Analysis of reliability indices from Humphrey visual field tests in an urban glaucoma population
Analysis of reliability indices from Humphrey visual field tests in an urban glaucoma population
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DOI：
10.1016/s0161-6420(97)30173-0
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发表时间：
1997-07-01
期刊：
影响因子：
13.7
通讯作者：
Lee, D
中科院分区：
文献类型：
--
作者：
Birt, CM;Shin, DH;Lee, D
目的：视野评估在青光眼治疗中是极其重要的，但其解释受到患者表现质量的影响。作者通过随机选择的城市三级护理实践中的慢性青光眼人群样本，调查了视野表现的可靠性。在随机选择的106例慢性开角型青光眼患者病历中研究了Humphrey自动视野测试的患者可靠性，其提供了768次测试（平均值，7.2 +/-4.8个视野;范围，2-18个视野）。根据Humphrey Instruments，Inc（圣莱安德罗，CA）的建议，将可靠性标准确定为小于20%的注视丢失，小于33%的假阴性错误和小于33%的假阳性错误。在106例患者中，只有35例（33%）双眼始终可靠，而8例（7.5%）双眼始终不可靠，最常见的不可靠原因是固定丢失（39%），而假阳性错误（5%）和假阴性错误（9%）较少。一个更严重的抑郁症的平均偏差显着相关性较差的性能上的三个可靠性指标，与假阴性错误具有最大的相关性，其次是固定损失和假阳性错误。校正模式标准差仅与假阴性误差密切相关。延长测试时间也与所有三个可靠性指标。年龄是一个显着的因素，固定损失，但不是假阴性或假阳性error.Conclusions：作者得出结论，不到三分之二的汉弗莱视野是可靠的，作者的城市三级护理人群的青光眼患者。将固视丢失标准放宽至小于33%，可将可靠率提高至约75%。昏迷性视野缺损的严重程度、测试时间和年龄被确定为影响Humphrey视野可靠性的因素。
Purpose: Visual field assessment is extremely important in glaucoma management, but interpretation is affected by the quality of the patient's performance, The authors have investigated the reliability of visual field performance by a randomly selected sample of the chronic glaucoma population at an urban tertiary care practice.Methods: Patient reliability in Humphrey automated visual field testing was studied in 106 randomly selected chronic open-angle glaucoma patient charts, which provided 768 tests (mean, 7.2 +/- 4.8 fields; range, 2-18 fields). Reliability criteria were established as less than 20% fixation losses, less than 33% false-negative error, and less than 33% false-positive error, as recommended by Humphrey Instruments, Inc (San Leandro, CA).Results: Patients performed reliably in 61% of right eye fields, 58% of left eye fields, and 59.5% overall. Of the 106 patients, only 35 (33%) were always reliable in both eyes, whereas 8 (7.5%) were always unreliable in both eyes, The most common cause of unreliability was fixation loss (39%), whereas false-positive error (5%) and false-negative error (9%) were less frequent. A more severely depressed mean deviation correlated significantly with poorer performance on the three reliability indices, with false-negative error having the greatest correlation, followed by fixation loss and false-positive error. Corrected pattern standard deviation correlated closely only with false-negative error. Prolonged test time also correlated with all three reliability indices. Age was a significant factor for fixation loss but not for false-negative or false-positive error.Conclusions: The authors conclude that fewer than two thirds of the Humphrey visual fields were reliable with the authors' urban tertiary care population of patients with glaucoma. Relaxing the fixation loss criterion to less than 33% improved the rate of reliability to approximately 75%. The severity of glaucomatous visual field defects, test time, and age were identified as factors influencing the reliability of the Humphrey visual fields.