ASSESSMENT OF PROGRESSIVE VISUAL FIELD LOSS IN GLAUCOMA

描述(调查人员摘要)：自动阈值视野检查 日益成为评估青光眼充分性的基础 管理，但很少有数据表明什么是正常的 在其他方面控制良好的青光眼中的变异，是什么构成了 进行性视神经损伤患者的有意义的斜视 在这样的视野差异出现之前，会有多大的损害 可靠地检测到。自动视野检查可生成丰富的定量 数据，但分析策略可能最好地检测有意义的变化 在视野中的应用还有待开发和评估。这个 评估进行性视野丧失具有实际意义 不仅要给临床医生在管理个别病人时，也要 在临床试验环境中评估青光眼治疗的疗效。 这项研究建议开发分析策略来评估 视野丧失的进展及其与其他疾病的比较 视神经损伤的测量。连续的自动视野 对照受试者，高眼压和青光眼患者 来自不同的来源。视觉的时间变异性 将对这些小组中的每一组进行实地测试。协变量 影响这种可变性将被用来更好地区分有意义的 从偶然性变化中改变。对视野变化的估计将是 通过对弥散和局部损失的几个度量进行回归得到 并将这些指标与视神经损伤的其他指标进行比较 如进行性拔罐、神经纤维层恶化和改变 在手动视野检查中。个别斜坡的估计亦会有所改善。 使用来自类似阶段的其他受试者的数据调整估计 疾病的威胁。

DESCRIPTION (Investigator's Abstract): Automated threshold perimetry has increasingly become the basis for assessing the adequacy of glaucoma management, yet there are few data suggesting what constitutes normal variation in otherwise well controlled glaucoma, what constitutes a meaningful deviation in a patient with progressive optic nerve damage and how much damage occurs before such differences in the visual field can reliably detected. Automated perimetry generates a wealth of quantitative data, but analytic strategies which might best detect meaningful changes in the visual field have yet to be developed and evaluated. The assessment of progressive visual field loss is of practical importance not only to clinicians in the management of individual patients, but also for evaluating the efficacy of glaucoma treatment in clinical trial settings. This study proposes to develop analytic strategies for assessing progression of visual field loss and to evaluate them against other measures of optic nerve damage. Consecutive automated visual fields of control subjects, patients with ocular hypertensive and glaucoma will be assembled from a variety of sources.The temporal variability of visual field testing will be estimated for each of these groups. Covariates which affect this variability will be used to better distinguish meaningful change from chance variation. Estimates of visual field change will be obtained by regressing several measures of diffuse and localized loss against time and comparing these to other measures of optic nerve damage such as progressive cupping, nerve fiber layer deterioration and changes in manual perimetry. Individual slope estimates will also be improved by adjusting the estimates with data from other subjects at a similar stage of disease.