Preferential hyperacuity perimeter (PreView PHP) for detecting choroidal neovascularization study
Preferential hyperacuity perimeter (PreView PHP) for detecting choroidal neovascularization study
复制标题
DOI：
10.1016/j.ophtha.2005.06.008
复制
发表时间：
2005-10-01
期刊：
影响因子：
13.7
通讯作者：
Toaff, T
中科院分区：
文献类型：
--
作者：
Alster, Y;Bressler, NM;Toaff, T
目的：评估优先超敏视野计（PreView PHP; Carl Zeiss Meditec，都柏林，CA）检测年龄相关性黄斑变性（AMD）引起的新近发生的脉络膜新生血管（CNV）并将其与中期AMD区分开来的能力。设计：前瞻性、比较性、同期、非随机、多中心研究。参会人员：符合条件的参与者的研究眼睛的矫正视力为20/160或更好，无论是未经治疗的CNV从AMD诊断在过去的60天内或中间阶段的AMD.Methods：获得同意后，视力与习惯性矫正，掩蔽PHP测试，立体彩色眼底照相，荧光素血管造影进行。照片和血管造影照片由不知道诊断和PHP结果的分级者进行评估。阅读中心的诊断确定，如果患者被归类为中期AMD或新生血管性AMD.Main Outcome Measures：一个成功的研究结果被定义为一个先验的敏感性至少为80%，特异性至少为80%.Results：185例患者同意被招募，11（6%）有PHP的结果被判定为不可靠。另有52人未被纳入，因为他们不符合所有资格标准。在其余122名患者中，57名患有AMD中期，65名患有新生血管性AMD。使用PHP检测新诊断的CNV的灵敏度为82%（95%置信区间[CI]，70%-90%）。结论：优先超敏视野计检测可检出AMD引起的新发CNV，并能以较高的敏感性和特异性将其与AMD中期相鉴别。这些数据表明，监测PHP应检测到大多数情况下，最近发生的CNV与少数假阳性结果的阶段，治疗通常是有益的。因此，在AMD中期阶段的管理中应考虑这种监测。
Purpose: To assess the ability of the Preferential Hyperacuity Perimeter (PreView PHP; Carl Zeiss Meditec, Dublin, CA) to detect recent-onset choroidal neovascularization (CNV) resulting from age-related macular degeneration (AMD) and to differentiate it from an intermediate stage of AMD.Design: Prospective, comparative, concurrent, nonrandomized, multicenter study. Participants: Eligible participants' study eyes had a corrected visual acuity of 20/160 or better and either untreated CNV from AMD diagnosed within the last 60 days or an intermediate stage of AMD.Methods: After obtaining consent, visual acuity with habitual correction, masked PHP testing, stereoscopic color fundus photography, and fluorescein angiography were performed. Photographs and angiograms were evaluated by graders masked to diagnosis and PHP results. The reading center's diagnosis determined if the patient was categorized as having intermediate AMD or neovascular AMD.Main Outcome Measures: A successful study outcome was defined a priori as a sensitivity of at least 80% and a specificity of at least 80%.Results: Of 185 patients who gave consent to be enrolled, 11 (6%) had PHP results judged to be unreliable. An additional 52 were not included because they did not meet all eligibility criteria. Of the remaining 122 patients, 57 had an intermediate stage of AMD and 65 had neovascular AMD. The sensitivity to detect newly diagnosed CNV using PHP testing was 82% (95% confidence interval [CI], 70%-90%). The specificity to differentiate newly diagnosed CNV from the intermediate stage of AMD using PHP testing was 88% (95% Cl, 76%-95%).Conclusions: Preferential Hyperacuity Perimeter testing can detect recent-onset CNV resulting from AMD and can differentiate it from an intermediate stage of AMD with high sensitivity and specificity. These data suggest that monitoring with PHP should detect most cases of CNV of recent onset with few false-positive results at a stage when treatment usually would be beneficial. Thus, this monitoring should be considered in the management of the intermediate stage of AMD.