趋势导向视野检查前段缺血性视神经病变

Evaluation of TOP perimetric threshold strategy in patients with anterior ischemic optic neuropathy

目的评价趋势导向（tendency-oriented perimetry, TOP）程序视野检查在前段缺血性视神经病变（AION）诊断中的价值。方法15名（30只眼）正常者和27例（32只眼）前段缺血性视神经病变患者分别采用Octopus101全自动视野计进行G2中心视野检查，所有受检者先后测试两次，每次测试程序包括TOP程序（TOP／Normal）和常规阈值程序（Normal／Normal）两种，检查顺序随机。比较第二次测试两种视野程序的检查时间和视野指数（MS、MD和Lv）。结果在正常组，TOP程序所用时间为（2．41±0．32）min，Normal程序所用时间为（11．57±1．41）min；AION组，TOP程序所用时间为（2．97±0．58）rain，Normal程序所用时间为（12．14±1．36）min。无论正常组还是AION组，分别用TOP程序和常规阈值程序所得的正常组阴性检出率之间，AION组阳性检出率之间，视野指数（MS、MD和LV）之间的差别都没有统计学意义（P〉0．05o无论是正常组还是AION组，上述两种程序所得视野指数之间都呈明显正相关。结论对于正常人和缺血性视神经病变患者，TOP程序与常规阈值程序的检查结果基本一致。而且TOP程序可明显缩短视野检查时间，因此在诊断前段缺血性视神经病变方面具有更广泛的应用价值。

Objective To evaluate the application of tendency-oriented perimetry （TOP） in detecting visual function of anterior ischemic optic neuropathy （AION）. Methods Fifteen normal volunteers （30 eyes） and 27 cases （32 eyes ） of A/ON were underwent central G2 program with both traditional threshold perimetry （Normal/Normal strategy） and TOP （TOP/Normal strategy） of Octopus 101 perimetry, respectively. All subjeers were checked twice. A comparison on examination duration and three visual field indices （mean sensitivi- ty, MS; mean damage, MD; and loss variance, LV） between two strategies in the second test was performed. Results The time of examination duration for TOP was about 20.8% of that for traditional threshold in normal people, and about 24.5% of that for traditional threshold in patients. In normal people, MS for TOP and for traditional threshold was 28.42±1.26 and 28.17±1.05 respectively; MD for them was 0.17± 1.12 and 0.21± 1.03 ; LV for them was 2.47± 1.06 and 3.16± 2.13. In patients with AION, MS for TOP and for tradi- tional threshold was 17.48± 3.25 and 17.11± 3.14 respectively; MD for them was 6.55± 3.37 and 6.83± 3.42; LV for them was 47.66± 38.27 and 56.98± 39.16. Conclusions TOP strategy reduced the examination time obviously. The visual field indices of TOP and traditional threshold perimetry are positively correlated. The sen- sitivity and reproducibility of TOP are high in detecting the visual function of AION.