PDF(Pubmed)
Abstract：
A timely detection of visual hemifield deficits (VHFDs; hemianopias or quadrantanopias) is critical for both the diagnosis and treatment of stroke patients. The present study determined the sensitivity and specificity of four qualitative visual field tests, including face description, confrontation tests (finger wiggle), and kinetic boundary perimetry, to screen large and dense VHFDs in right-brain-damaged (RBD) stroke patients. Previously, the accuracy of qualitative visual field tests was examined in unselected samples of patients with heterogeneous aetiology, in which stroke patients represented a very small fraction. Building upon existing tests, we introduced some procedural ameliorations (incl. a novel procedure for kinetic boundary perimetry) and provided a scoresheet to facilitate the grading. The qualitative visual field tests\' outcome of 67 consecutive RBD stroke patients was compared with the standard automated perimetry (SAP; i.e., reference standard) outcome to calculate sensitivity and specificity, as well as positive and negative predictive values (PPV and NPV), both for each individual test and their combinations. The face description test scored the lowest sensitivity and NPV, while the kinetic boundary perimetry scored the highest. No test returned false positives. Combining the monocular static finger wiggle test (by quadrants) and the kinetic boundary perimetry returned the highest sensitivity and specificity, in line with previous studies, but with higher accuracy (100% sensitivity and specificity). These findings indicate that the combination of these two tests is a valid approach with RBD stroke patients, prompting referral for a formal visual field examination, and representing a quick, easy-to-perform, and inexpensive tool for improving their care and prognosis.
摘要：
及时检测视觉偏场缺陷（VHFDs；半阿片类或象限阿片类）对于中风患者的诊断和治疗至关重要。本研究确定了四个定性视野测试的敏感性和特异性，包括面部描述，对抗测试(手指摆动)，和动力学边界视野，在右脑受损（RBD）中风患者中筛查大型和密集的VHFDs。以前,定性视野测试的准确性在未选择的患者样本中进行了检查，其中中风患者只占很小一部分。在现有测试的基础上，我们介绍了一些程序改进(包括。一种新的动力学边界视野检查程序），并提供了一个记分表以促进分级。将67例连续RBD卒中患者的定性视野测试结果与标准自动视野检查(SAP；即参考标准)计算灵敏度和特异性的结果，以及阳性和阴性预测值(PPV和NPV)，对于每个单独的测试和它们的组合。面部描述测试得分最低的灵敏度和净现值，而动力学边界视野检查法得分最高。没有测试返回假阳性。结合单眼静态手指摆动测试（通过象限）和动力学边界视野法返回最高的灵敏度和特异性，根据以前的研究，但具有更高的准确性（100％的灵敏度和特异性）。这些发现表明，这两种测试的组合是RBD卒中患者的有效方法，提示转介正式的视野检查，代表一个快速的，易于执行，和廉价的工具来改善他们的护理和预后。
