Persistence, Spatial Distribution and Implications for Progression Detection of Blind Parts of the Visual Field in Glaucoma A Clinical Cohort Study 英文参考文献.docVIP

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Persistence, Spatial Distribution and Implications for Progression Detection of Blind Parts of the Visual Field in Glaucoma A Clinical Cohort Study 英文参考文献.doc

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Persistence, Spatial Distribution and Implications for Progression Detection of Blind Parts of the Visual Field in Glaucoma A Clinical Cohort Study 英文参考文献

Persistence,SpatialDistributionandImplicationsfor ProgressionDetectionofBlindPartsoftheVisualFieldin Glaucoma:AClinicalCohortStudy FranciscoG.JunoyMontolio1.,ChristiaanWesselink1.,NomdoM.Jansonius1,2 * 1Dept.ofOphthalmology,UniversityMedicalCenterGroningen,UniversityofGroningen,Groningen,TheNetherlands,2Dept.ofEpidemiology,ErasmusMedicalCenter, Rotterdam,TheNetherlands Abstract Background:Visualfieldtestingisanessentialpartofglaucomacare.Itishamperedbyvariabilityrelatedtothedisease itself, response errors and fatigue. In glaucoma, blind parts of the visual field contribute to the diagnosis but - once established – not to progression detection; they only increase testing time. The aims of this study were to describe the persistenceandspatialdistributionofblindtestlocationsinstandardautomatedperimetryinglaucomaandtoexplorehow theomissionofpresumedblindtestlocationswouldaffectprogressiondetection. Methodology/Principal Findings: Data from 221 eyes of 221 patients from a cohort study with the Humphrey Field Analyzerwith30–2gridwereused.Patientswerestratifiedaccordingtobaselinemeandeviation(MD)insixstrataof5dB widtheach.Forone,two,threeandfourconsecutive,0dBsensitivitiesinthesametestlocationinaseriesofbaseline tests,themedianprobabilitiestoobserve,0dBagainintheconcerningtestlocationinafollow-uptestwere76,86,88and 90%, respectively. For ,10 dB, the probabilities were 88, 95, 97 and 98%, respectively. Median (interquartile range) percentagesoftestlocationswiththreeconsecutive,0dBsensitivitieswere0(0–0),0(0–2),4(0–9),17(8–27),27(20–40)and 60(50–70)%forthesixMDstrata.Similarpercentageswerefoundforasubsetoftestlocationswithin10degreeeccentricity (P.0.1 for all strata). Omitting test locations with three consecutive ,0 dB sensitivities at baseline did not affect the performanceoftheMD-basedNonparametricProgressionAnalysisprogressiondetectionalgorithm. Conclusions/Significance: Test locations that have been shown to be reproducibly blind tend to display a reasonable blindness