The Effective Dynamic Ranges for Glaucomatous Visual Field Progression With Standard Automated Perimetry and Stimulus Sizes III and V.
The Effective Dynamic Ranges for Glaucomatous Visual Field Progression With Standard Automated Perimetry and Stimulus Sizes III and V.
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具有标准自动化的圆锥体和刺激大小III和V的青光眼视野进程的有效动态范围。
DOI：
10.1167/iovs.17-22390
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发表时间：
2018-01-01
影响因子：
4.4
通讯作者：
Artes PH
中科院分区：
文献类型：
--
作者：
Wall M;Zamba GKD;Artes PH
已有研究表明，阈值估计低于约20 dB对青光眼视野进展的检测能力几乎没有影响。我们的目的是比较刺激大小V和刺激大小III在视觉损伤区域，通过使用(1)不同的数据集，(2)不同的级数分析技术，以及(3)分析评估审查对平均偏差（MD）的影响来证实这些发现。在爱荷华州的变异性视野研究中，120名青光眼受试者每6个月进行一次测试，持续4年，使用尺寸为III的SITA标准和尺寸为V的全阈值。通过三种互补技术确定进展：点线性回归（PLR）、PLR置换和MD指数线性回归。在“审查”数据集上重复所有分析，其中低于给定标准值的阈值估计被设置为等于标准值。我们的分析证实了之前的观察结果，即低于20 dB的阈值对视野进展的影响远小于高于此范围的阈值。这些发现与刺激大小III和v大致相似。阈值< 20 dB的去除对轻度至中度青光眼患者视野进展率的影响相对较小。尺寸V具有较低的重测变异性，在纵向青光眼进展分析中表现至少与尺寸III一样好，并且由于灵敏度上限较高，似乎具有更大的有用动态范围。
It has been shown that threshold estimates below approximately 20 dB have little effect on the ability to detect visual field progression in glaucoma. We aimed to compare stimulus size V to stimulus size III, in areas of visual damage, to confirm these findings by using (1) a different dataset, (2) different techniques of progression analysis, and (3) an analysis to evaluate the effect of censoring on mean deviation (MD). In the Iowa Variability in Perimetry Study, 120 glaucoma subjects were tested every 6 months for 4 years with size III SITA Standard and size V Full Threshold. Progression was determined with three complementary techniques: pointwise linear regression (PLR), permutation of PLR, and linear regression of the MD index. All analyses were repeated on “censored'' datasets in which threshold estimates below a given criterion value were set to equal the criterion value. Our analyses confirmed previous observations that threshold estimates below 20 dB contribute much less to visual field progression than estimates above this range. These findings were broadly similar with stimulus sizes III and V. Censoring of threshold values < 20 dB has relatively little impact on the rates of visual field progression in patients with mild to moderate glaucoma. Size V, which has lower retest variability, performs at least as well as size III for longitudinal glaucoma progression analysis and appears to have a larger useful dynamic range owing to the upper sensitivity limit being higher.
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