Comparative material on automated and semiautomated perimeters--1986.
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Automation↗
Biomedical subjects
J L Keltner
Publications and source records attributed to J L Keltner.
Comparative material on automated and semiautomated perimeters--1985.
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Bibliographies as Topic↗
Quantitative office perimetry.
This study presents a preliminary comparison of six commercially-available automated threshold static parameters, consisting of three projection perimeters (Humphrey Field Analyzer, Squid, and Octopus 500) and three light-emitting diode (LED) perimeters (Dicon 2000, Fieldmaster 50, and Digilab 350). Eighteen individuals were included in the study: 6 normal observers (31-58 years old), six patients with glaucomatous field loss in both eyes (55-70 years old), and six patients with neuro-ophthalmologic or retinal visual field abnormalities in both eyes (12-61 years old). Three aspects of quantitative testing were evaluated: (1) the patients' and normal observers' acceptance and subjective impressions of the test procedure; (2) the technician's ease of operating the device and related tasks; and (3) practitioner-oriented considerations such as test-retest reliability, comparability of test results and testing time. Our results showed that no device was clearly superior to the others in all respects. Patients were most favorably impressed with the Octopus 500, Squid, and the Fieldmaster 50, while technician impressions were most favorable to the Humphrey Field Analyzer and the Squid. The projection perimeters (Humphrey Field Analyzer, Squid, and Octopus 500) were the easiest to perform cross-comparisons of test results, although there was considerable variation in the clarity of data interpretation from one case to another. Test-retest reliability and the time of testing varied among the six automated perimeters.
Adolescent↗
The California syndrome. Functional visual complaints with potential economic impact.
The records of 84 patients with functional visual loss (59 adults and 25 children) were reviewed over a six-year period. The patients were between 7 and 69 years of age. In the young patients, psychosocial problems relating to parental divorce, poor school performance and attention-getting behavior were common, while in adult patients, financial gain was present in 51 of 59 (86%) individuals. Over 90% of the claimed abnormalities related to the afferent visual system. Fifty-three percent of the patients had underlying organic problems with functional overlay. Inconsistent test results were the most reliable means of identifying the malingering patients. In California, both ophthalmologists and optometrists are able to declare a patient legally blind as well as visually disabled for the purpose of income tax, workers' compensation, and disability benefits. The potential financial impact of malingering patients is discussed.
Adolescent↗
Computer analysis of the optic cup in glaucoma.
This paper describes two complementary methods for computer analysis of the optic disc in glaucoma. The objective of both techniques is to detect and monitor changes in the optic disc through the use of digital image processing techniques that allow user intervention. In the first method, optic disc photographs from successive years are digitized, scaled and registered (aligned) with each other, and are then displayed in rapid sequence on a television monitor. Changes in the optic cup thus appear as localized movement on the display, while stable regions of the optic cup appear stationary. Both monocular and stereo photographs can be processed by this technique. In the second method, stereo optic disc photographs are digitized and processed by a new, robust, photogrammetric computer algorithm that quantifies optic cup depth information. Together, these two techniques may be valuable for both clinical and research purposes in the detection and monitoring of glaucomatous optic cupping.
Computers↗
The ultimate diagnoses of patients undergoing temporal artery biopsies.
Patients with signs and symptoms of giant cell arteritis may have normal temporal artery biopsy specimens. To study the relationships between signs and symptoms of this disease and the ultimate clinical diagnosis, we reviewed 51 patients who had undergone temporal artery biopsy. The mean age of the patients with abnormal biopsy specimens was higher than that of patients with normal biopsy specimens. We found headache, fever, and jaw claudication were useful symptoms in predicting abnormal biopsy specimens. The ultimate diagnoses of patients with normal biopsy specimens and no response to treatment showed high incidence of malignant neoplasms and diabetes mellitus.
Aged↗
Correlation of color vision deficits and observable changes in the optic disc in a population of ocular hypertensives.
Both glaucomatous cupping and the presence of acquired color vision deficits have been reported to be precursors to the onset of visual field defects in patients with suspected glaucoma. To examine the relationship between early glaucomatous cupping and acquired color vision anomalies, we performed anomaloscope (Pickford-Nicholson) and Farnsworth-Munsell 100-Hue color vision tests in 48 ocular hypertensive eyes with either clinical evidence of early glaucomatous cupping (group 1) or no evidence of glaucomatous cupping (group 2). All patients had normal visual fields, as determined by extensive static perimetry of the central visual field and kinetic perimetry of the peripheral visual field. Although the overall incidence of blue and blue-green color vision anomalies in the ocular hypertensives was comparable with that reported in previous studies, we found no clear association between early glaucomatous cupping and color vision anomalies. The relationship between these two precursors to visual field loss remains unclear.
Adult↗
Automated and manual perimetry-a six-year overview. Special emphasis on neuro-ophthalmic problems.
Between August 1976 and September 1982, more than 34,000 manual and automated visual fields have been analyzed in the Department of Ophthalmology, University of California, Davis. Approximately 27% of these tests consisted of manual kinetic visual fields performed on the Goldmann perimeter, while 73% were conducted using automated perimetry. Automated testing alone, or a combination of automated perimetry and manual kinetic testing (Goldmann perimeter) was usually employed to monitor progression or regression of visual field loss. This paper provides an overview of two aspects of automated suprathreshold static perimetry that have not been emphasized in our previous studies: (1) methodologic difficulties and problem patients in automated suprathreshold static perimetry, and (2) examples of automated suprathreshold static perimetry in neuro-ophthalmologic patient populations.
Adult↗
Role of electrophysiologic testing in the preoperative evaluation of corneal transplant patients.
We performed preoperative skin electrode bright-flash ERG and VEP testing on 32 patients undergoing elective penetrating keratoplasty. Twenty-six patients had unilaterally decreased vision and six had bilateral visual impairment. By combining our quantitative electroretinogram (ERG) and qualitative visual evoked potential (VEP) results with clinical findings, we were able to predict visual outcome in 92% of cases. Our findings suggest that bright-flash ERG and VEP testing are useful adjunct studies to clinical and ultrasound findings in patients with media opacities, comparison of a and b wave amplitudes with the fellow eye may yield prognostic information, a normal ERG and VEP in the presence of an equivocal afferent pupillary defect may signal a good visual prognosis, and ERG and VEP are not reliably predictive in patients with media opacity and amblyopia or macular disease.
Adolescent↗
Incidence of visual field loss in 20,000 eyes and its relationship to driving performance.
Automated visual field screening of 10,000 volunteers (20,000 eyes) showed the incidence of visual field loss was 3.0% to 3.5% for persons aged 16 to 60 years but was approximately 13.0% for those older than 65 years. Approximately half of the persons with abnormal visual fields were previously unaware of any problem with peripheral vision. Follow-up results suggested that the most common causes of visual field loss were glaucoma, retinal disorders, and cataracts. Drivers with binocular visual field loss had accident and conviction rates twice as high as those with normal visual fields. Drivers with monocular visual field loss had accident and conviction rates equivalent to those of a control group. Our results have important implications for mass visual field screening to detect eye diseases and for vision-related factors in traffic safety.
Accidents, Traffic↗
Photoreceptor degeneration. Possible autoimmune disorder.
A 61-year-old woman with progressive blindness, initially responsive to steroid therapy, was found to have an undifferentiated neoplasm in the cervix uteri. Visual fields demonstrated ring scotomas and the electroretinographic pattern eventually became flat. The interval from onset of visual symptoms to blindness was 19 months. Eye pathologic findings included loss of retinal photoreceptors, a macular hole, and normal optic nerves. Antibodies were demonstrated in the patient's serum to normal fresh human retinal photoreceptors. An autoimmune mechanism may have been responsible for the retinal degeneration in this patient, and such a hypothesis raises questions about (1) autoimmune mechanisms in patients with retinitis pigmentosa and other retinal degenerative diseases and (2) autoimmune mechanisms in other cases of remote effects of carcinoma.
Autoantibodies↗
Comparative material on automated and semiautomated perimeters-1983.
In reviewing all the responses from the private practitioners and clinicians in Departments of Ophthalmology throughout the United States and Canada, it would appear that the majority of individuals are quite happy with the automated perimeters they have purchased. Clinicians should be aware that this is a rapidly changing field and several devices which were previously available are no longer being manufactured. In addition, because of the competition which has recently developed in the automated perimetry industry, prices are continuing to come down. Some practitioners have been unhappy with the fact they paid a higher price for a device which is currently selling at a lower price. However, a similar phenomenon has happened in the computer world and is to be expected as competition increases. The major problems which seem to be of concern to all ophthalmologists, are the difficulty in interpreting data and the management of the data. We believe one of the major frustrations of all practitioners using automated perimeters relates to the fact that this is a totally new technique, which requires time and practice to gain familiarity. In general, it would appear that most of the practitioners have been happy with the service provided by various companies, although there are a few exceptions. Read the enclosed responses and develop your own conclusions. We hope you find the information useful.
Catalogs, Commercial as Topic↗
Neuro-ophthalmology for the pediatrician.
The pediatrician needs to develop some skills in evaluating afferent visual functions and ocular motor abnormalities. He must know some fundamental neuro-ophthalmologic facts to prevent his patients from undergoing unnecessary diagnostic and surgical procedures. In addition, he needs to understand the fundamentals of strabismus and amblyopia, which are briefly considered in this article. First, the most common type of nystagmus in children is congenital nystagmus. These children often have a head turn or tilt. Also, it should be remembered that numerous drugs may cause nystagmus. Second, any child with a head turn or tilt must be considered to have some ocular motor abnormality until a complete ophthalmologic evaluation has eliminated this possibility. In addition, before a child is considered to have an isolated sixth-nerve palsy, the child should be examined for Duane's retraction syndrome. Also, before an inferior oblique palsy is diagnosed, a Brown's tendon sheath syndrome should be considered. Thus, any ocular muscle abnormality deserves an ophthalmologic evaluation. Third, when bilateral swollen optic nerves are noted as an incidental finding, drusen of the optic nerve head should be suspected. A unilateral swollen disk with decreased visual acuity and a Marcus Gunn pupil should bring to mind a papillitis, which is a local inflammatory condition of the optic nerve head. Remember, papilledema is a bilateral condition secondary to increased intracranial pressure with normal vision. Children with papilledema usually have other signs of increased intracranial pressure.
Child↗
Corneal anesthesia after percutaneous radiofrequency trigeminal rhizotomy. A retrospective study.
Fifteen patients with intentional or unintentional V1 lesions one to five years after percutaneous radiofrequency trigeminal rhizotomy were examined. No corneal changes developed in the majority of patients. These findings raise the question as to the precipitating factor(s) for neuroparalytic keratitis. The suggested mechanism for preservation of corneal function appears to be intact axonal mechanism(s).
Aged↗
Giant-cell arteritis. Signs and symptoms.
Giant-cell arteritis is a polysymptomatic disease of the elderly. Systemic symptomatology includes headaches, arthralgias, myalgias, tender temporal arteries, jaw claudication, low-grade fever, anemia, anorexia, malaise, and weight loss. Visual loss from anterior ischemic optic neuropathy and diplopia resulting from ischemia of the ocular muscles represents the major ocular manifestations of giant cell arteritis. When the diagnosis is suspected, blood for a sedimentation rate should be drawn, and, if it confirms the clinical impression, high dose prednisone should be started immediately and a temporal artery biopsy performed at a later date. Only by asking the proper questions and suspecting the diagnosis will this preventable form of blindness receive the prompt attention it deserves.
Aged↗
Effectiveness of automated perimetry in following glaucomatous visual field progression.
The Fieldmaster automated perimeter's effectiveness in determining glaucomatous visual field progression was evaluated. One hundred fifty-four eyes with glaucoma (41) and ocular hypertension (113) were followed for two to four years with manual static and kinetic perimetry (Tübingen) and automated suprathreshold static perimetry (Fieldmaster). With Tübingen static testing, 11 eyes with established glaucomatous visual field loss demonstrated progressive field loss and one eye showed improvement. Ten of these 12 eyes showed progression on the Fieldmaster. Two ocular hypertensive eyes demonstrated consistent defects on the Fieldmaster over several years, but were not detected on Tübingen static perimetry. Comparison between Tübingen static testing and Fieldmaster perimetry was good except for four Fieldmaster false alarms.
Evaluation Studies as Topic↗
Acute cerebellar ataxia of childhood and optic neuritis with retrochiasmal involvement.
A case of a 4-year-old white girl affected with unilateral optic neuritis and acute cerebellar ataxia is presented. Visual evoked potentials (VEP) demonstrated prolonged latency of the right optic nerve as well as the left retrochiasmal pathways. This child had complete resolution of the cerebellar ataxia and the optic neuritis with return to normal of her VEP. This case is an example of a disease characterized by a single episode of multifocal involvement of the CNS differing from diffuse encephalomyelitis and multiple sclerosis.
Acute Disease↗
Corneal sensitivity after percutaneous radiofrequency trigeminal rhizotomy: a quantitative study.
Using the Cochet-Bonnet esthesiometer, we evaluated the corneal sensation in 13 patients with trigeminal neuralgia. We compared the preoperative and postoperative results after the trigeminal rhizotomy in a quantitative study. Of 13 patients who underwent operation, a decrease in corneal sensation developed compared with the eye that was not operated on in five patients. This decrease in sensitivity was not suggested by clinical symptoms or signs, and up to 23 months of follow-up failed to reveal any clinical symptoms. The failure to manifested clinical corneal symptoms in the follow-up period may result from the selective fiber destruction technique employed in radiofrequency rhizotomy with preservation of other myelinated nerves maintaining corneal nutrition.
Adult↗