Dry Eye Symptom Severity and Visual Field Reliability Metrics.
Dry Eye Symptom Severity and Visual Field Reliability Metrics.
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DOI：
10.1097/ijg.0000000000002017
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发表时间：
2022-05-01
影响因子：
2
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中科院分区：
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干眼病的症状常见于青光眼患者，局部青光眼药物可加重干眼病的症状。干眼病可能影响视野（VF）测试的可靠性，影响结果的准确解释。在2018年12月至2019年2月的VF测试之前，圣地亚哥退伍军人管理局医疗中心的患者完成了五项干眼症问卷（DEQ5）。记录每位患者的VF可靠性指标。标准可靠性指标包括固定损失、假阳性和假阴性率。门跟踪（GT）指标包括注视偏差在1到2度、3-5度、6度或更大的刺激的百分比，以及跟踪失败（TFF或跟踪失败频率）的刺激的百分比。还记录了青光眼药物和人工泪液的使用情况。494例患者完成DEQ5和VF检测。干眼症状严重程度与标准可靠性指标或大多数GT指标之间没有关联。然而，TFF随着干眼症状严重程度的增加而增加（p=0.015）。左眼TFF也较高，为次之（p=0.012）；没有其他可靠性指标与侧性相关。干眼症状严重程度增加的患者更有可能使用人工泪液（p<0.001），但症状严重程度与青光眼药物使用之间没有关系。当使用GT指标确定VF可靠性时，干眼症状的严重程度可能会影响TFF的可接受范围或阈值。同样，TFF的可接受范围或阈值在眼睛之间可能是不同的。跟踪失败的频率随着干眼症状的严重程度和左眼的增加而增加。
Symptoms of dry eye disease are commonly encountered in glaucoma patients and can be exacerbated by topical glaucoma medications. Dry eye disease may influence the reliability of visual field (VF) tests and impact accurate interpretation of the results. Patients at the Veterans Administration Medical Center San Diego completed the five-item dry eye questionnaire (DEQ5) prior to VF testing between December 2018 and February 2019. VF reliability metrics were recorded for each patient. Standard reliability metrics included fixation losses, false positive, and false negative rates. Gate tracking (GT) metrics included percent of stimuli with gaze deviations between 1 and 2 degrees, 3–5 degrees, 6 degrees or greater, and percent of stimuli with tracking failure (TFF or Tracking Failure Frequency). The use of glaucoma medications and artificial tears was also recorded. 494 patients completed the DEQ5 and VF testing. There was no association between dry eye symptom severity and standard reliability metrics or most GT metrics. However, TFF increased as dry eye symptom severity increased (p=0.015). TFF was also greater in the left eye, which was tested second (p=0.012); no other reliability metrics were related to laterality. Patients were more likely to use artificial tears with increased dry eye symptom severity (p<0.001), but there was no relationship between symptom severity and glaucoma medication use. Dry eye symptom severity may influence the acceptable range or threshold of TFF when using GT metrics to determine VF reliability. Likewise, the acceptable range or threshold for TFF may be different between eyes. Tracking failure frequency increases with dry eye symptom severity and in the left eye.