Contrast sensitivity perimetry and clinical measures of glaucomatous damage.
Contrast sensitivity perimetry and clinical measures of glaucomatous damage.
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DOI：
10.1097/opx.0000000000000395
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发表时间：
2014-11
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影响因子：
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通讯作者：
Horner DG
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文献类型：
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作者：
Swanson WH;Malinovsky VE;Dul MW;Malik R;Torbit JK;Sutton BM;Horner DG
比较传统的结构和功能测量昏迷损害与一种新的功能测量-对比敏感度视野检查（CSP-2）。使用CSP-2、III号24-2常规自动视野检查（CAP）、24 -2倍频视野检查（FDP）和视网膜神经纤维层（RNFL）厚度，对51例青光眼患者和62例年龄相似的对照受试者的各一只眼睛进行测试。对于上级颞（ST）和下级颞（IT）视盘扇区，缺损深度计算为低于平均正常值的量，以对数单位表示。使用Bland-Altman分析评估缺损深度的一致性，使用一致性限值和三个指标：截距、斜率和平均差。p < 0.0014的显著性标准使用Bonferroni校正。两个扇区的对比敏感度视野检查-2和FDP一致。CSP-2的正常变异性低于CAP和FDP（F > 1.69，p < 0.02），患者数据的Bland-Altman一致性限与对照受试者的变异性一致（平均差异，-0.01 log单位; SD，0.11 log单位）。IT的截距表明，当CAP处于平均正常值时，CSP-2和FDP低于平均正常值（t > 4，p < 0.0005）。斜率表明，随着扇区损伤变得更严重，IT和ST的CAP缺陷比CSP-2缺陷更快地加深（t > 4.3，p < 0.0005），ST的RNFL缺陷比CSP、FDP和CAP更慢地加深。平均差异表明ST和IT的FDP缺损平均比RNFL缺损更深，ST的CSP-2缺损也是如此（t > 4.9，p < 0.0001）。在轻度损伤的视盘部分，对比敏感度视野检查-2和FDP缺损比CAP缺损更深，在严重损伤的部分显示更大的残余功能。昏迷损害的不同测量方法之间的不一致性可以通过无病人群的变异性来解释。
To compare conventional structural and functional measures of glaucomatous damage with a new functional measure—contrast sensitivity perimetry (CSP-2). One eye each was tested for 51 patients with glaucoma and 62 age-similar control subjects using CSP-2, size III 24-2 conventional automated perimetry (CAP), 24-2 frequency-doubling perimetry (FDP), and retinal nerve fiber layer (RNFL) thickness. For superior temporal (ST) and inferior temporal (IT) optic disc sectors, defect depth was computed as amount below mean normal, in log units. Bland-Altman analysis was used to assess agreement on defect depth, using limits of agreement and three indices: intercept, slope, and mean difference. A criterion of p < 0.0014 for significance used Bonferroni correction. Contrast sensitivity perimetry-2 and FDP were in agreement for both sectors. Normal variability was lower for CSP-2 than for CAP and FDP (F > 1.69, p < 0.02), and Bland-Altman limits of agreement for patient data were consistent with variability of control subjects (mean difference, −0.01 log units; SD, 0.11 log units). Intercepts for IT indicated that CSP-2 and FDP were below mean normal when CAP was at mean normal (t > 4, p < 0.0005). Slopes indicated that, as sector damage became more severe, CAP defects for IT and ST deepened more rapidly than CSP-2 defects (t > 4.3, p < 0.0005) and RNFL defects for ST deepened more slowly than for CSP, FDP, and CAP. Mean differences indicated that FDP defects for ST and IT were on average deeper than RNFL defects, as were CSP-2 defects for ST (t > 4.9, p < 0.0001). Contrast sensitivity perimetry-2 and FDP defects were deeper than CAP defects in optic disc sectors with mild damage and revealed greater residual function in sectors with severe damage. The discordance between different measures of glaucomatous damage can be accounted for by variability in people free of disease.