Comparison of contrast sensitivity, visual acuity, and Humphrey Visual Field testing in patients with glaucoma
Comparison of contrast sensitivity, visual acuity, and Humphrey Visual Field testing in patients with glaucoma
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DOI：
10.1097/00061198-200304000-00008
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发表时间：
2003-04-01
影响因子：
2
通讯作者：
Wilensky, JT
中科院分区：
文献类型：
--
作者：
Hawkins, AS;Szlyk, JP;Wilensky, JT
背景：尽管青光眼患者的Snellen视力正常或接近正常，但患者经常抱怨视力较差。目的：调查视力在20/40或更高的青光眼患者的大字母对比敏感度、高对比度视力和视野缺陷之间的关系。设计：前瞻性、横断面病例序列。患者和方法：我们评估了来自伊利诺伊大学芝加哥医学院青光眼服务部的144名受试者的250只眼。被诊断为青光眼、疑似青光眼或高眼压的受试者符合20/40或更好的视力要求。用后照明灯塔视力表在4英寸处测量视力。对比敏感度的测量使用佩利-罗布森图表，在前面照亮的盒子里，整个图表的亮度都很均匀。用Humphrey视野分析仪的24-2全阈值程序测量患者的视野。结果：视野平均偏差与对比敏感度得分之间存在显著相关性(r=0.57，P<；0.001，n=127)。视野平均偏差与对数平均视力之间的相关性较小(r=-0.322，P<；0.001)，对比敏感度得分与对数平均视力之间的相关性较小(r=-0.370，P<；0.001)。在慢性开角型青光眼患者亚组中，平均视野偏差与对比敏感度得分的相关性较高，为0.689(P<或等于0.001，n=62)。结论：在视力达到或超过20/40的青光眼患者中，对比敏感度降低与视野损失显著相关。研究数据支持这一结论，与视力相比，疾病过程优先影响对比敏感度。在我们以前的工作中，对比敏感度被证明比视觉敏感度与青光眼早期改变患者的真实世界功能更相关。
Background: Despite their normal or near-normal Snellen visual acuity, patients with glaucoma often complain of "poor" vision.Objective: To investigate the relationship between large-letter contrast sensitivity, high-contrast visual acuity, and visual field defects in patients with glaucoma who have 20/40 or better visual acuity.Design: Prospective, cross-sectional case series.Patients and Methods: We evaluated 250 eyes of 144 subjects from the Glaucoma Service at the University of Illinois at Chicago College of Medicine. Subjects with a diagnosis of glaucoma, suspected glaucoma, or ocular hypertension who met the 20/40 or better vision requirement were recruited. Visual acuity was measured using the rear-illuminated Lighthouse Visual Acuity Chart at 4 In. Contrast sensitivity was measured using the Pelli-Robson Chart in a front-illuminated box with even luminance across the chart. Visual fields of the patients were measured using the 24-2 full-threshold program on the Humphrey Visual Field Analyzer.Results: A significant correlation (r = 0.57, P < 0.001, n = 127) was found between the visual field mean deviations and the contrast sensitivity scores. The correlation (r = -0.322, P < 0.001, n = 127) was less between the visual field mean deviation and the log MAR visual acuity values, as was the correlation between the contrast sensitivity scores and log MAR visual acuity values (r = -0.370, P < 0.001, n = 127). In the subgroup of patients with chronic open-angle glaucoma, the correlation between the mean visual field deviation and the contrast sensitivity score was higher at 0.689 (P less than or equal to 0.001, n = 62).Conclusions: Reduced contrast sensitivity is significantly correlated with visual field losses in patients with glaucoma and a visual acuity of 20/40 or better. The study data support the conclusion that, compared with visual acuity, the disease process preferentially affects contrast sensitivity. In our previous work, contrast sensitivity was shown to be more related than visual acuity to real-world function in patients with early glaucomatous changes.