【作者】 吴劲松；

【导师】 王竫华；

【作者基本信息】 青岛大学 ， 眼科学， 2003， 硕士

【摘要】 目的： 通过一系列的临床实验与调查，研究电脑视野检查(Octopus101视野计)中假阴性反应的性质。分为三部分： 一，探讨单侧青光眼缺损患者电脑视野检查假阴性反应率的眼间差异及相关因素； 二，研究正常人、青光眼患者、有视野缺损的非青光眼患者间的假阴性反应率差异及与视野指数的关系； 三，探讨随访检查中，稳定的青光眼患者的假阴性反应率的变化和相关视野指数的变化规律。 方法： 一，选取2000年1月至2002年10月在青岛大学医学院附属医院眼科视野检查室行Octopus101静态视野视野检查的单侧青光眼视野缺损患者66例进行研究；比较患者眼间视力、眼压、杯盘比、检查时间及假阴性反应率、假阳性反应率、平均偏差、平均光敏感度的差异，并分析了的假阴性反应率的相关因素。 二，对30例正常人，68例青光眼患者，21例有视野缺损的非青光眼患者进行前瞻性研究。每位患者只随机取一眼纳入检查范围。对每位受检者行Octopus101静态视野检查(2001年10月到2002年10月间)。检查程序选择G2。分析各组受检者假阴性反应率的差异及其相关因素及无关因素。 三，对正常人和青光眼患者各25人进行了前瞻性的视野随访对比观察。每位受检者均随机取一眼纳入研究。在8月内(2001年10月到2002年10月间)行3-4次连续Octopus101静态视野检查。分析两组人群假阴性反应率及相关因素的变化。 结果： 一，视野缺损眼与视野正常眼的FN差异显著(P＜0.01)，并且与检查的先后顺序无关，而二眼在视力、眼压、瞳孔直径等方面无明显差异(P＞0.05)；视野缺损眼MD与FN相关，在MD越高的眼，FN越高；而正常眼MD与FN无关。 二，不同患者组间视力、眼压及瞳孔直径的差别无显著性(P＞0.05)。各组的FN均与这此因素无明显相关。正常人组的短期波动小于青光眼组和有视野缺损的非青光眼患者。假阴性反应在时间上呈大致均匀分布。三，随访检查中，稳定的青光眼患者的FN仍高于正常人，并且与平均缺损等因素密切相关;稳定的青光眼患者的FN亦相对稳定，但有少数患者出现较大波动。结论: ·，假阴性反应率作为可靠性指数来监测受检者的专心程度、注意力集中程度，是不合适的。 几，假阴性反应率与平均偏差、短期波动及绝对暗点数量等密切相关，与长期波动也有定的关联，从检查原理推测，其发生与绝对缺损边缘区阐值波动性增大有关。 几，假阴性反应率可以粗略地反映视野缺损尤其是局部较深缺损的状况，在视野检查及视野随访中有一定的参考价值。更多还原

【Abstract】 Objective:To study the properties of false-negative responses of visual field tests on Octopus 101 perimetry through a series of clinical delectations and investigations.The study was divided into three independent portions:1, To detect intereye differences of false negative responses rate(FN) and mean deviation(MD) in glaucoma patients with unilateral visual field defect. 2,To study the discrepancy of FN between normal subjects,glaucoma patients and non-glaucoma patients with visual field damage,and relationships between FN and visual field indexes.3,To investigate stabilization of FN in glaucoma patients and chang of the correlation between FN and visual field defect. Methods:1, Glaucoma patients with nomal visual field in one eye and damaged in another who performed automated perimetry between Jan 2000 and Oct 2002 were involved in this study. Intereye differences of false negative FN and MD were analyzed; 2,A prospective study was performed on NS(30cases),GP(68 cases),NGP(21 cases).One eye was selected at radom for test.OctopuslOl perimetry was performed on each subject with programme G2(Oct2001-Oct2002).Diffrerences of FN between groups and correlation factors were analyzed .3,A prospective follow-up study was carried out on NS(25 cases) and GP(25 cases).All subjects handled 3-4 successive automated perimetry in a 8-months duration (Oct2001-Oct2002) and indexes observed similar to part 2.Results:1, FN between nomal eyes and damaged eyes was significant different(P<0.001),and this kind of differences has no relationship with consequence of the tests.No significant differences were found in visual acuity,IOP,pupil diameter intereyes(P>0.05). 2,No significant differences of visual acuity,IOP,and pupil diameter was found between NS,GP,and NGP(P>0.05).There was no correlation between FN and these factors for all groups.FN,SF of NS group were far lower than those of GP and NGP(P<0.01).Ingeneral,the distributing of false negative responses was equalence in every time section.3,Relative tranquilization was kept for FN in a 8-months period follow-up tests,butcounterpoise was also observed in several patients and MD changed meantime.Conclusions:1,FN reflects visual field state of glaucoma patients in some extent while it is in-properiate to take it as a predict index of attentiveness of the patients.2,Closely relationship were found between FN and MD,SF,ADL and LF in someextent.To explain it from test principle ,it was linked to the increasing of the thresholdvariation in the border of the absolute visual field defect.3, FN could be a indication of visual field defect .especially local visual field with deepdepression.更多还原