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NYQ, T., Tham, Y.C., Koh, V., et al.




摘要:目的:旨在定量测定标准自动视野计(SAP)的可靠性指标如何影响非青光眼患者的视野(VF)结果。设计:观察性,横断面研究。对象:从基于人口的新加坡中华眼病研究(SCES)中选择830名没有视力障碍,青光眼,显着性白内障,主要眼病的40岁至80岁成人。方法:研究参加者进行了全面和标准化的眼部检查和VF评估(使用Humphrey视野分析仪IICarl Zeiss MeditecInc.DublinCA)检测)。测试可靠性分为假阴性(FN),假阳性(FP)和固定损失(FL)率,对全眼指标的影响由平均偏差(MD)和模式标准偏差经多变量回归分析判断。主要观察指标:MDPSD。结果:分析纳入了830名研究对象的1235只正常眼的1828VF结果。调整了年龄,性别,最佳矫正视力和测试持续时间后,多变量回归分析显示,在较低的错误答案率(<15%)下,FN可降低MD(β[分贝变化(dB/ 错误答案率增加5] = -0.71 dB; P <0.001),而FPs可增加MD(β= 0.65 dB; P <0.001)。在更高的频率(≥15%)下,错误答案影响MD的程度更大,其中FNFP的关联分别为-1.151.26 dB(均P <0.001)。当FN<15%时,FN率越高,PSD越大(β= 0.51 dB; P <0.001),当FN率≥15%时,影响稍大(β= 0.71 dB; P < 0.001)。只有当FP<15%时(β= -0.22 dB; P <0.001)才能观察到FPsPSD的影响。 FLMD无关,对PSD的影响最小。结论:我们量化了SAPMDPSD不可靠反应的影响。我们的研究可能允许临床医师估计不同程度的不可靠性对VF结果的影响,而不是依赖可靠性指数的临界值。

PURPOSE:To quantitatively determine how the reliability indices in standard automated perimetry (SAP) affect the global indices of visual field (VF) results in nonglaucomatous eyes.DESIGN:Observational, cross-sectional study.PARTICIPANTS:A total of 830 adults aged 40 to 80 years, without visual impairment, glaucoma, significant cataract, and major eye diseases, were selected from the population-based Singapore Chinese Eye Study (SCES).METHODS:Study participants underwent a comprehensive and standardized ocular examination and VF assessment using a Humphrey Field Analyzer II (Carl Zeiss Meditec, Inc., Dublin, CA). The effects of the test reliability, as indicated by the false-negative (FN), false-positive (FP), and fixation loss (FL) rates, on global indices, as indicated by the mean deviation (MD) and pattern standard deviation (PSD), were analyzed with multivariable regression models.MAIN OUTCOME MEASURES:The MD and PSD.RESULTS:A total of 1828 VF results from 1235 normal eyes of 830 study subjects were included in the analyses. The multivariable regression analyses adjusted for age, gender, best-corrected visual acuity, and test duration showed that at lower frequencies of false answers (<15%), FNs decreased the MD (β [change in decibels {dB} per 5% increment in false answers] = -0.71 dB; P < 0.001), whereas FPs increased the MD (β = 0.65 dB; P < 0.001). At higher frequencies (15%), the false answers influenced the MD to a greater extent, where the β for the associations with FN and FP rates was -1.15 and 1.26 dB, respectively (both P < 0.001). We also found that when FN rate was <15%, higher FN rate increased the PSD (β = 0.51 dB; P < 0.001), and the effect was slightly larger when FN rate was 15% (β = 0.71 dB; P < 0.001). The effect of FPs on PSD was observed only when FP rate was <15% (β = -0.22 dB; P < 0.001). The FL had no associations with the MD, and had minimal effects on the PSD.CONCLUSIONS:We quantified the effect of unreliable responses on the MD and PSD in SAP. Our study may allow clinicians to estimate how VF results are affected by varying degrees of unreliability, instead of relying on cutoff values for reliability indices.


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