Optic disc and visual field progression in ocular hypertensive subjects: Detection rates, specificity, and agreement
Optic disc and visual field progression in ocular hypertensive subjects: Detection rates, specificity, and agreement
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DOI：
10.1167/iovs.05-1584
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发表时间：
2006-07-01
影响因子：
4.4
通讯作者：
Garway-Heath, David F.
中科院分区：
文献类型：
--
作者：
Strouthidis, Nicholas G.;Scott, Andrew;Garway-Heath, David F.
目的.研究高眼压（OHT）患者视野（VF）进展与海德堡视网膜断层扫描（HRT; Heidelberg Engineering，GmbH，Heidelberg，德国）边缘区（RA）进展之间的检出率、特异性和一致性。用常规Humphrey VF（Carl Zeiss Meditec，Inc.，都柏林，CA）和HRT测试。采用标准和三省略（不太严格和严格）标准，采用灵敏度/时间的逐点线性回归（PLR）评估VF进展。HRT检测到的进展的变化通过部门RA/时间的线性回归进行评估，定义为斜率> 1%/年，根据系列变异性调整显著性水平。测试了不太严格和严格的标准。通过疾病进展的对照受试者和显著改善受试者（所有）的比例估计特异性。评估OHT受试者椎间盘和视野进展之间的一致性，VF和HRT的特异性匹配。当使用标准标准时，VF PLR的特异性估计为85.7%至95.4%，使用不太严格的标准时，RA/时间的特异性估计为88.1%至90.5%。在这项比较中，21.2%的进展是由RA单独和20.2%的VF单独，和12.1%的进展是由RA和VF。分别使用三项省略标准和严格的RA/时间标准，估计VF PLR和RA/时间的特异性为95.2%至98.2%。在这个比较中，8.6%的进展单独RA，15.1%单独VF，3.5%的RA和VF。两种方法检测到的疾病进展频率相对较高，VF进展的发生频率至少与RA进展的发生频率相同。无论进展标准的特异性如何，观察到RA和VF进展之间的一致性较差。结果表明，在高眼压患者中，VF和视盘的监测是必要的，因为视盘和VF进展之间的协议是例外，而不是规则。
PURPOSE. To examine the detection rates, specificity, and agreement between visual field (VF) progression and Heidelberg Retina Tomograph (HRT; Heidelberg Engineering, GmbH, Heidelberg, Germany) rim area (RA) progression in subjects with ocular hypertension (OHT).METHODS. One hundred ninety-eight OHT and 21 control subjects were examined prospectively (1994-2001) with regular Humphrey VF (Carl Zeiss Meditec, Inc., Dublin, CA) and HRT testing. Point-wise linear regression (PLR) of sensitivity/time was used to assess VF progression, using standard and three-omitting (less stringent and stringent) criteria. The change in HRT-detected progression was assessed by linear regression of sectoral RA/time, defined as slope > 1%/year, with significance level tailored according to series variability. Less stringent and stringent criteria were tested. Specificity was estimated by the proportions of control subjects with disease progression and significantly improving subjects (all). Agreement between disc and field progression in the subjects with OHT was assessed with specificities matched for both VF and HRT.RESULTS. Specificity for VF PLR was estimated to be 85.7% to 95.4% when standard criteria were used, and for RA/time to be 88.1% to 90.5% with the less-stringent criteria. In this comparison, 21.2% progressed by RA alone and 20.2% by VF alone, and 12.1% progressed by both RA and VF. Specificity was estimated to be 95.2% to 98.2% for both VF PLR and RA/time, using the three-omitting criteria and the stringent RA/time criteria, respectively. In this comparison, 8.6% progressed by RA alone, 15.1% by VF alone, and 3.5% by both RA and VF.CONCLUSIONS. A relatively high frequency of detected disease progression was observed with either method, with progression by VF occurring at least as frequently as progression by RA. Poor agreement between RA and VF progression was observed regardless of the specificity of the progression criteria. The results indicate that, in patients with ocular hypertension, monitoring of both VF and optic disc is necessary, as agreement between optic disc and VF progression is the exception rather than the rule.