a cut-off point of >0 defects, and an area under the ROC curve of 0.93.     

青光眼合并白内障患者的全自动视野检查结果解读

全自动视野检查被广泛用于诊断和随访青光眼患者,当白内障存在时将会影响到结果的正确分析。就白内障如何影响视野结果及解决办法进行综述。     

倍频视野计检测青光眼性视野缺损能力的研究

目的评估倍频视野计检测青光眼性视野缺损的能力以及与OCTOPUS101全自动视野计检查结果之间的相关性。方法应用倍频视野计的C-20—5筛选程序以及OC—TOPUS101全自动视野计的G2-TOP程序对23例正常对照者、20例早期青光眼患者、35例中晚期青光眼患者、11例高眼压患者及13例疑似青光眼患者进行视野检测。正常对照组、高眼压组及疑似青光眼组随机选择一眼进行测试，青光眼组选择具有较严重视野缺损的一眼进行测试。结果倍频视野计的C-20—5筛选程序在检测青光眼时ROC曲线下面积为0．925（敏感性85％，特异性91％），与OCTOPUS视野指数-平均缺损、偏离缺失之间的Pearson系数分别为0．702与0．429（P〈0．001），倍频视野计与OCTOPUS101视野计检查平均所需时间分别为1．00min与2．33min．2者之间有明显差异（P〈0．001）。结论倍频视野计检测青光眼性视野缺损具有良好的敏感性与特异性，与OCTOPUS101视野计的视野指数之间亦存在理想的相关性，而且前者比后者检测速度更快，使大规模人群筛查成为可能。