Detection of visual-field deterioration by Glaucoma Progression Analysis and Threshold Noiseless Trend programs
Detection of visual-field deterioration by Glaucoma Progression Analysis and Threshold Noiseless Trend programs
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DOI：
10.1136/bjo.2007.136739
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发表时间：
2009-03-01
影响因子：
4.1
通讯作者：
Azuara-Blanco, A.
中科院分区：
文献类型：
--
作者：
Diaz-Aleman, V. T.;Anton, A.;Azuara-Blanco, A.
背景：比较青光眼进展分析(GPA)和阈值无噪声趋势(TNT)程序检测视野恶化的能力。方法：对开角型青光眼患者进行至少2年和至少7个可靠视野的随访。四位蒙面青光眼专家对进展进行了主观评估，并与GPA和TNT结果进行了比较。结果：对42例56只眼进行了平均5.5(1.04)年的随访，平均7.8次(SD 1.0)。观察者间检测进展的一致性良好(平均kappa=0.57)。专家检测10-19只眼，GPA检测6只眼，TNT检测24只眼。以一致的专家意见为金标准(4名临床医生检测到进展)，GPA的敏感度和特异度分别为75%和83%，而TNT的敏感度和特异度分别为100%和77%。结论：TNT在检测视野恶化方面与专家的符合率高于GPA。GPA具有较高的特异性，但敏感性较低，主要发现高病灶和明显平均缺损斜率的病例。
Background: To compare the ability of Glaucoma Progression Analysis (GPA) and Threshold Noiseless Trend (TNT) programs to detect visual-field deterioration.Methods: Patients with open-angle glaucoma followed for a minimum of 2 years and a minimum of seven reliable visual fields were included. Progression was assessed subjectively by four masked glaucoma experts, and compared with GPA and TNT results. Each case was judged to be stable, deteriorated or suspicious of deteriorationResults: A total of 56 eyes of 42 patients were followed with a mean of 7.8 (SD 1.0) tests over an average of 5.5 (1.04) years. Interobserver agreement to detect progression was good (mean kappa = 0.57). Progression was detected in 10-19 eyes by the experts, in six by GPA and in 24 by TNT. Using the consensus expert opinion as the gold standard (four clinicians detected progression), the GPA sensitivity and specificity were 75% and 83%, respectively, while the TNT sensitivity and specificity was 100% and 77%, respectively.Conclusion: TNT showed greater concordance with the experts than GPA in the detection of visual-field deterioration. GPA showed a high specificity but lower sensitivity, mainly detecting cases of high focality and pronounced mean defect slopes.