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At least 109 records · Page 6Linked to original sources
PubMed1998

Comparison between high-pass resolution perimetry and differential light sensitivity perimetry in patients with glaucoma.

PURPOSE: High-pass resolution perimeters such as the Ophthimus (High Tech Vision, Malmö, Sweden) may provide an easier, faster assessment of the visual field than conventional perimeters such as the Humphrey (Humphrey Instruments Inc., San Leandro, CA, U.S.A.), which is based on differential light sensitivity. The Ophthimus provides global indices and statistical analyses conceptually similar to those produced by the Humphrey. In addition, the Ophthimus provides, as a unique parameter, the estimated neural capacity. PATIENTS AND METHODS: Twenty-one patients with chronic open-angle glaucoma and reliable fields on both Humphrey and Ophthimus testing were evaluated. The results from the two different techniques were compared. RESULTS: The estimated neural capacity was correlated to global deviation and mean deviation at a statistically significant level. There were also correlations between mean deviation and global deviation and between pattern standard deviation and local deviation, but not between retest standard deviation and short-term fluctuation. CONCLUSION: It is not clear at this point if the neural capacity of the Ophthimus provides any clinically useful information over and above global deviation. Mean test time was shorter with the Ophthimus system than the Humphrey. Performance on the reliability indices was better for the Ophthimus. The Ophthimus may prove useful in following patients with glaucoma.

Aged↗
PubMed2001

Incidence and prevalence of short wavelength automated perimetry deficits in ocular hypertensive patients.

PURPOSE: To determine the prevalence and incidence of short wavelength automated perimetry deficits in comparison to standard automated perimetry deficits in patients with ocular hypertension. METHODS: Five hundred eyes of 250 patients with ocular hypertension were recruited into a prospective, longitudinal study and tested with standard automated perimetry and short wavelength automated perimetry annually for 5 years. Both eyes of 60 normal subjects, 21 to 85 years of age, were used to establish normative data for short wavelength automated perimetry and standard automated perimetry. This allowed independent evaluation of left and right eyes of patients. All normal data were corrected for age, and short wavelength automated perimetry results were corrected for lens transmission. The lowest fifth and first percentiles for the normal observers were derived for the 10 glaucoma hemifield test zones for short wavelength automated perimetry and standard automated perimetry. Visual fields were considered outside normal limits if two glaucoma hemifield test zones were below the normal fifth percentile or one glaucoma hemifield test zone was below the normal first percentile. RESULTS: Baseline prevalence of short wavelength automated perimetry and standard automated perimetry deficits were 9.4% and 1.4%, respectively. During the study, incident rates of field loss were 6.2% (1.23% per year) for short wavelength automated perimetry and 5.9% (1.18% per year) for standard automated perimetry. Once abnormal, 80% of short wavelength automated perimetry fields remained abnormal on the next examination, whereas only 45% of abnormal standard automated perimetry fields remained abnormal. New short wavelength automated perimetry deficits in ocular hypertensives were more prominent and more persistent than new standard automated perimetry deficits. CONCLUSIONS: Our findings are consistent with the interpretation that short wavelength automated perimetry deficits occur before standard automated perimetry deficits in glaucoma. The similar incidence rates suggest that both standard automated perimetry and short wavelength automated perimetry are monitoring the same underlying glaucomatous disease process.

Adult↗
PubMed2002

Automated perimetry: a report by the American Academy of Ophthalmology.

OBJECTIVE: The purpose of this document is to summarize and evaluate the effectiveness of new automated perimetry tests and algorithms in diagnosing glaucoma and detecting disease progression. METHODS: A literature search on automated perimetry retrieved over 300 citations from 1994 to 2001, of which 71 were selected as relevant to this assessment. The quality of the evidence obtained from these studies was assessed by the methodologist. RESULTS: The four automated perimetry techniques described in this assessment are short wavelength automated perimetry (SWAP), frequency doubling technology perimetry (FDT), high-pass resolution perimetry (HPRP), and motion automated perimetry (MAP). The algorithms described are Swedish interactive threshold algorithm (SITA) and SITA fast. With the exception of SWAP, these techniques and algorithms reduce testing time and inconsistent patient performance when compared with conventional full threshold testing. CONCLUSIONS: Short wavelength automated perimetry detected visual field loss earlier than standard threshold automated perimetry, with a sensitivity and specificity of about 88% and 92% respectively. However, it is a lengthy, demanding test, is sensitive to media opacities, and has a greater magnitude of long-term fluctuation compared with standard threshold automated perimetry, which make it difficult to assess disease progression accurately. When compared to standard threshold automated perimetry, FDT perimetry showed sensitivity and specificity greater than 97% for detecting moderate and advanced glaucoma, and sensitivity of 85% and specificity of 90% for early glaucoma. As FDT perimetry has a short testing time and is resistant to blur and pupil size, it may be a useful screening tool. In a longitudinal study, high-pass resolution perimetry was more effective than standard threshold automated perimetry in monitoring progressive glaucomatous loss, detecting progression at a median of 12 months earlier in 54% of patients studied. Motion automated perimetry demonstrated usefulness in detecting early glaucomatous visual loss in a longitudinal study. Studies on SITA demonstrated greater sensitivity and reproducibility and less intertest variability when compared to standard full threshold testing and a 50% reduction in testing times. A study comparing standard full threshold, SITA, and SITA fast found a sensitivity of 95% for the first two techniques and 93% for SITA fast. Long-term follow-up studies are needed to assess the ability of these techniques to detect progression of glaucoma over time.

Algorithms↗
PubMed2000

Visual function-specific perimetry for indirect comparison of different ganglion cell populations in glaucoma.

PURPOSE: To compare short-wavelength automated perimetry, frequency-doubling technology perimetry, and motion-automated perimetry, each of which assesses different aspects of visual function, in eyes with glaucomatous optic neuropathy and ocular hypertension. METHODS: One hundred thirty-six eyes from 136 subjects were evaluated with all three tests as well as with standard automated perimetry. Fields were not used in the classification of study groups to prevent bias, because the major purpose of the study was to evaluate each field type relative to the others. Seventy-one of the 136 eyes had glaucomatous optic neuropathy, 37 had ocular hypertension, and 28 served as age-matched normal control eyes. Glaucomatous optic neuropathy was defined by assessment of stereophotographs. Criteria were asymmetrical cupping, the presence of rim thinning, notching, excavation, or nerve fiber layer defect. Ocular hypertensive eyes had intraocular pressure of 23 mm Hg or more on at least two occasions and normal-appearing optic disc stereophotographs. Criteria for abnormality on each visual field test were selected to approximate a specificity of 90% in the normal eyes. Thresholds for each of the four tests were compared, to determine the percentage that were abnormal within each patient group and to assess the agreement among test results for abnormality, location, and extent of visual field deficit. RESULTS: Each test identified a subset of the eyes with glaucomatous optic neuropathy as abnormal: 46% with standard perimetry, 61% with short-wavelength automated perimetry, 70% with frequency-doubling perimetry, and 52% with motion-automated perimetry. In the ocular hypertensive eyes, standard perimetry was abnormal in 5%, short wavelength in 22%, frequency doubling in 46%, and motion in 30%. Fifty-four percent (38/71) of eyes with glaucomatous optic neuropathy were normal on standard fields. However, 90% were identified by at least one of the specific visual function tests. Combining tests improved sensitivity with slight reductions in specificity. The agreement in at least one quadrant, when a defect was present with more than one test, was very high at 92% to 97%. More extensive deficits were shown by frequency-doubling perimetry followed by short-wavelength automated perimetry, then motion-automated perimetry, and last, standard perimetry. However, there were significant individual differences in which test of any given pairing was more extensively affected. Only 30% (11/37) of the ocular hypertensive eyes showed no deficits at all compared with 71% (20/28) of the control eyes (P < 0.001). CONCLUSIONS: For detection of functional loss standard visual field testing is not optimum; a combination of two or more tests may improve detection of functional loss in these eyes; in an individual, the same retinal location is damaged, regardless of visual function under test; glaucomatous optic neuropathy identified on stereophotographs may precede currently measurable function loss in some eyes; conversely, function loss with specific tests may precede detection of abnormality by stereophotograph review; and short-wavelength automated perimetry, frequency-doubling perimetry, and motion-automated perimetry continue to show promise as early indicators of function loss in glaucoma.

Glaucoma↗
PubMedDate not supplied

Influence of blue light spectrum filter on short-wavelength and standard automated perimetries.

PURPOSE: To evaluate the influence of a blue light spectrum filter (BLSF), similar in light spectrum transmittance to the intraocular lens Acrysof Natural, on standard automated perimetry (SAP) and short-wavelength automated perimetry (SWAP). METHODS: Twenty young individuals (< 30 y.o.), without any systemic or ocular alterations (twenty eyes) underwent a random sequence of four Humphrey visual field tests: standard automated perimetry (SAP) and short-wavelength automated perimetry (SWAP) with and without a blue light spectrum filter. All patients had intraocular pressure lower than 21 mmHg, normal fundus biomicroscopy, and no crystalline lens opacity. Foveal threshold (FT), mean deviation (MD), and pattern standard deviation (PSD) indexes obtained from the visual field tests and the difference caused by eccentricity in short-wavelength automated perimetry examinations were analyzed using paired t test. Interindividual variability (standard deviation) was calculated using Pitman's test for correlated samples. RESULTS: Statistically significant reductions in the mean deviation (p < 0.001) and in the foveal threshold (p < 0.001) measured by short-wavelength automated perimetry with the use of the blue light spectrum filter in comparison to short-wavelength automated perimetry without the use of the blue light spectrum filter were observed, but not in standard automated perimetry exams. No other parameters showed statistically significant differences in the short-wavelength automated perimetry and standard automated perimetry tests. Interindividual standard deviation of the test points in the short-wavelength automated perimetry exams increased with eccentricity both with and without the use of the blue light spectrum filter, as sensitivity for inferior and superior hemifields (inferior hemifield minus superior hemifield), but no statistically significant difference in the variability when comparing the use or not of the blue light spectrum filter was noted. When comparing only the four most inferior points and the four most superior points, the inferior-superior difference increases in both situations - without and with the use of the blue light spectrum filter. The difference between without and with the use of the blue light spectrum filter was not statistically significant. CONCLUSION: Statistically significant reductions in mean deviation and foveal threshold in the short-wavelength automated perimetry with the use of the blue light spectrum filter were observed, but not in standard automated perimetry examinations. Additional studies are necessary to determine the influence of intraocular lenses with short-wavelength light filter after cataract extraction on short-wavelength automated perimetry.

Adolescent↗
PubMed1993

Progression of early glaucomatous visual field loss as detected by blue-on-yellow and standard white-on-white automated perimetry.

OBJECTIVE: To determine whether blue-on-yellow perimetry reveals progression of glaucomatous damage before it is evident with standard white-on-white perimetry. DESIGN: A Humphrey field analyzer (Humphrey Instruments, San Leandro, Calif) was modified to perform blue-on-yellow perimetry to isolate and measure the sensitivity of short wavelength-sensitive mechanisms. Participants were tested annually with standard white-on-white automated perimetry and blue-on-yellow automated perimetry for 5 years. PATIENTS: Sixteen patients with early glaucomatous visual field loss in one or both eyes and 62 age-matched normal control subjects. RESULTS: At baseline, 25 (78.1%) of the 32 eyes exhibited larger deficits with blue-on-yellow perimetry, five (15.6%) had equivalent loss with both tests, and two (6.3%) had larger deficits with standard white-on-white perimetry. Seven (21.9%) of the 32 eyes demonstrated evidence of progressive visual field loss with standard white-on-white perimetry in 5 years, while the other 25 eyes (78.1%) were relatively stable. Deficits with blue-on-yellow perimetry were twice as large as deficits with white-on-white perimetry in the stable group and were three to four times as large in the group with progressive field loss. CONCLUSIONS: Blue-on-yellow perimetry is effective in predicting which patients with early glaucomatous visual field loss are most likely to have progressive loss. The rate of progressive loss is greater with blue-on-yellow perimetry than with standard white-on-white perimetry.

Adult↗
PubMed2002

Evaluation of VEP perimetry in normal subjects and glaucoma patients.

PURPOSE: To estimate sensitivity to glaucomatous visual field loss using multifocal visual evoked potential (VEP) perimetry, to compare these findings to those of conventional achromatic perimetry and to determine specificity of VEP perimetry in normal subjects. METHODS: A total of 33 glaucoma patients with known visual field defects in at least one eye on standard computerized perimetry and 33 healthy subjects were tested with VEP perimetry. The glaucoma patients were also tested with standard computerized perimetry using the 30-2 SITA Fast program of the Humphrey Field Analyzer (HFA). Visual evoked potential perimetry classification and VEP probability maps were used to determine the sensitivity and specificity of the technique. RESULTS: Visual evoked potential perimetry classified 68% of all eyes in the glaucoma group (45/66) as pathological; sensitivity increased to 81% (38/47) when considering only those eyes with HFA field defects. It also identified more test locations with significant loss at the p < 5% level in both groups (48% and 37%, respectively) than did HFA, while HFA identified more loss at the higher significance levels p < 2%, and p < 1%. Visual evoked potential perimetry showed more significant loss in eyes with almost normal or slightly damaged standard fields, while HFA identified more significant field loss in eyes with severe conventional field damage. The mean VEP amplitude of the 66 glaucoma eyes was 1.46e(-7) V; it was 1.676e(-7) V for the 66 control eyes. This difference was significant (p = 0.0033), but the overlap between groups was large. Visual evoked potential perimetry classified 42% of the control eyes as 'outside normal limits', and VEP probability maps showed 30.0% of test segments as significantly depressed at the p < 5% level, 10.8% of sites at p < 2%, and 4.6% at the p < 1% level. CONCLUSION: Mean VEP amplitude differed significantly between normal and glaucoma eyes, but the overlap was considerable. Visual evoked potential perimetry falsely classified a large number of normal eyes as pathological and showed many more significantly depressed test locations than expected. Agreement between VEP and standard perimetry was relatively poor for the glaucoma group. Further refinements are needed before VEP perimetry can be regarded as a reliable clinical method of mapping glaucomatous visual fields.

Aged↗
PubMed1999

Comparison of conventional and high-pass resolution perimetry in a prospective study of patients with glaucoma and healthy controls.

OBJECTIVE: To determine whether high-pass resolution perimetry detected glaucomatous visual field progression earlier than conventional perimetry. METHODS: In a prospective longitudinal study, we observed 113 patients with open-angle glaucoma and with early to moderate visual field damage and 119 healthy control subjects. Each subject underwent testing at 6-month intervals using conventional and high-pass resolution perimetry (program 30-2 of the Humphrey Field Analyzer [Humphrey Instruments, Inc, San Leandro, Calif] and the Ring program of the Ophthimus perimeter [Hi-Tech Vision, Göteborg, Sweden], respectively). Our predetermined criterion for progression with conventional perimetry was the presence of at least 4 overlapping nonedge locations outside the fifth percentile for test-retest variability of threshold deviations (defined by the Glaucoma Change Probability Analysis of the Statpac 2 program) in 2 of 3 consecutive visual fields. We employed the identical criterion for progression with high-pass resolution perimetry using our own test-retest variability data. We repeated this procedure in the controls to measure the false-positive rate of progression. RESULTS: Patients were observed for a median of 4.5 years and 11 examinations with each technique. Fifty-seven patients (50.4%) did not show progression with either technique. Twenty-four patients (21.2%) showed progression with high-pass resolution perimetry alone, whereas 6 (5.3%) showed progression with conventional perimetry alone. Of the remaining 26 patients (23.0%) who showed progression with both techniques, 14 (54%) showed progression with high-pass resolution perimetry first (median, 12 months earlier); 5 (19%), with conventional perimetry first (median, 6 months earlier); and 7 (27%), with both techniques at the same time. Controls were observed for a median of 5 years and 11 examinations with each technique. One control (0.8%) showed progression with high-pass resolution perimetry. CONCLUSIONS: Our results suggest that high-pass resolution perimetry detects glaucomatous visual field progression earlier than conventional perimetry in most patients with progression.

Adolescent↗
PubMed2000

Correlation between static automated and scanning laser entoptic perimetry in normal subjects and glaucoma patients.

OBJECTIVE: To compare the effectiveness of scanning laser entoptic perimetry with static automated perimetry as a noninvasive instrument for screening for glaucomatous damage in visually asymptomatic subjects within the central 60 degrees (diameter) of vision. DESIGN: A masked cross-sectional study comparing entoptic perimetry to achromatic threshold perimetry. PARTICIPANTS: Twenty-three subjects and controls from the Sharp Rees-Stealy Hospital and the Shiley Eye Center at the University of California, San Diego. TESTING: Virtual reality-based entoptic perimetry was compared with achromatic threshold perimetry. MAIN OUTCOME MEASURES: For each testing session, we compared the presence of a disturbance in the entoptic perimetry stimulus with the presence of defects in visual function as measured by Humphrey automated visual field perimetry. RESULTS: Scanning laser entoptic perimetry reasonably estimates the overall visual field loss for moderate-to-severe scotomas as measured by the pattern deviation in standard visual field perimetry. Scanning laser entoptic perimetry has a sensitivity from 27% to 90% and a specificity from 50% to 100% for screening moderate-to-severe visual field defects caused by glaucoma within the central 60 degrees diameter of vision. CONCLUSIONS: Scanning laser entoptic perimetry may be an effective and inexpensive screening test in hospitals and community clinics for diagnosing visual field loss caused by glaucoma.

Cross-Sectional Studies↗
PubMed2005

Recent developments in perimetry: test stimuli and procedures.

Automated perimetry has evolved substantially in recent years, in part due to modern computer technology that enables more complex visual stimuli and test procedures to be realised than those incorporated in traditional white-on-white luminance increment perimetry. This paper reviews briefly a number of advances in automated perimetry. The review includes discussion of new test types: frequency doubling technology perimetry, short wavelength automated perimetry, flicker perimetry, high-pass resolution perimetry and rarebit perimetry. Test algorithms applied to perimetry such as zippy estimation of sequential thresholds (ZEST), Swedish interactive thresholding algorithm (SITA), tendency-oriented perimetry (TOP) and multi-sampling supra-threshold perimetry are also discussed.

Algorithms↗
PubMed2000

Comparison of conventional and pattern discrimination perimetry in a prospective study of glaucoma patients.

PURPOSE: To determine whether pattern discrimination perimetry detects progression of glaucomatous visual fields earlier than conventional static automated perimetry. METHODS: One hundred nine eyes of 109 patients with open angle glaucoma were enrolled in a longitudinal prospective study. Each patient underwent visual field examinations with conventional and pattern discrimination perimetry using the 30-2 program of the Humphrey Visual Field Analyzer (Humphrey Instruments Inc., San Leandro, CA) and a custom program for the pattern discrimination perimeter, respectively at 6-month intervals. Progression of glaucomatous visual field damage was assessed separately at each visit by predetermined criteria for conventional and pattern discrimination perimetry. The time to progression from baseline was calculated and the hemifield that showed progression first was documented for both conventional and pattern discrimination perimetry. RESULTS: Patients were followed for a mean of 5.1 years and a mean of 11.6 visits. Sixty-eight (62.3%) patients did not show progression with either technique. Of the remaining 41 patients, 15 (36.5%) showed progression with conventional perimetry alone, 9 (21.9%) with pattern discrimination perimetry alone, and 17 (41.4%) showed progression with both techniques. Of these 17 patients, 11 (64.7%) were detected earlier by conventional perimetry, and 6 (35.2%) were detected earlier by pattern discrimination perimetry. CONCLUSIONS: This study suggests that pattern discrimination perimetry is less effective than conventional perimetry in evaluating progressive glaucomatous visual field damage.

Adolescent↗
PubMed1996

Field of dreamers and dreamed-up fields: functional and fake perimetry.

PURPOSE: Hysterical and malingering patients can manifest visual field defects on perimetry (visual field testing), including defects suggestive of true visual pathway pathology. It has been shown that control subjects can easily imitate some pathologic defects with automated, computed perimetry. The authors sought to determine whether subjects could imitate the same pathologic defect with manual and automated perimetry. METHOD: Six subjects posed as patients with neurologic problems. They had manual perimetry with both an experienced and inexperienced technician followed by automated perimetry. They were later interviewed about the methods of the technicians and the difficulty of the exercise. RESULTS: Four of six subjects easily imitated the assigned defects with both technicians on manual perimetry and with automated perimetry. These included quadrantic, altitudinal, hemianopic, and enlarged blind-spot defects. Two subjects who were assigned cecocentral and paracentral scotomas instead produced enlarged blind spots by manual perimetry and defects suggestive of chiasmal pathology by automated perimetry. Paradoxically, some subjects found that experienced technicians were easier to fool than inexperienced technicians because of the systematic way in which experienced technicians defined defects. CONCLUSIONS: With minimal coaching, some subjects can imitate visual fields with enlarged blind spots, quadrantic, hemianopic, and altitudinal defects with ease and reproducibility by both automated and manual perimetry. Cecocentral and paracentral scotomas are harder to imitate but may be mistaken as representing chiasmal pathology. Paradoxically, experienced technicians may not be better at detecting hysterical or malingering individuals.

Adult↗
PubMed2000

Entoptic perimetry screening for central diabetic scotomas and macular edema.

OBJECTIVE: The aim of this study was to compare entoptic perimetry, using conventional television, to Amsler grid and patient-reported visual loss for the detection of functional diabetic maculopathy and macular edema. DESIGN: Observational case series. PARTICIPANTS: A single eye from each of 104 consecutive patients with diabetes in an academic retina clinic. INTERVENTION: Each eye was screened by Amsler grid, entoptic perimetry, and Humphrey 10-2 threshold visual field testing (HVF 10-2; Humphrey Instruments Inc., San Leandro, CA) in random order. Eyes were then examined clinically. MAIN OUTCOME MEASURES: The presence or absence of new visual decline since the patient's last clinical examination, the presence or absence of central visual field abnormalities using an Amsler grid, entoptic perimetry, HVF 10-2, and the presence or absence of clinically significant macular edema (CSME). RESULTS: The sensitivities and specificities for the detection of central diabetic scotomas as evidenced by HVF 10-2 abnormalities were: subjective impression, 31 of 90 eyes (34.4%) and 11 of 14 eyes (78.6%); Amsler grid, 29 of 90 eyes (32.2%) and 13 of 14 eyes (92.9%); and entoptic perimetry, 58 of 90 eyes (64.4%) and 11 of 14 eyes (78.6%). Entoptic perimetry was statistically more sensitive than both subjective impression (P < 0.001) and Amsler grid (P < 0.001), but the specificities were statistically indistinguishable. The sensitivities and specificities for the detection of CSME were: subjective impression, 6 of 24 eyes (25.0%) and 52 of 80 eyes (65.0%); Amsler grid, 9 of 24 eyes (37.5%) and 59 of 80 eyes (73.8%); and entoptic perimetry, 17 of 24 eyes (70.8%) and 44 of 80 (55.0%) eyes. These results are also statistically significant, with entoptic perimetry being more sensitive and less specific than both subjective impression (P = 0.007 and P = 0.011, respectively) and Amsler grid (P = 0.008 and P < 0.001, respectively) in this subset of patients. CONCLUSIONS: Entoptic perimetry is 87% more sensitive than the subjective impression of visual decline (P < 0.001) and 100% more sensitive than Amsler grid (P < 0.001) for the detection of central scotomas in diabetic patients. For the detection of CSME, entoptic perimetry is 183% more sensitive than subjective impression (P = 0.007) and 89% more sensitive than Amsler grid (P = 0.008). Hence, entoptic perimetry, performed using conventional television, has the potential to be an effective, inexpensive, and widespread adjunct to surveillance examinations for the early detection of diabetic maculopathy.

Adult↗
PubMed2003

Scanning eye movements in homonymous hemianopia documented by scanning laser ophthalmoscope retinal perimetry.

Sparing or partial recovery of visual fields in hemianopic patients is frequently difficult to document. This is because when testing large field losses, the standard automated or manual visual field testing systems have limited fixation controls. Measured visual field recovery in these cases may not be real but instead may be due to an artifact such as scanning eye movement. This article illustrates a way to separate the actual visual field sparing from scanning eye movement artifact by using perimetry testing with the scanning laser ophthalmoscope (SLO). During the SLO perimetry, the examiner has a direct and magnified view of the retinal fixation locus. This direct view allows for the added ability to monitor the fixation stability during target presentation. When eye movements larger than 1 degrees are noted, the examiner can repeat the trial. During static perimetry, our SLO records the retinal position of the fixation target at the end of the stimulus presentation and corrects scanning eye movements that occur during stimulus presentation. These special features enable us to identify when the apparent sparing of the visual field is due to the artifact of scanning. To demonstrate this, we selected the records of four hemianopic patients whose fields were examined by both standard perimetry and the SLO. We then compared the clinical visual fields with the SLO perimetry fields. One of the patients had a complete homonymous hemianopia on both the clinical perimetry and the SLO perimetry. A second patient was found by the SLO to have unstable fixation during testing. The SLO perimetry revealed that the apparent spared fields seen in standard perimetry were the result of eye scanning and not an actual enlargement of the visual field. Two other patients were confirmed by the SLO findings to have valid partial recovery of the visual field, one with and one without scanning eye movements. The advantages and limitations of SLO perimetry in analyzing hemianopic field sparing are discussed.

Adolescent↗
PubMed2006

Automated flicker perimetry in glaucoma using Octopus 311: a comparative study with the Humphrey Matrix.

PURPOSE: We evaluated the clinical usefulness of flicker perimetry in glaucoma and glaucoma suspect patients using the new Octopus 311 automated perimeter. METHODS: A total of 52 eyes of 52 glaucoma patients, 26 eyes of 26 glaucoma suspect patients and 61 eyes of 61 normal subjects were examined using standard automated perimetry (SAP), flicker perimetry and frequency doubling technology (FDT) perimetry. Flicker perimetry was performed using the Octopus 311 and its remote software package. Suprathreshold four-zone probability strategy was used to classify the critical fusion frequency probability level. The classified levels were set at 5% and 1% of probability of normality and 5 Hz. Frequency doubling technology perimetry was performed using 24-2-5, 24-2-1, N-30-5, N-30-1 screening programs using Humphrey Matrix perimetry. Standard automated perimetry was performed using the Humphrey field analyser program 24-2 full threshold. Optical coherence tomography using Stratus OCT was used for evaluating the retinal nerve fibre layer thickness in all glaucoma and glaucoma suspect patients. RESULTS: Receiver operating characteristic (ROC) curves were calculated. In the early stage of glaucoma, the areas under the ROC curve (AUCs) were 0.96 in flicker and 0.90 in Matrix perimetry. In the moderate and advanced stages of glaucoma, the AUCs were almost 1.0 in all tests. In glaucoma suspect patients, the AUC of the 5% probability level in flicker was significantly higher than in Matrix perimetry. CONCLUSION: The four-zone probability strategy using the Octopus 311 is a useful method for evaluating the flicker field in early glaucoma and glaucoma suspect patients.

Adult↗
PubMed2007

Glaucoma detection with matrix and standard achromatic perimetry.

BACKGROUND: Matrix perimetry is a new iteration of frequency-doubling technology (FDT) which uses a smaller target size in the standard achromatic perimetry presentation pattern. AIM: To compare the performance of matrix and Swedish interactive thresholding algorithm (SITA) perimetry in detecting glaucoma diagnosed by structural assessment. DESIGN: Prospective cross-sectional study. METHODS: 76 eyes from 15 healthy subjects and 61 consecutive glaucoma suspects and patients with glaucoma were included. All patients underwent optic nerve head (ONH) photography, SITA and matrix perimetries, and optical coherence tomography (OCT) within a 6-month period. Glaucoma diagnosis was established by either glaucomatous optic neuropathy or OCT by assessing retinal nerve fibre layer (RNFL) thickness. Mean deviation (MD), pattern standard deviation (PSD), glaucoma hemifield test and cluster of abnormal testing locations were recorded from matrix and SITA perimetries. RESULTS: Similar correlations were observed with matrix and SITA perimetry MD and PSD with either cup-to-disc ratio or OCT mean RNFL. The area under the receiver operating characteristic (AROC) curves of MD and PSD for discriminating between healthy and glaucomatous eyes ranged from 0.69 to 0.81 for matrix perimetry and from 0.75 to 0.77 for SITA perimetry. There were no significant differences among any corresponding matrix and SITA perimetry AROCs. CONCLUSIONS: Matrix and SITA perimetries had similar capabilities for distinguishing between healthy and glaucomatous eyes regardless of whether the diagnosis was established by ONH or OCT-RNFL assessment.

Adult↗
PubMed1999

[Short-term fluctuation of blue-on-yellow perimetry in normal eyes].

PURPOSE: To evaluate short term fluctuation (SF) of blue-on-yellow perimetry (B/Y) as compared with white-on-white perimetry (W/W) in normal eyes. SUBJECTS AND METHOD: One eye each of 25 healthy persons underwent B/Y and W/W perimetry repeated 5 times each. The test subjects had no previous experience of perimetry. An automated perimeter, Humphrey Field Analyzer, model 750, was used throughout. RESULTS: The SF at the first session of B/Y perimetry averaged 2.02 dB. This value was significantly different from those of the subsequent 4 sessions. Each of SF of B/Y perimetry at the first two sessions was significantly different from that of W/W perimetry at the first two sessions. The SF of B/Y perimetry showed wider fluctuations than those of W/W perimetry at each session. CONCLUSION: B/Y perimetry in normal eyes showed individual differences as well as fluctuations between the initial and consecutive sessions. This feature has to be considered in interpretation of the findings.

Adolescent↗
PubMed1991

Light-sense, flicker and resolution perimetry in glaucoma: a comparative study.

A total of 106 eyes of 106 patients with different types of glaucoma were examined by automated light-sense, flicker and resolution perimetry (Humphrey Field Analyzer, program 30-2; flicker perimeter as described by Lachenmayr [16, 18]; resolution perimeter as devised by Frisén [4, 6, 8-11]). The fields were classified in a masked fashion as being normal or as having purely diffuse loss, purely localized loss or diffuse as well as localized loss. As compared with light-sense perimetry, resolution perimetry had a markedly lower sensitivity in the detection of glaucomatous damage (77%) but a high specificity (93%); the comparison of resolution perimetry with flicker perimetry showed similar results (sensitivity, 75%; specificity, 85%). When flicker perimetry was compared with light-sense perimetry and vice versa, the sensitivity was high (95% and 94%, respectively), but the specificity was low (57% and 62%, respectively). The prevalence of detection of diffuse loss by both light-sense and resolution perimetry was related to visual acuity, whereas flicker perimetry did not show such a relationship.

Adult↗