四点阈值视野检查对快速筛查青光眼性视野缺损的诊断价值

目的探讨国产YDS301视野计（简称YDS）四点阈值程序对快速筛查青光眼性视野缺损的诊断价值。方法采用瑞士Octopus101型视野计（简称Octopus）和YDS对67例（75眼）青光眼患者分别进行视野检查。YDS选用四点阈值程序,Octopus选用G1TOP程序,分别在定性、定量和每眼检测时间方面进行对比分析。结果定性诊断：以Octopus为准,YDS敏感性和特异性分别为92.5%和86.4%。定量诊断：YDS与Octopus的平均敏感度和平均缺损的相关系数r分别为0.869和0.865。每眼检测时间分别为48.65s和141.64s（t=26.534,P〈0.01）,YDS比Octopus减少了约2/3时间。结论YDS四点阈值程序在快速筛查青光眼性视野缺损中与Octopus有很高的一致性,而且检测时间是目前国内外现有视野计中最短的。因此,YDS四点阈值程序适用于青光眼的视野筛查。     

国产YDS-201自动视野计四点阈值程序在青光眼视野筛查诊断中的应用价值

目的 探讨国产YDS-201自动视野计四点阈值程序在青光眼视野筛查诊断中的临床应用价值.方法 采用国产YDS-201自动视野计的中心52及四点阈值程序对77例(140只眼)青光眼患者在半暗室环境下检测中心30°视野.分别进行定性、定位、检测时间的对比分析.结果 定性诊断:两种程序检查结果视野缺损部位一致的119只眼(85%),不一致的21只眼(15%);定位诊断:四个象限均符合者为118只眼,约占84.3%,两个或三个象限符合者为22只眼,约占15.7%,未见四个象限均不符合者;检测耗时:中心52程序检查用时183～638s,平均(302.13±99.02)s,四点阈值程序检查用时23～101s,平均(44.11±18.00)s,P＜0.001.结论 YDS-201视野计四点阈值程序在快速筛查青光眼视野缺损中具有较高敏感性和特异性,检查用时短,适合于青光眼的视野筛查,是一种在大量人群中快速筛查青光眼的良好方法.     

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.     

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。     

倍频视野检查在青光眼视野缺损的应用

目的研究倍频视野检查在青光眼视野检查中的效果.方法应用倍频视野仪及Humphrey视野仪对64眼正常眼及120眼青光眼患者进行视野检查.结果倍频视野检查在青光眼视野检查中的特异性为55/64(85.9%),敏感性为104/120(86.7%).倍频视野检查在184眼正常眼及青光眼的视野检查中与Humphrey视野检查结果有密切相关(MD的相关系数为0.948,p＜0.001,PSD相关系数为0.712,p＜0.001).结论倍频视野检查是青光眼视野检查的一个有效手段.     

结合视野检测确诊青光眼模式的临床研究

目的探讨提高筛选并能早期诊断青光眼效率的有效方法。方法按照临床筛选可疑青光眼患者标准,门诊筛选出可疑青光眼者。采用横断面研究设计,应用Octopus-101型计算机自动视野计的G2程序,对来我院就诊的可疑青光眼患者进行中心30°阈值视野检测。统计分析视野异常情况,并随访统计确诊青光眼病例。结果取得完整可靠视野结果可疑青光眼者共75例(150只眼),视野存在异常者45眼,视野发生可疑改变52只眼,53只眼正常。青光眼确诊病例占可疑青光眼的34.67%。结论通过可疑青光眼患者视野异常情况的临床观察,筛选可疑青光眼后进一步临床检查、视野监测而进行青光眼确诊的筛查模式具有一定的可靠性,该模式能大大提高筛选及早期诊断青光眼的效率。     

可疑青光眼患者视野检测异常的临床观察

目的 观察可疑青光眼患者中心30°阈值视野检测的异常情况.方法 按照临床筛选可疑青光眼患者标准,门诊筛选出可疑青光眼者.采用横断面研究设计,应用Octopus-101型计算机自动视野计的G2程序,对就诊的可疑青光眼患者进行中心30°阈值视野检测.统计分析视野异常情况,并进行可疑青光眼筛选指标的相关分析.结果 取得完整可靠视野结果可疑青光眼者共75例150眼,视野存在异常者45眼,视野发生可疑改变52眼,53眼正常.不同可疑指标的可疑青光眼者视野异常情况存在不同x2=27.71,P＜0.05(x20.05为9.49).青光眼确诊病例占可疑青光跟的34.67％.结论 通过可疑青光眼患者视野异常情况的临床观察,进一步寻求提高筛选并能早期诊断青光眼效率的有效方法,以进行青光眼的有效筛查.该研究提示在临床筛查中要特别重视存在异常眼压和眼底杯/盘比者,并可进一步筛查其视野情况,对该群体做好相关随访工作.     

北京市西长安街社区50岁以上人群青光眼调查

目的调查北京市城市社区50岁以上人群中青光眼患病状况及其视功能损害情况。设计横断面调查。研究对象北京市西城区西长安街社区≥50岁居民。方法共检查2410人,应答率88．06％。检查包括视力、裂隙灯显微镜、检眼镜检查,询问青光眼家族史。采用非接触眼压计测量眼压,裂隙灯显微镜测量周边前房深度,观察视盘有无青光眼性视神经改变。对已确诊为青光眼者,记录其青光眼发作史、手术史等。对高危人群及可疑青光眼患者Goldman眼压计测量眼压、前房角镜检查、激发试验、视野检查等。主要指标青光眼患病率,盲与低视力比例。结果西城区西长安街社区50岁及50岁以上人群青光眼患病率为2．49％,其中原发性闭角型青光眼、原发性开角型青光眼、继发性青光眼患病率分别为1．66％、0．62％、0．08％。57．89％的青光眼患者视功能有损伤,青光眼患者中双眼盲比例为7．02％,均为≥66岁的患者。单眼盲、双眼低视力和单眼低视力的比例分别为24．56％、5．26％和21．05％。结论社区居民青光眼患者中以原发性青光眼为主。原发性开角型青光眼的构成比较既往有增加的趋势。防治青光眼是今后社区防盲工作的重点之一。     

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     

青光眼快速筛查的初步研究

目的　为了有效地进行青光眼筛查,对用于检测眼压、前房、视神经、视野4个方面的简易、快速方法,进行特异性及敏感性的评价。方法　利用4个周末,每日筛查约200人次。眼压检测使用笔式眼压计,前房深度测定采用VanHerick法,视神经检查采用非散瞳眼底照像,由专家阅片;视野检查采用阈上值定性筛查程序,采用倍频视野计（frequencydoublingperimeter,FDP）、Octopus123及Humphery605自动视野计。筛查阳性者需进行青光眼的全面检查,如自动视野的阈值检查、立体眼底及视网膜神经纤维层（retinalnervefiberlayer,RNFL）照像。结果　在734位被筛查者中,开角型青光眼55例（占7.5%）,闭角型青光眼59例（占8.4%）,可疑青光眼98例（占13.4%）。青光眼患者中,眼压>21mmHg(1mmHg=0.133kPa)者34例（占29.8%）。其中开角型青光眼的视神经、视野异常率分别为94.5%、67.3%;闭角型青光眼的前房、视野、视神经异常率分别为89.8%、72.9%、45.8%。结论眼底照像并由专家评估是开角型青光眼筛查的最有效方法。前房检查在我国青光眼筛查中必不可少。自动视野阈上值筛查特异性低,FDP可能是快速筛查特异性较好的方法。     

The usefulness of frequency doubling technology perimetry in glaucoma screening in health-check program

PURPOSE: Visual field testing has not been used as a screening procedure because it requires too much testing time and manpower. We evaluated the usefulness of Frequency Doubling Technology(FDT) visual field testing as a screening procedure for glaucoma in a health-check screening program. METHODS: A total of 800 eyes of 400 persons were examined for visual acuity, noncontact tonometry, slit-lamp biomicroscopy, funduscopy, and FDT testing of visual fields (N-30-5). The initial screening result was considered positive for glaucoma if any abnormality of FDT perimetry was detected, the intraocular pressure exceeded 21 mmHg, or funduscopy showed glaucomatous disc cupping or retinal nerve fiber layer defect. The re-examination comprised several ophthalmic examinations such as automatic perimetry 9 Humphrey field analyzer). RESULTS: Glaucoma was suspected in 118 eyes; 16 eyes were thus diagnosed after re-examination. FDT detected visual field abnormalities in 15 eyes. There were 40 eyes that were not diagnosed although FDT detected visual field abnormalities. CONCLUSIONS: FDT detected visual field abnormalities in glaucoma patients with high sensitivity and specificity. FDT is a useful screening test for glaucoma.     

Predictive value of frequency doubling technology perimetry for detecting glaucoma in a developing country

PURPOSE: To determine the feasibility and diagnostic precision of Frequency Doubling Technology (FDT) perimetry as a method to detect glaucoma in rural villages of a developing country. DESIGN: Cross-sectional study. METHODS: Testing included FDT perimetry (C-20-5 screening protocol), tonometry, anterior segment biomicroscopy, and dilated ophthalmoscopy in 296 rural, non-English speaking residents of Southern India over 35 years old. Participants repeated the FDT if they had a location with reduced sensitivity or an unreliable result. We defined an abnormal FDT as one location of reduced sensitivity present on both the initial and repeat examination. We determined the diagnostic precision of FDT separately for a glaucomatous optic disc, a cup to disc ratio (C/D) > or = 0.7, and a C/D > or = 0.8. RESULTS: Ninety-three percent of subjects were able to complete the test satisfactorily. With repeat FDT testing, 37% of eyes with abnormal FDT results subsequently converted to normal and 67% of eyes with unreliable results subsequently became reliable. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for a glaucomatous optic disc were 7%, 87%, 13%, 76%, and 69%, respectively; for a C/D > or = 0.7, they were 0%, 87%, 0%, 91%, and 81%, respectively; and for a C/D > or = 0.8, they were 0%, 87%, 0%, 99%, and 87%, respectively. CONCLUSION: Clinicians can use FDT perimetry to rapidly screen for glaucoma in rural villages of a developing country. FDT testing had high specificity and negative predictive value, but low sensitivity and positive predictive value. The low sensitivity suggests that FDT has limited applicability as the sole test for glaucoma screening in this population. Repeat testing of FDT results that are unreliable or suspected of being abnormal is beneficial for this screening procedure.     

Frequency doubling perimetry in glaucoma

PURPOSE: To evaluate the validity of frequency doubling perimetry (FDP) in the detection of glaucomatous field defects. METHODS: Group I consisted of 85 eyes of 85 patients with established field defects in automated perimetry, classified by severity of defect. Group II consisted of 48 eyes of 48 control subjects. Both groups underwent Swedish Interactive Testing Algorithm (SITA) standard tests as well as FDP screening strategies (C20-1 and C20-5 and full threshold test). Sensitivity and specificity measures for the FDP tests were calculated using one new and two previously published algorithms. RESULTS: A described scoring system provided the best sensitivity (85.9%) and specificity (95.1%). For moderate and severe cases, the sensitivity improved to 91%. Quantification of the defect did not improve detection. CONCLUSIONS: FDP is a valid screening test for glaucoma. The scoring system described by Patel et al. provided the best results.     

Comparison of frequency doubling perimetry and standard achromatic computerized perimetry in patients with glaucoma

PURPOSE: To evaluate the reproducibility and efficacy of frequency-doubling perimetry (FDP), a new perimetric method for the detection of functional glaucomatous damage. METHODS: Thirty-four glaucomatous eyes of 34 patients were examined by FDP (using the complete N30 threshold test of the Humphrey Frequency Perimeter) and by standard achromatic computerized perimetry (SAC; using the full threshold program 30-2 of the Humphrey Field Analyzer). Twenty-six of these eyes were examined twice by FDP. Reproducibility of repeated FDP was tested by the difference and the average of mean deviations (MD). Efficacy was studied by comparison of FDP and SAC using MD, as well as threshold results of FDP and corresponding SAC-tested areas. Spearman's rank correlation was calculated. RESULTS: A significant correlation of repeated FDP examinations was found regarding MD [r=0.94, P<0.00001 (n=26)]. The reproducibility of FDP was independent of the glaucomatous damage [r=0.04, P=0.85 (n=26)], based on the correlation of the difference, and the average of MD. The MD of FDP and that of SAC showed a significant correlation [r=0.87, P<0.00001 (n=34)]. In advanced glaucoma, FDP tended to yield lower measurement values than SAC. Regarding corresponding areas, there was a significant correlation between threshold results of FDP-tested areas and the corresponding SAC testpoints [r=0.92, P<0.00001 (n=34)]. The conformity decreased from the peripheral to the central tested visual field. CONCLUSIONS: Sufficient reproducibility of FDP could be demonstrated in early and advanced glaucomatous visual field defects. Conformity between FDP and SAC was shown in terms of MD and threshold results of FDP-tested areas and corresponding SAC testpoints.     

Application of frequency doubling technology perimetry in the diagnosis of glaucoma

PURPOSE: Evaluation of the frequency doubling technology perimetry in the detection of an early glaucomatous field loss. MATERIAL AND METHODS: Twenty-two patients (40 eyes), who were diagnosed with ocular hypertension were enrolled in the study. The diagnosis was made based on slit lamp examination, 3 measurements of intraocular pressure (IOP) over 21 mmHg. Standard perimetry was performed with Humphrey perimeter and SITA program (30-2 threshold). Then, all patients underwent FDT perimetry with 30-2 threshold program. Patients, who had any changes in FDT visual field had to repeat the test, to confirm the results. RESULTS: Out of 40 eyes with the normal white on white perimetry 5 eyes (5 patients) presented defects in FDT perimetry. They had optic disc c/d asymmetry > 0.1 and the nerve fiber layer defects corresponding to the visual field defects in FDT perimetry. CONCLUSION: Frequency Doubling Technology perimetry may be useful as a supplemental method of the visual field evaluation, particularly in patients where standard perimetry does not show any functional damage.     

早期原发性开角型青光眼倍频视野的改变

目的　探讨早期原发性开角型青光眼(POAG)倍频视野(FDP)的表现。 方法　应用FDP的N 30全阈值程序和HFA视野计(HFA)中心 30 2全阈值程序检查早期青光眼患者 35例 37眼、进展期青光眼患者 36例 43眼、晚期青光眼患者 6例 7眼;正常人 21例 25眼作为对照组。 结果　早期青光眼的FDP主要表现为相对性旁中心暗点和 /或相对性的弓状暗点,上方弓形区(尤其是 10°~20°的视野)和鼻侧视野在青光眼早期最易受到损害。FDP显示的视野损害与HFA的基本一致,但暗点的范围更大,部分早期青光眼病例HFA显示视野正常的部位FDP也可发现局限性暗点。早期青光眼FDP的三个视野指数(FMS、FMD、FPSD)与正常人比较差异有显著性意义,FDP的FMD与HFA的MD有较好的相关性(相关系数r=0 326,P=0 026)。 结论　早期青光眼FDP的改变与HFA有较高的一致性,在POAG早期诊断中FDP可作为一种快速敏感的视功能检测方法。     

Learning effect for frequency doubling perimetry in patients with glaucoma.

PURPOSE: We studied the results obtained by repeated frequency doubling perimetry in patients with glaucoma and demonstrated a learning effect. METHODS: Prospective observational study. Thirty-three patients who had glaucoma and had never experienced frequency doubling perimetry participated in this study. The patients were examined by frequency doubling perimetry three times within 6 months. Mean deviation, pattern standard deviation, and intraocular pressure at examination were compared among three results. RESULTS: On frequency doubling perimetry, the mean deviation results of the first, second, and third tests were -7.96 dB, -7.29 dB, and -7.36 dB, respectively. The first and second results and the first and third results were significantly different (P = 0.029 and P = 0.049, respectively). No significant differences with regard to pattern standard deviation and intraocular pressure were noted. CONCLUSION: A positive learning effect was found for frequency doubling perimetry in the first and second mean deviation results of patients with glaucoma.     

Agreement between frequency doubling perimetry and static perimetry in eyes with high tension glaucoma and normal tension glaucoma

AIMS: To investigate the agreement in results between frequency doubling technology (FDT) and the conventional automated static perimeter in eyes with normal tension glaucoma (NTG) and high tension glaucoma (HTG). METHODS: 72 eyes of 36 patients, who had two or more experiences with the Humphrey field analyser (HFA) program C30-2, were examined with the screening C-20-1 program of FDT. The result of FDT at each of the 17 stimulus points was graded as one of four categories. 58 out of 76 test points of HFA were assigned to one of the 17 clusters corresponding to FDT test points. Each cluster was represented as the lowest (scotoma of HFA) or the highest (threshold of HFA) probability symbol of total deviation (TD) of the HFA test points included in the cluster. The agreement between scotoma/threshold of HFA and FDT results was evaluated for NTG and HTG. RESULTS: In a total of 65 eyes, the Spearman coefficients between the FDT and HFA (threshold/scotoma of HFA) were 0.599 and 0.515 (p<0.0001), respectively. In the HFA mean deviation matched 20 HTG eyes and 20 NTG eyes, the number of points with abnormal FDT results were 102 and 62 in eyes with HTG and NTG, respectively. The eyes with HTG had more abnormal FDT results than NTG eyes (p=0.0014, Mann-Whitney U test). The kappa coefficient between FDT and threshold of HFA in eyes with HTG and NTG was 0.288 and 0.520, respectively, and the agreement between FDT and scotoma of HFA was 0.480 and 0.439, respectively. CONCLUSIONS: The best agreement of the results of FDT and HFA was observed in eyes with NTG using threshold of HFA. The eyes with HTG showed lower agreement with more abnormal points in FDT results, which suggests enough sensitivity of FDT in eyes with NTG, and higher sensitivity of FDT in eyes with HTG.     

Role of frequency doubling technology perimetry in screening of diabetic retinopathy

PURPOSE: To study the ability of frequency-doubling technology perimetry (FDT) to detect sight-threatening diabetic retinopathy. METHOD: Fifty-eight eyes of fifty-eight patients with established diagnosis of diabetes mellitus with diabetic retinopathy, fifty-five eyes of fifty-five diabetic patients without retinopathy and forty-one eyes of forty-one normals underwent FDT and dilated stereo-biomicroscopic fundus examination. The sensitivity and specificity of FDT in identification of "sight-threatening retinopathy" (severe and very severe nonproliferative diabetic retinopathy and proliferative diabetic retinopathy) and clinically significant macular edema (CSME) were determined. RESULTS: For the detection of sight-threatening retinopathy, two abnormal adjacent points depressed to any level on the 20-1 screening program had a sensitivity of 90.5% and specificity of 97.6%. At (assuming a) 10% prevalence of sight-threatening retinopathy in a diabetic clinic, two abnormal adjacent points anywhere in the field depressed to any level has a positive predictive value (PPV) of 48% with a negative predictive value of 98.8%. Sensitivity and specificity for the detection of CSME was poor. CONCLUSIONS: The 20-1 screening program of the FDT is useful in the detection of sight-threatening diabetic retinopathy (PPV 48%). A normal 20-1 test rules out sight-threatening retinopathy. FDT was not useful in the detection of CSME.