短波长自动视野检查中学习因素对结果产生的影响程度

Purpose: To document the magnitude of any learning effect for short-wave length automated perimetry (SWAP) in patients with either ocular hypertension (OHT) or open-angle glaucoma (OAG) who are experienced in standard automated perimetry (SAP). Design: Experimental study. Participants: Thirty-five patients (22 with OHT and 13 with OAG) who had previously undergone at least 3 threshold SAP visual field examinations with the Humphrey Field Analyzer (HFA; Carl Zeiss Meditech Inc.,Dublin,CA),and 9 patients with OHT who had not previously undertaken any form of perimetry. Methods: Each patient attended for SWAP on 5 occasions,each separated by 1 week. At each visit,both eyes were examined using Program 24-2 of the HFA; the right eye was always examined before the left eye. Main Outcome Measures: (1) Change over the 5 examinations,in each eye,of the visual field indices Mean Deviation (MD),Short-term Fluctuation (SF),Pattern Standard Deviation (PSD),and Corrected Pattern Standard Deviation. (2) Change in each eye between Visits 1 and 5 in proportionate Mean Sensitivity (pMS) for the central annulus of stimulus locations compared with that for the peripheral annulus thereby determining the influence of stimulus eccentricity on any alteration in sensitivity. (3) Change between Visits 1 and 5 in the number and magnitude of the Pattern Deviation (PD) probability levels associated with any alteration in sensitivity. Results: The MD,SF,and PSD each improved over the 5 examinations (each at P< 0.001). The improvement in pMS between Visits 1 and 5 was greater for the peripheral annulus than for the central annulus by approximately two fold for the patients with OAG. Considerable variation was present between patients,within and between groups,in the number of locations exhibiting an improving sensitivity between Visits 1 and 5 by 1 or more PD probability levels. Conclusions: Care should be taken to ensure that,during the initial examinations,apparent field loss with SWAP in patients exhibiting a normal field by SAP is not the result of inexperience in SWAP. Apparently deeper or wider field loss in the initial examinations with SWAP compared with that exhibited by SAP in OAG also may arise from inexperience in SWAP.

短波自动视野检查在早期原发性开角型青光眼诊断中的应用

目的探讨短波自动视野检查(SWAP)在早期原发性开角型青光眼(POAG)中的应用价值。方法应用Humphrey II 750i电脑自动视野分析仪对正常组、早期POAG患者分别进行白白视野(WWP)、SWAP检查,并对各组测得的平均偏差(MD)、图形标准偏差(PSD)、缺损点数(选择模式偏差概率图中P<0.05的异常点)进行比较和分析。结果早期POAG患者的SWAP检测的MD、PSD较WWP检测的数值大,缺损点数多,二者比较差异有统计学意义(P<0.05)。早期POAG患者42只眼中SWAP检测阳性者38只眼,阳性率为90.48%;WWP检测阳性者28只眼,阳性率为66.67%。结论在POAG的早期诊断中SWAP较WWP更敏感,检出的阳性率更高,SWAP较WWP检出的视野缺损更深范围更大,甚至能够发现一些WWP所不能检测出的已受损的检测位点。

短波长自动视野计对原发性青光眼诊断效能的Meta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,对短波长自动视野计(SWAP)诊断原发性青光眼的文献进行Meta分析,评价SWAP的临床诊断效能。设计 基于文献检索的Meta分析研究。对象 电子检索MEDLINE、EMBASE、CochraneLibrary、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。方法 检索上述文献。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MetaTestversion 0 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,绘制汇总受试者工作特征曲线(SROC)、计算曲线下面积并进行敏感性分析。主要指标 敏感性、特异性及相应的95 %可信区间(95 %CI)、SROC曲线下面积。结果 共检索到相关文献136篇,5篇英文文献(7个研究)符合纳入标准,研究对象共5 14例。SWAP诊断原发性青光眼的敏感性范围为0 39～0 94 ,特异性范围为0 83～1 0 0。纳入研究不存在异质性。

短波自动视野检查与标准白白视野检查在原发性开角型青光眼中对比研究

目的 探讨短波自动视野检查（SWAP）在原发性开角型青光眼（POAG）中的应用价值,期望能为临床对POAG的诊断提供一种较好的检查方法.方法 临床病例对照研究.对2011年6月至2014年6月在河北省眼科医院应用HumphreyII 750i电脑自动视野分析仪对正常组、POAG组分别进行白白视野（WWP）、SWAP检查,并对各组测得的平均偏差（MD）、图形标准偏差（PSD）、缺损点数（选择模式偏差概率图中P ＜0.05的异常点）进行比较和分析.结果 早、中期POAG患者的SWAP检测的MD、PSD较WWP检测的数值大,缺损点数多,二者比较差异有统计学意义（P＜0.05）;晚期患者SWAP和WWP检测的结果差异无统计学意义（P＞0.05）.早期POAG患者42只眼中SWAP检测阳性者38只眼,阳性率为90.48％ （38/42）;WWP检测阳性者28只眼,阳性率为66.67％ （28/42）;中期患者阳性率为100％ （48/48）;晚期患者阳性率为100％ （18/18）.结论 在早、中期POAG的视野检查中SWAP较WWP检出的视野缺损更深范围更大,甚至能够发现一些WWP所不能检测出的已受损的检测位点.在POAG的早期诊断中SWAP较WWP更敏感,检出的阳性率更高,晚期视野检测中SWAP和WWP具有一致性,优势不明显.

小梁切除术后青光眼的各项解剖及功能评价指标无变化

Purpose:To assess the influence of glaucoma filtration surgery on anatomical and functional tests for glaucoma evaluation.Methods:Twenty-five eyes(25 patients)with primary openangle glaucoma were evaluated,prospectively.Data were collected on vision acuity,intraocular pressure,standard automated perimetry,frequency doubling technology perimetry,scanning laser polarimetry(GDx)and confocal scanning laser ophthalmoscopy(HRT II)before and 3-6 months after surgery.Results:Mean(± SD)pre-and postoperative visual acuities(logMAR)were 0.28(± 0.18)and 0.30(± 0.17),respectively(P=0.346).In a mean time of 4.5(± 1.1)months after surgery,the mean preoperative intraocular pressure of 20.7(± 5.4)mmHg decreased to 11.04(± 2.52)mmHg(P < 0.001).The results of the standard automated perimetry,frequency doubling technology perimetry,scanning laser polarimetry and confocal scanning laser ophthalmoscopy diagnostic methods revealed no significant difference(P > 0.162)between pre and postoperative values and no significant correlation(P > 0.296)between intraocular pressure reduction and value changes.Conclusion:No significant change on any test variable was detected after glaucoma filtration surgery.Trabeculectomy does not appear to influence standard automated perimetry,frequency doubling technology perimetry,scanning laser polarimetry and confocal scanning laser ophthalmoscopy(HRT II)results after a 4.5-month period of surgery in early to moderate glaucoma.

CORRELATION OF SHORT-WAVELENGTH AUTOMATED PEREMETRY INDICES TO OPTIC DISC TOPOGRAPHY

Purpose: To correlate structural parameters of the optic nerve head and global indices of short-wavelength automated perimetry (SWAP) in ocular hypertensives. Methods: The study included 195 eyes with ocular hypertension (IOP>21 mmHg, normal conventional automated perimetry). Short-wavelength automated perimetry was performed (full-threshold, 24-2). The optic

TOPOGRAPHIC CONCORDANCE BETWEEN SHORT WAVE AUTOMATED PEREMETRY AND FREQUENCY DOUBLING TECHNOLO-GY IN OCULAR HYPERTENSION

Purpose: To evaluate the topographic concordance between sensibility values of short wave automated perimetry (SWAP) and frequency doubling technology (FDT) in ocular hypertension. Methods: 22 eyes of 22 patients diagnosed of ocular hypertension underwent SWAP (24-2 test, Humphrey analyser) and FDT (C-20 threshold test). According the 17 points examined

眼科学

0203251 老年人群中发现眼病试验的敏感性和特异性/Ivers R Q∥J Am Aead Oph-thalmol.-2001,108(5).-968～975北大图0203252 短波长自动视野检查的最适宜标准/Polo V∥J Am Acad Ophthalmol.-2000,108(2).-285～289

试题与解答

1.自动视野计结果分析可靠性指标有,除外: A 假阳性率, B 假阴性率 C 固视丢失率,D 短期波动 E

眼科诊断学

9911006 正常短波长视野的不对称性短波长自动视野仪的意义/Sample P A//AmJ Ophthalmol.-1997,124(1).-46～52四军大9911007 经眼动脉侧枝血供:彩色多普勒成象窃取现象的分析/Costa V P//J

黑种人和白种人健康眼之间视功能和视神经结构的差别

目的：观察黑种人和白种人健康眼之间视功能、视盘地形和视网膜神经纤维层（RNFL）厚度的差别。 方法：采用标准自动视野计检查、短波长自动视野计检查及倍频技术视野计检查评价50位黑种人和50位白种人健康眼视功能。采用Heidelberg视网膜地形图和光学相干断层扫描仪测量视盘形态和RNFL厚度。 结果：两组平均标准自动视野检查平均偏差均在正常范围内。黑种人倍频技术视野检查的平均偏差比白种人较差（均数±标准差，-1．8±3．2dB对-0．1±2．4dB）。采用Heidelberg视网膜地形图测得黑种人视盘面积较白种人大（均数±标准差。2．1±0．4mm^2对1．7±0.4mm^2）。光学相干断层扫描仪测得的黑种人RNFL较白种人更厚。其中上方厚16．91pm。下方厚10．10μm。而且黑种人的眼内压较白种人略高（均数±标准差,16．5±2．5mmHg对15．2±3．2mmHg），中央角膜较薄（均数±标准差，540．5±43．2μm对560．9±35．5μm）。在平均RNFL厚度、所有测试的模式标准偏差或短波长自动视野检查的变量中均未见人种差别。结论：在视功能方面发现有微小的人种差别。但在健康眼。人种显著影响视盘形态及上方和下方RNFL的厚度测量。所观察到的眼内压具有人种差别，在校正中央角膜厚度之后。理论上也是升高的。需要前瞻性研究来进一步观察这些结果。

本期导读

本期以青光眼的诊治研究为重点报道内容。吴玲玲在“如何运用OCTA助力青光眼诊治”的述评中对相干光断层扫描血管成像术(OCTA)如何合理应用其检测青光眼进行了详细分析,评论了OCTA用于青光眼的主要检测指标(视盘及其周围的浅层微血管密度、黄斑区浅层血管密度以及视盘旁深层微血管缺失)检测青光眼的能力和特点,认为其可对结构OCT和视野检查起到补充作用。周孟田等的论著报告了通过用10-0聚丙烯缝线缝合小梁切除术内滤过口对应位置的角膜和虹膜2~3针来构建新生血管膜拦截堤坝,从而防止新生血管长入,维持滤过通道通畅,文章总结了28例(31眼)随访1年的数据结果。