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PubMed2002

Structure and function evaluation (SAFE): I. criteria for glaucomatous visual field loss using standard automated perimetry (SAP) and short wavelength automated perimetry (SWAP).

PURPOSE: To develop criteria for detecting glaucomatous visual field loss for standard automated perimetry (SAP) and short wavelength automated perimetry (SWAP). DESIGN: Longitudinal observational study. METHODS: Three populations were evaluated: (1) 348 normal subjects (348 eyes) were tested to develop normative databases and statistical analysis packages for SAP and SWAP. (2) An independent group of 47 normal subjects (94 eyes) with 4 years of longitudinal follow-up was evaluated to determine specificity of different criteria. (3) A group of 298 patients (479 eyes) with elevated intraocular pressure and normal baseline SAP visual fields were evaluated to determine the sensitivity of different criteria for detecting early glaucomatous visual field loss. RESULTS: Six criteria demonstrated high specificity for correctly identifying eyes with normal visual fields (98%-100%) for both SAP and SWAP: (1) a pattern standard deviation (PSD) worse than the normal 1% level, (2) a glaucoma hemifield test (GHT) "outside normal limits," (3) one hemifield cluster worse than the normal 1% level, (4) two hemifield clusters worse than the normal 5% level, (5) four abnormal (P <.05) locations, (6) five abnormal locations (P <.05) on the pattern deviation probability plot. For all criteria, confirmation on a second visual field was required for high specificity. The GHT "outside normal limits," two hemifield clusters worse than the normal 5% level and four abnormal (P <.05) test locations on the pattern deviation probability plot provided the highest percentages of conversion from a normal to a glaucomatous visual field. CONCLUSIONS: Criteria based on the GHT, GHT hemifield clusters, and the pattern deviation probability plot provide high sensitivity and specificity for detecting early glaucomatous visual field changes.

Adolescent↗
PubMed2000

Comparison between Tendency-Oriented Perimetry (TOP) and octopus threshold perimetry.

OBJECTIVE: To compare the results obtained by a new ultra-short automated perimetry test known as Tendency-Oriented Perimetry (TOP), which is an algorithm based on estimation of thresholds from information gathered from adjacent points with those obtained by a standard bracketing approach. TOP is designed to save up to 1/5 of the time taken by standard strategy by presenting each stimulus once on each location (instead of 4 to 6 times per location with the standard technique) and reaching a final threshold estimate by gathering information from responses to adjacent locations. DESIGN: Prospective, multicenter, observational comparative case series. PARTICIPANTS/METHODS: Four academic institutions provided data from testing 57 subjects, 15 with a normal ocular exam and 42 with a variety of visual field abnormalities. A total of 228 visual fields were analyzed. Two examinations of standard thresholding testing (Octopus program 32) and two examinations of the TOP program were obtained in each subject the same day. MAIN OUTCOME MEASURES: Comparison of global indices such as mean deviation (MD), square root of loss of variance (sLV), topographical defects, point by point differences, reproducibility, sensitivity/specificity, and time required to complete the test. RESULTS: Correlation coefficient of global indices between both tests was high, with mean deviation of r = 0.97 (SE[YX] +/- 1.65 decibels) and square root of loss variance of r = 0.93 (SE[YX] +/- 1.10 dB). Mean sensitivity tended to be 1 dB higher while MD tended to be 1 dB lower with TOP strategy. Reproducibility was equally good between both tests for threshold determination as well as for all global indices (MS, MD per quadrant, and LV). Cluster criteria for abnormality demonstrated TOP versus 32: sensitivity of 89/87; specificity of 90/77; positive predictive value of 96/91; negative predictive value of 75/68; and accuracy of 89/84. Mean time taken by this beta version of TOP was 4.05 minutes standard deviation +/- 0.55 versus the standard 32 version taking 14.65 minutes standard deviation +/- 3.75. CONCLUSIONS: TOP was four times faster than the traditional full-threshold technique and was successful in detecting visual field abnormalities. Defects with TOP tended to be smaller, shallower, and with softer edges than with standard approach. TOP could prove an alternative to traditional perimetric techniques.

Adult↗
PubMed1999

Correlation between high-pass resolution perimetry and standard threshold perimetry in subjects with glaucoma and ocular hypertension.

PURPOSE: To evaluate the correlation between High-Pass Resolution Perimetry (HRP) and standard threshold perimetry in patients with glaucoma or ocular hypertension. METHODS: 31 glaucomatous patients and 37 ocular hypertension subjects with previous perimetric examination experience were consecutively recruited and only one eye for each patient was selected at random. Glaucomatous patients were classified as having primary open angle glaucoma when they had an abnormal visual field and/or an abnormal optic nerve head (ONH)/retinal nerve fiber layer (RNFL) typical of glaucoma, open angle at gonioscopy and no clinically apparent secondary cause for their glaucoma. Ocular hypertension subjects were defined as having intraocular pressure >21 mm Hg on no treatment, normal visual field, normal ONH and RNFL, elevated intraocular pressure without any treatment. All the subjects were examined with Humphrey Field Analyzer (HFA) 640, 'program central 30-2' (Humphrey Systems, San Leandro, CA, USA) and with High-Pass Resolution Perimeter (HRP), Ophthimus version 2.4,'ring program' (Nikon-HighTech Vision, Goteborg, Sweden). Visual field indices were obtained with both systems: for HFA mean deviation (MD), corrected pattern standard deviation (CPSD) and short term fluctuation (SF), while for HRP global deviation (GD), local deviation (LD), form index (FI) and neural capacity (NC). The data were analyzed by descriptive analysis, Student's t test with Bonferroni's correction or Mann-Whitney non-parametric test and Pearson or Spearman's correlation coefficient. RESULTS: A significant correlation was found between MD and GD (r = -0.81), CPSD and LD (r = 0.87), PSD and LD (r = 0.72). NC was significantly correlated with MD (r = 0.76), GD (r = -0.94). FI was significantly correlated with PSD (r = -0.58), CPSD (r = -0.72), LD (r = -0.56). When the same data were analyzed for the glaucomatous group only, similar results were found; in the ocular hypertensive group no significant correlation was found except between NC and MD (r = 0.52). CONCLUSION: HRP indices vary comparably with HFA indices. Parameters as NC and FI were significantly correlated with standard visual field indices of both HFA and HRP. Although the clinical applications for FI are not clear yet, NC could detect both early glaucomatous damage and age related changes.

Disease Progression↗
PubMed2001

Scanning laser polarimetry versus frequency-doubling perimetry and conventional threshold perimetry: changes during a 12-month follow-up in preperimetric glaucoma. A pilot study.

PURPOSE: To evaluate the possibility for detecting the progression in preperimetric primary open angle glaucoma (POAG) using scanning laser polarimetry (SLP), frequency-doubling technology (FDT), and conventional automated perimetry (AP). PATIENTS AND METHODS: 22 eyes of 11 preperimetric POAG patients were evaluated using SLP (Nerve Fiber Analyzer, GDx), AP (Humphrey 24-2 threshold test) and FDT (30 degrees threshold test). All eyes had intraocular pressure (IOP) higher than 21 mmHg before treatment, but were consistently lower than 22 mm Hg with unchanged topical medication before and during the study. At the initial evaluation session optic nerve heads showed mild glaucomatous changes but the visual fields were normal (MD better than 2.0 dB, Glaucoma Hemifield Test: within normal limits or borderline). AP and FDT measurements were repeated 6 months later, and all three tests were repeated 12 months after the first investigation. RESULTS: IOP, AP and FDT measurements showed no statistically significant changes during the 12-month follow up period. In contrast to this, a tendency for a glaucomatous type decrease was seen with SLP in the retinal nerve fibre layer (RNFL) thickness parameters (mean superior and inferior sector thickness values, ellipse average thickness and maximal modulation). The mean decrease of RNFL thickness in the superior and inferior sectors was 2.77 microm and 2.48 microm, respectively. Using the two-way nested ANOVA, which considers the relation between the right and left eyes of the subjects, the decrease was statistically significant (p=0.021) for the inferior sector RNFL thickness. CONCLUSION: The results suggest that scanning laser polarimetry is a useful technique to detect and measure glaucomatous progression in early glaucoma. Scanning laser polarimetry of the RNFL may help to detect and quantify early progression even if worsening is not seen with perimetry and FDT tests.

Adult↗
PubMed2001

[Prospective randomized comparative study of frequency doubling perimetry vs standard automated perimetry in patients with glaucoma].

AIM: To compare frequency doubling perimetry (FDP) versus standard automated perimetry in glaucoma. To evaluate the reproducibility of both methods. PATIENTS AND METHODS: All the patients were tested (full threshold test) twice with both FDP (N-30) and Humphrey Field Analyzer II model 750 (HFA) (30-2 procedures) in random sequence, within one day. The parameters mean deviation (MD), pattern standard deviation (PSD) and measured thresholds per quadrant and center areas were evaluated for FDP/HFA comparison in 45 glaucoma patients. The same parameters were used for testing the reproducibility of FDP (n = 46) and HFA (N = 39). Additionally, the center and each quadrant area were checked for any deviation in the total deviation probability plots. For statistical analysis Kappa coefficients and Bland/Altman plots were used. RESULTS: An average MD (FDP vs HFA) of -7.3 +/- 5.8 dB vs -8.9 +/- 7.6 dB and PSD of 6.9 +/- 2.4 dB vs 6.5 +/- 3.6 dB were found. Kappa coefficients denote marginal accordance (kappa: 0.11-0.38) for area deviations. In a total of 225 areas HFA detected 191 deviations and FDP 165. HFA measured more negative deviation compared with FDP in the case of MD < -15 dB. The reproducibility was 0.98 (MD) and 0.92 (PSD) for FDP and 0.98 (MD) and 0.95 (PSD) for HFA (95% confidence interval). CONCLUSIONS: There was great conformity between FDP and HFA in glaucoma patients. HFA detected more deviations in the total deviation probability plots than FDP. There was a high reproducibility of both methods. FDP is an appropriate tool for detecting visual field loss in glaucoma patients.

Adult↗
PubMed2003

Concordance of high-pass resolution perimetry and frequency-doubling technology perimetry results in glaucoma: no support for selective ganglion cell damage.

PURPOSE: To compare the results of frequency-doubling technology perimetry (FDT), assumed to test the magnocellular visual pathway, and high-pass resolution perimetry (HRP), assumed to test the parvocellular visual pathway, in patients with ocular hypertension or glaucoma. PATIENTS AND METHODS: Forty-eight consecutive patients with glaucoma or ocular hypertension, covering the entire range of optic nerve function from normal to severely damaged, were examined on the same day using FDT and HRP. RESULTS: There was a linear correlation between both global and local indices in FDT and HRP (r = -0.84 P<0.0001 and r = 0.8 P<0.001, respectively). The HRP and FDT classifications agreed in 32 of the 48 (67%) eyes (Cohen kappa = 0.5). There was no significant difference between the ability of the different techniques to detect abnormality. CONCLUSION: The observations in the present study indicate either that both cell populations are similarly affected by glaucomatous damage or that both methods measure activity in the same cell populations.

Adult↗
PubMed2006

Sensitivity and specificity of frequency-doubling technology, tendency-oriented perimetry, SITA Standard and SITA Fast perimetry in perimetrically inexperienced individuals.

PURPOSE: To evaluate the sensitivity and specificity of the screening modes of frequency-doubling technology (FDT), tendency-oriented perimetry (TOP), SITA Standard (SS) and SITA Fast (SF) in perimetrically inexperienced individuals. METHODS: One eye of 64 glaucoma patients and 53 normal subjects who had never undergone automated perimetry were tested with programs C-20-5 (FDT), G1 (TOP) and 24-2 (SS and SF). The gold standard for glaucoma was the presence of a typical glaucomatous optic disc appearance on stereoscopic examination (judged by a glaucoma expert), and intraocular pressure (IOP) > 21 mmHg. The test order among strategies was randomized for each subject. To define an abnormal visual field, we applied three criteria for SS and SF and two criteria for TOP and FDT, all of which have been previously described in the literature. Sensitivities and specificities among the different criteria were compared using the Cochran test. RESULTS: Frequency-doubling technology showed the shortest mean test duration, followed by TOP, SF and SS (p < 0.05). Sensitivity ranges were 87.5-89.1% for SS, 92.2-93.8% for SF, 87.5-89.1% for TOP, and 82.8-85.9% for FDT (p = 0.34). Specificity ranges were 73.6-83% for FDT, 56.6-62.3% for TOP, 60.4-69.8% for SF and 66.0-71.7% for SS. The specificity obtained with criterion 2 for FDT (based on the presence of two or more abnormal locations regardless of the severity of abnormal points) was higher than those measured with the other strategies (p < 0.01). CONCLUSION: When testing individuals with no perimetric experience, moderate sensitivities and specificities should be expected, regardless of the strategy chosen.

Adult↗
PubMed1988

Comparative evaluation of oculokinetic perimetry and conventional perimetry in glaucoma.

Oculokinetic perimetry is a new method of visual field assessment in which the patient moves the eye around a central static target to look sequentially at an array of numbers. When fixation on a number is accompanied by disappearance of the central target, that number is deleted from a recording chart. Inversion of the recording chart gives a plot of the central visual field. In this study we have shown that in 64 eyes of 37 patients, with unequivocal field loss attending a glaucoma clinic, the test is efficient and reliable when compared with conventional static (Dicon 3000) and kinetic (Tübingen Oculus) field tests. The results were identical in 88% of eyes tested and approximately comparable in another 6%. Quantitative equivalent targets for the different methods are described. Oculokinetic perimetry was carried out by a previously untrained person, and it is suggested that this new method merits further study as a screening device for glaucoma in the community.

Adult↗
PubMed1991

Pituitary adenomas: automatic static perimetry and Goldmann perimetry. A comparative study of 345 visual field charts.

In a series of 81 cases of pituitary adenoma 345 charts of visual field performed with static automatic perimetry (AP) on the Vision Monitor and Goldmann perimetry (GP) were compared. Generally both methods were equivalent in the detection of chiasmal compression. The charts were divided into two groups: (A) 208 charts and (B) 137 charts according to the number of isoptres investigated: two (V4, 112) or three (V4, 112, 12). In group A the AP was more often altered than the GP, and the difference was statistically significant (p less than 0.001). In group B the GP seemed more effective, but the number of questionable cases was greater and the difference was not statistically significant. When the most internal isoptre of GP was outside the central 30 degrees, AP was more often abnormal (29%) than GP (2.2%), and the difference was statistically significant (chi 2, p less than 0.001). Within the central 30 degrees the GP seemed more often to be altered (23% of cases) than the AP (19.4%), but one-third of the cases were questionable. Within the central 30 degrees both techniques gave identical results and there was no statistically significant difference. The discrepancies between both static and kinetic techniques are an argument for their complementary use.

Adenoma↗
PubMed2005

Subclinical visual involvement in multiple sclerosis: a study by MRI, VEPs, frequency-doubling perimetry, standard perimetry, and contrast sensitivity.

PURPOSE: To evaluate the effectiveness of visual evoked potentials (VEPs), frequency-doubling perimetry (FDP), standard achromatic perimetry (SAP), contrast sensitivity (CS) test, and magnetic resonance imaging (MRI), isolated or in combination, in detecting subclinical impairment of visual function in multiple sclerosis (MS). METHODS: Twenty-two eyes of 11 patients affected by clinically definite MS, without a history of optic neuritis and asymptomatic for visual disturbances, underwent full ophthalmic examination and, in addition, VEPs, FDP, SAP, CS, and MRI. Abnormal results were taken to be as follows: for VEPs, a P100 latency >115 ms; for FDP, abnormal mean deviation (MD) or pattern SD (PSD); for SAP, abnormal MD or PSD; for CS, abnormal CS at one spatial frequency, at least; and for MRI, evidence of at least one demyelinating plaque along the visual pathway. RESULTS: VEPs showed abnormal results in 12 eyes (54.4%), FDP in 11 (50%), SAP in 14 (63.6%), CS in 17 (77.1%), and MRI in 16 (72.7%). In only two (9.1%) eyes of the same patient was no abnormality found. No single test detected all the abnormal eyes. Four (18.2%) eyes had pure optic nerve involvement and the remaining 16 (72.7%) had both pre- and postchiasmal involvement. CONCLUSIONS: In patients affected by clinically definite MS without history of optic neuritis and no visual symptoms, there is a large prevalence of visual pathway involvement that can be diagnosed only by performing multiple tests. The comparison of the tests is also useful to detect the presence of multiple lesions in the same patient.

Adolescent↗
PubMed2002

Sensitivity and specificity of frequency doubling perimetry in neuro-ophthalmic disorders: a comparison with conventional automated perimetry.

PURPOSE: Frequency-doubling technology (FDT) perimetry was developed as a screening test for glaucoma. Patients with damage to the neuro-ophthalmic sensory visual pathways have different patterns of visual loss than patients with glaucoma. The current study was designed to determine the sensitivity and specificity of FDT as a screening test, compared with conventional automated perimetry (CAP) in neuro-ophthalmic disorders and to test the extent to which it may isolate the M(y) cells. METHODS: FDT and CAP were performed in 97 patients with sensory neuro-ophthalmic disorders and 42 subjects from the general population. The total and pattern-deviation probability plots for test loci common to the two perimetric tests were compared. The gold standard was an unequivocal clinical diagnosis. RESULTS: The sensitivity of FDT was 81.3%, with a specificity of 76.2%. The difference in sensitivity and specificity of CAP, 87.5% and 81.0%, respectively, was not statistically significant (by chi(2) test). In subjects with optic neuropathies, the similarity of the defect shown on FDT and CAP was judged good or fair in 62 of 72 cases. The extent of the defect as seen with FDT and CAP was equal in 41 of 72 cases, more extensive with FDT in 12, and more extensive with CAP in 19. In the patients with hemianopia, scattered abnormal test locations with FDT testing masked the hemianopic nature of the defect in 15 of 25 patients. Also, test locations along the vertical midline in densely hemianopic areas were seen with FDT testing in some patients with hemianopia, probably due to light scatter across the vertical midline and into the uninvolved hemianopic field. CONCLUSIONS: FDT has sensitivity and specificity similar to that of CAP for detecting visual field defects in patients with optic neuropathies. However, defects in patients with hemianopias may be missed because of the presence of scattered abnormal test locations and failure to detect test locations along the vertical meridian. The defects demonstrated by both tests in patients with optic neuropathies are similar in number, extent, and shape of the defects. This suggests FDT may not be isolating the magnocellular (M) cells with nonlinear responses to stimulus contrast (M(y) cells) in patients with visual loss.

Adult↗
PubMed2002

[Computer perimetry--rapid TOP (tendency oriented perimetry) and normal threshold methods in clinical practice--comparison of results].

Computer perimetry is constantly being developed but still remains a subjective examination method. The patient's cooperation plays an important part and therefore examination strategies are improved to make it possible to obtain the most accurate possible results during the shortest possible examination time. The author presents an account on the comparability of results of rapid TOP strategy (Tendency Oriented Perimetry) and normal threshold strategy with programme G2 on the perimeter OCTOPUS 101. It involves the retrospective evaluation of 73 visual fields which were divided into four groups according to the achieved retinal sensitivity during examination with TOP strategy and with normal threshold strategy. The author compared the obtained parameters MD and LV, she compared the sites of defects of retinal sensitivity in both strategies and calculated the time saved by rapid TOP strategy. High comparability was achieved in group 1 with normal retinal sensitivity in both strategies and also in group 4 with abnormal retinal sensitivity in both strategies. In groups 2 and 3 comparability was not proved (group 2--abnormal retinal sensitivity in TOP and normal retinal sensitivity in normal threshold strategy, group 3--normal retinal sensitivity in TOP and abnormal retinal sensitivity in normal threshold strategy). In these groups we may assume a higher ratio of the so-called learning effect or conversely fatigue and poorer cooperation of the patients during the lengthy examination by normal threshold strategy. The localization of defects agreed in group 4 in 83.3% and in the other groups it was not compared (group 1 practically without defects, in groups 2 and 3 the results were not comparable). The total time saved with TOP strategy was 75.8%, the mean examination time with TOP strategy was 3 minutes 27 seconds, with normal threshold strategy 14 minutes 17 seconds. With regard to the significant time saving the programme G2 with TOP strategy can be considered suitable for patients with glaucoma, with intraocular hypertension and with suspected glaucoma but it can be also used as a screening method with quantitative results for other situations.

Adult↗
PubMed2006

[A comparative analysis of standard automated perimetry and short wavelength automated perimetry in early diagnosis of glaucoma].

PURPOSE: To assess the concordance between standard automated perimetry (SAP) and short wavelength automated perimetry (SWAP). To analyze comparatively the early detection and the extent of visual field defects in glaucoma suspects and in early glaucoma. METHOD: A prospective, randomized study that included 55 patients (107 eyes), glaucoma suspects or with early glaucoma who were randomly subject to both SAP and SWAP; the examinations were repeated at 3 and 6 months in order to establish that the visual field defects were real. The studied parameters were the mean value of MD and PSD in the two techniques, the correlation between the results (global and on patients subgroups), the percentage of patients in which the defects were larger, deeper or new defects were found when examined in SWAP. RESULTS: There was no statistically significant difference in the MD value between the two methods (-3.42 +/- 5.17 dB in SWAP, -2.83 +/- 4.84 dB in SAP, p = 0.14); the PSD value was significantly higher (p < 0.0001) in SWAP (3.63 +/- 1.36 dB) than in SAP (2.66 +/- 1.97 dB). There was a high correlation of the MD and PSD values between the two techniques; the highest correlation appeared in POAG patients. The SWAP test has evidenced visual field defects in 10.1% of eyes with normal SAP tests and also larger and deeper defects in 18.7% of cases. CONCLUSIONS: The SWAP and SAP results were concordant; the visual field defects were earlier detected, appeared larger and deeper in SWAP than in SAP.

Adolescent↗
PubMed1985

Matched comparison of Goldmann perimetry and automated two-zone suprathreshold Dicon perimetry in open-angle glaucoma.

Goldmann kinetic perimetry is a commonly used measurement of visual field defects in open-angle glaucoma. The many new automated perimeters should be assessed against this common standard with a view to comparing their sensitivity in making clinical judgments of the presence and extent of a visual field defect. This study compares the Coopervision Dicon 2000 perimeter and its automated two-zone suprathreshold program with Goldmann kinetic perimetry in 26 patients with open-angle glaucoma. The two-zone suprathreshold testing program on the Coopervision Dicon perimeter was found to be at least as sensitive as the Goldmann kinetic perimeter in identifying the presence and extent of visual field defects in open-angle glaucoma.

Glaucoma, Open-Angle↗
PubMed2002

Sensitivity and specificity of frequency-doubling technology, tendency-oriented perimetry, and Humphrey Swedish interactive threshold algorithm-fast perimetry in a glaucoma practice.

PURPOSE: To evaluate the sensitivity and specificity of the screening mode of the Humphrey-Welch Allyn frequency-doubling technology (FDT), Octopus tendency-oriented perimetry (TOP), and the Humphrey Swedish Interactive Threshold Algorithm (SITA)-fast (HSF) in patients with glaucoma. DESIGN: A comparative consecutive case series. METHODS: This was a prospective study which took place in the glaucoma unit of an academic department of ophthalmology. One eye of 70 consecutive glaucoma patients and 28 age-matched normal subjects was studied. Eyes were examined with the program C-20 of FDT, G1-TOP, and 24-2 HSF in one visit and in random order. The gold standard for glaucoma was presence of a typical glaucomatous optic disk appearance on stereoscopic examination, which was judged by a glaucoma expert. The sensitivity and specificity, positive and negative predictive value, and receiver operating characteristic (ROC) curves of two algorithms for the FDT screening test, two algorithms for TOP, and three algorithms for HSF, as defined before the start of this study, were evaluated. The time required for each test was also analyzed. RESULTS: Values for area under the ROC curve ranged from 82.5%-93.9%. The largest area (93.9%) under the ROC curve was obtained with the FDT criteria, defining abnormality as presence of at least one abnormal location. Mean test time was 1.08 +/- 0.28 minutes, 2.31 +/- 0.28 minutes, and 4.14 +/- 0.57 minutes for the FDT, TOP, and HSF, respectively. The difference in testing time was statistically significant (P <.0001). CONCLUSIONS: The C-20 FDT, G1-TOP, and 24-2 HSF appear to be useful tools to diagnose glaucoma. The test C-20 FDT and G1-TOP take approximately 1/4 and 1/2 of the time taken by 24 to 2 HSF.

Aged↗
PubMed2000

Comparison between relative dispersion analysis of high-pass resolution perimetry and standard threshold perimetry.

PURPOSE: To evaluate the correlation of the dispersion index (DI) of relative dispersion analysis (RDA), a new high-pass resolution perimetry (HRP) index, with other HRP indices and those of the Humphrey standard threshold perimeter (STP) parameters. METHODS: Sixty-eight eyes were randomly recruited. Thirty-one eyes were classified as glaucomatous (high intraocular pressure, abnormal visual field and/or optic disc) and 37 as ocular hypertensives (high intraocular pressure, normal visual field, normal optic disc). All the subjects were examined with Humphrey Perimeter, program 30-2, and HRP. The HRP data were also analysed with the RDA program. Statistical analysis was performed with Student's t-test, Pearson's r correlation coefficient, Mann-Whitney nonparametric test and Spearman correlation coefficient when appropriate. RESULTS: Within the entire sample significant correlations were found between the RDA index (DI) and all the HRP indices (p < 0.001) and corrected pattern standard deviation (p < 0.01), pattern standard deviation (PSD) (p < 0.01), mean deviation (p < 0.05) and short-term fluctuation (p < 0.05) of STP. A stronger correlation was found in glaucomatous patients. In subjects with ocular hypertension DI was only weakly correlated with PSD, local deviation and form index. No difference in DI was found between glaucoma and ocular hypertension. CONCLUSION: The DI of HRP has the theoretical capacity to detect localised inhomogeneity of retinal sensitivity, but at present our data do not support this hypothesis. Before any clinical applications of this index further studies are needed.

Adult↗
PubMed2004

[Correlation between glaucomatous hemifield scotomas in white-on-white perimetry and blue-on-yellow perimetry using the oculus twinfield perimeter].

INTRODUCTION: The "Twinfield Perimeter" can be used for white-on-white and blue-on-yellow perimetry. Since the normative database which is used fort the calculation of the visual field indices for both strategies is based on data from white-on-white perimetric evaluations of normal persons using the "Tübinger Automatikperimeter", the validity of this approach may be questioned. In the study presented here we compared the correlation of white-on-white (W/W) and blue-on-yellow (B/Y) visual fields in glaucoma patients with a hemifield scotoma. PATIENTS AND METHODS: One eye each from 40 normal persons and from 40 glaucoma patients was included in the study. Both W/W-perimetry and B/Y-perimetry was performed using the "Twinfield Perimeter" (Oculus, Modell 56 900, Wetzlar, Germany). From the sensitivity values determined with the 30/2 strategy, we calculated the mean sensitivity (MS), mean deviation (MD) of the total field and of both hemifields (HMS bzw. HMD) separately. Normal values derived from the normal persons of the present study were compared with the normal values used by the Twinfield Perimeter. To determine the strength of the association of B/Y- and W/W-hemifield scotoma, we calculated the linear correlation coefficient (Pearson's R) between the HMD of B/Y und W/W-hemifields. RESULTS: MS of both glaucoma patients and normal persons were determined to be significantly higher for B/Y visual fields (14.17 +/- 4.15 and 20.97 +/- 3.56) when compared with W/W-visual fields (10.70 +/- 3.19 or 15.98 +/- 3.3). When normal values from the Twinfield Perimeter were applied, the MD for normal persons was calculated to be - 4.69 +/- 3.22 compared with 0 +/- 3.6 when the MD was calculated with the normal values from the study. For both normal values we confirm a strong correlation between HMD-values of W/W- and B/Y-visual fields. CONCLUSIONS: Since the mean sensitivity of B/Y visual fields is higher than the mean sensitivity of W/W visual fields, calculations of the MD of B/Y visual fields of glaucoma patients should be based on normative databases which are derived from B/Y visual fields of normal persons.

Aged↗
PubMed2006

Prediction of future scotoma on conventional automated static perimetry using frequency doubling technology perimetry.

AIM: To see if scotoma detected with frequency doubling technology (FDT) is confirmed by Humphrey field analyser (HFA) 3 years later. METHODS: Subjects were first examined with the screening C-20-1 program of FDT. The visual field was examined annually for 4 years using HFA program C30-2. The central 58 test points in HFA were assigned to one of the 17 clusters corresponding to FDT test points. Each cluster was represented as the lowest probability symbol of total deviation (TD) of the HFA test points included in the cluster. Clusters were graded normal, suspected scotoma, and scotoma depending on probability of TD-5% or more, 5%-1%, less than 1%, respectively. Relative risk (RR) of abnormality on FDT for future scotoma on HFA was estimated. RESULTS: 80 eyes of 42 patients were followed up for 4 years. While 4.0% of normal clusters of HFA with normal FDT results developed into scotoma cluster, 20.8% of normal clusters with abnormal FDT results developed into scotoma cluster with HFA at the third year. RR for future scotoma was 5.24 (95% CI, 2.75 to 10.0, p<0.05). CONCLUSION: An abnormal result in FDT shows a high risk of future scotoma on HFA after 3 years even if the original HFA perimetry showed normal results.

Adult↗