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At least 217 records · Page 12Linked to original sources
PubMed2006

Functional field score: the effect of using a Goldmann V-4e isopter instead of a Goldmann III-4e isopter.

PURPOSE: To investigate the underestimation of field loss in functional field score (FFS) between the Goldmann isopters III-4e and V-4e in visually impaired patients, in order to develop a predictive model for the FFS(III-4e) based on FFS(v-4e) that adjusts for possible confounders. Although the visual field is generally evaluated using Goldmann isopter III-4e, it has the disadvantage that not all low-vision patients are able to see the stimulus corresponding to this isopter. METHODS: Goldmann visual fields were obtained from 58 patients with a variety of eye diseases. Eligibility criteria were age of 18 years or older and valid results of a Goldmann III-4e and V-4e visual field test in at least one eye. Linear regression was used to develop the model, setting FFS(III-4e) as the dependent variable and FFS(V-4e) as the independent one. RESULTS: The FFS(V-4e) was higher than the FFS(III-4e), the mean difference being 14.56 points (95% CI, 12.48 -16.64). Multiple linear regression analysis showed that age, functional acuity score, primary eye disease, and central-peripheral loss were not confounders for the prediction of FFS(III-4e). FFS(III-4e) was estimated with the following equation: FFS(III-4e) = -19.25 + 1.063 x FFS(V-4e). CONCLUSIONS: The relationship between FFS(III-4e) and FFS(V-4e) is linear, and the FFS(V-4e) can be used to estimate the FFS(III-4e). In practice, just subtracting 19.25 points of the value of FFS(V-4e) will be sufficient to estimate the value of FFS(III-4e). This model should give confidence about using the bigger isopter for determining the visual impairment of a person by the FFS.

Adult↗
PubMed1997

Lack of association between localized cataract and visual field loss: the Blue Mountains Eye Study.

PURPOSE: To examine whether localized cataract is related to localized field defects on suprathreshold visual field testing. METHODS: Suprathreshold screening visual fields (Humphrey 76-point test) and lens photographs, graded using the Wisconsin System, were performed on participants attending the Blue Mountains Eye Study, which examined 3654 subjects residing in an area west of Sydney, NSW, Australia. The results for 2276 subjects were analysed in the present study. RESULTS: There were no significant relationships between total points missing in the visual field and the degree of cortical, posterior subcapsular (PSC) or nuclear cataract after adjusting for confounders (test for trend P = 0.9, 0.7 and 0.9, respectively). Adjusted prevalence ratios and 95% confidence limits for the association between 10 or more points missing and the presence of cataract were 0.94 (0.77-1.25) for cortical, 1.26 (0.82-1.93) for PSC and 1.06 (0.86-1.30) for nuclear cataract. Similarly, there was no relationship between the presence of cortical or PSC cataract and sectoral visual field loss in any quadrant or hemifield. CONCLUSIONS: Neither cortical, nuclear nor PSC cataracts increase the total points missing on the 76-point suprathreshold field test. Similarly, neither cortical nor PSC cataracts cause sectoral visual field loss on this screening field test. In the presence of cataract, sectoral visual field loss on non-thresholding visual field screeners must be attributed to other causes, such as glaucoma. The present study provides a clinical alert that localized field loss is unlikely to be related to cataract.

Aged↗
PubMed1989

Pattern electroretinogram recorded by skin electrodes in early ocular hypertension and glaucoma.

Diagnostic value of transient pattern electroretinogram (PERG), recorded by skin electrodes, was compared with Goldmann perimetry in cases of ocular hypertension and glaucoma. According to the assumption that the PERG mostly reflects activity of the retinal ganglion cells, and histological evidence that 30-50% atrophy of the retinal ganglion cells is necessary to cause defects in visual field, we wanted to assess if i) this method could be more sensitive in detecting early glaucomatous damage than routine Goldmann perimetry in eyes with normal or only borderline elevated intraocular pressure in the time of PERG recording (first group of patients), and ii) how the PERG amplitude corresponds to ganglion cell loss, expected in the eyes with already detectable initial glaucomatous visual field defects, according to Goldmann II/2 isopter, with normal or borderline elevated intraocular pressure in the time of PERG recording (second group). In the group with no visual field defects subnormal amplitude of the major positive component of the PERG, N1-P1, was detected in three of 30 eyes (10%), while in the group with initial visual field defects N1-P1 amplitude was subnormal in 6 of 11 eyes (54%). The amplitude of the major negative PERG component, P1-N2, was found normal in all eyes of the first group and subnormal in 5 eyes (45%) of the second group.

Adult↗
PubMed2005

Towards an optimal perimetric strategy for progression detection in glaucoma: from fixed-space to adaptive inter-test intervals.

BACKGROUND: The aim was to compare two perimetric strategies for progression detection in glaucoma. METHODS: Two perimetric strategies for progression detection were compared by means of a thought experiment in a theoretical cohort. In strategy I, visual field testing is performed with fixed-space inter-test intervals at a frequency of two tests per year. In strategy II, the frequency of visual field testing is set to one test per year as long as the fields are apparently unchanged, whereas as soon as progression is suspected, confirmation or falsification is performed within a short time span. Outcome measures were the time delay between the progression event and the diagnosis of definite progression, and the number of visual field tests performed per patient per year. RESULTS: Average time delay between the actual progression event and the final diagnosis of definite progression was 15 months in the case of strategy I and 6 months in the case of strategy II. Maximum time delays were 18 and 12 months respectively. The frequency of visual field testing was 2 tests per patient per year for strategy I and 1.45 tests per patient per year for strategy II. CONCLUSIONS: Perimetry in glaucoma can be optimised by postponing the next test in the case of an apparently stable field and accelerating the next test in the case of a suspected progression. This results in an earlier diagnosis, a lower perimetric frequency and a shorter period of uncertainty for the patient.

Bayes Theorem↗
PubMed1993

Validity and interpretation of Amsler grid reports.

OBJECTIVE: To compare the reports of scotomas and metamorphosia in standard and threshold Amsler grid testing with the location and extent of scotomas in the macular region as determined by standard and threshold fundus perimetry. DESIGN: Fundus perimetry determined the existence, size, and retinal location of macular scotomas. Amsler grid testing was performed with the scanning laser ophthalmoscope and the TA-300 system (Stereo Optical, Chicago, Ill). All testing was done at both standard and threshold light conditions. PATIENTS: Fifty-five patients with vision loss in the macular region and 10 normally sighted subjects. RESULTS: Nearly half of the standard and threshold scotomas were not detected by Amsler grid testing. For scotomas of 6 degrees or less in diameter, 77% of standard and 87% of threshold scotomas were not detected by Amsler grid testing. Of the eyes with central scotomas involving the fovea, 66% used an eccentric preferred retinal locus for fixating the center of the grid. Finally, more than half of the distortion reported in Amsler grids was at the retinal area that corresponded to the scotoma area, not a nonscotoma retinal area. CONCLUSION: Amsler grid reports have poor validity and cannot be accurately interpreted for use in the clinical diagnosis of retinal defects.

Adolescent↗
PubMed1987

High-pass resolution targets in peripheral vision.

Visual acuity was measured at 10 degree intervals on the horizontal meridian in two normal subjects, using high-pass spatial frequency filtered test targets in a computer graphics display. The close similarity between detection and recognition thresholds resulted in quick and reliable measurements. Peripheral acuity was proportional to local retinal ganglion cell separation. High-pass targets appear to be nearly ideal for clinical perimetry because of the easy test task and the possibility of interpreting results in terms of numbers of functional neuroretinal channels. The major limitation appears to be a somewhat fuzzy definition of small, circumscribed defects.

Adult↗
PubMed1997

An improved method to estimate frequency of false positive answers in computerized perimetry.

Reliability of patient performance in static computerized perimetry is important for evaluation of results. False positive answers tend to falsely increase measured threshold sensitivity. The frequency of false positive responses is traditionally measured by adding extra questions, catch trials, to the test. Catch trials are few and limited because of time constraints, leading to inexact estimates. We developed an improved method for estimation of false positive answers by using information already available in current ordinary computerized visual field testing, without increasing test time. We here describe the method and evaluate it in a prospectively collected material of 49 glaucoma eyes of 49 patients. The results show that the new method reduces measurement errors considerably and significantly as compared with the traditional catch trials method. Test-retest change was only half with the new method as compared to the traditional method of catch trials. Furthermore, it can reduce test time by eliminating the need to use catch trials to estimate the frequency of false positive responses.

Adult↗
PubMed1998

Assessment of visual function in idiopathic intracranial hypertension: a prospective study.

The visual function of 35 patients with a diagnosis of idiopathic intracranial hypertension was assessed prospectively over a 3 year period. In assessing the visual function of cases of idiopathic intracranial hypertension a number of tests were employed including visual field assessment with Humphrey and Goldmann perimeters and documentation of visual acuity and contrast sensitivity. Loss of visual function is the only serious complication and may occur early or late in the course of the condition. An appropriate and sensitive clinical assessment regime is therefore of importance in the outpatient situation. Visual field assessment was documented as the most sensitive to detection of visual loss, with statistically greater sensitivity in comparison with visual acuity and contrast sensitivity testing. Detection of asymptomatic visual loss indicates the necessity for visual monitoring to ensure detection of insidious visual loss. The types of visual field defects noted in this study were typical of anterior optic nerve pathology of raised intracranial pressure and commonly included arcuate defects, nasal steps and global constriction. Visual loss was noted at presentation and during follow-up in up to 87% of patients using Goldmann perimetry and up to 82% of patients using Humphrey perimetry. The visual status improved significantly throughout the follow-up period and the final visual outcome was excellent or good in 83% of patients.

Adolescent↗
PubMed1977

Glaucoma: the value of a diurnal curve and Goldmann visual field.

A 35-year-old man was treated with maximum medical therapy for open-angle glaucoma. A diurnal curve revealed that the pressure was not controlled as might have been thought by a single reading. Reference is also made to the value of Goldmann visual field testing, since in this patient visual field defects were discovered with normal, healthy-appearing optic discs. A careful regimen including precise visual field testing and the plotting of the diurnal curve is most important in evaluating ocular hypertension and glaucoma.

Adult↗
PubMed2002

Glaucoma patients' assessment of their visual function and quality of life.

PURPOSE: To determine how glaucoma and glaucoma suspect patients' rating of their vision correlates with Esterman binocular visual field testing and other visual function tests. METHODS: One hundred ninety-one glaucoma patients and 46 glaucoma suspect patients underwent binocular visual field testing and evaluated their vision using the linear rating scale and time-tradeoff utility tests, the National Eye Institute Visual Functional Questionnaire (NEI VFQ-25), and the Short Form 36 (SF-36) quality-of-life instruments. RESULTS: The mean Esterman score was 88.2 +/- 17.4 for the glaucoma subjects and 95.2 + 6.9 for glaucoma suspect subjects (maximum score 100). On a scale from 0 (blind) to 100 (ideal), the mean rating of vision for glaucoma patients and glaucoma suspect patients was 74.8 +/- 17.3 and 78.9 +/- 18.5, respectively. The Esterman test correlated moderately with the overall NEI VFQ-25 score (partial correlation coefficient (PCC) = 0.32, P = 0.001), but only weakly with the linear rating scale (PCC = 0.17, P = 0.02), and the time-tradeoff (PCC = 0.14, P = 0.06). CONCLUSION: Utility values that glaucoma and glaucoma suspect patients assign to their vision do not correlate well with Esterman results. A challenge for the future is the design of clinical tests of vision that better correlate with patient perceptions.

Aged↗
PubMed2001

Interpreting automated perimetry.

Visual field testing is mandatory for many ophthalmic conditions including glaucoma. The current gold standard for visual field testing is automated perimetry. In this article we familiarize the reader with the components of an automated perimetry printout. We describe a systematic approach that leads to a thorough interpretation of the printout. With the help of examples the reader should be able to learn to identify a normal field, detect the presence of a field defect, determine whether it is due to glaucoma, and establish progression, if any.

Humans↗
PubMed1987

Optic nerve dysfunction during gravity inversion. Visual field abnormalities.

Inversion in a head-down position (gravity inversion) results in an intraocular pressure of 35 to 40 mm Hg in normal subjects. We used computerized static perimetry to measure the visual fields of normal subjects during gravity inversion. There were no visual field changes in the central 6 degrees of the visual field compared with the baseline (preinversion) values. However, when the central 30 degrees of the visual field was tested, reversible visual field defects were found in 11 of 19 eyes. We believe that the substantial elevation of intraocular pressure during gravity inversion may pose potential risks to the eyes, and we recommend that inversion for extended periods of time be avoided.

Adult↗
PubMed2006

Isolated bilateral lateral geniculate infarction producing bow-tie visual field defects.

CASE REPORT: We examined a unique case of stroke in a 29-year-old woman. Magnetic resonance imaging revealed isolated bilateral acute infarctions of the lateral geniculate bodies (LGB). Visual field testing demonstrated incongruous but homonymous bilateral visual field loss in a bow-tie configuration. COMMENTS: Isolated bilateral damage to the LGB is a rare event. Literature review has revealed only 4 previous incidents of bilateral damage to both LGB. We present a literature review and a case of bilateral LGB infarction producing visual field defects suggestive of bilateral lateral choroidal artery involvement in an individual with classic migraine.

Adult↗
PubMed2004

The effect of attention on conventional automated perimetry and luminance size threshold perimetry.

PURPOSE: To investigate the effects of divided attention on conventional automated perimetry (CAP) and luminance size threshold perimetry (LSTP). METHODS: Ten healthy subjects, ages 27 to 65, with two perimetry types (CAP and LSTP) were tested in random order. At a later session, these tests were given with a mental workload to simulate the effect of anxiety or distraction on subjects performing visual field testing, also in random order. The mental workload, the Paced Auditory Serial Addition Test (PASAT), was first administered to each subject, and the score was recorded. During the visual field testing, the PASAT was again administered continuously. Each subject was instructed to attend primarily to the PASAT while taking each visual field test. RESULTS: CAP was affected by the addition of the PASAT, with a worsening of sensitivity from an average of 30.0 +/- 0.67 to 24.2 +/- 7.4 dB with a range of -0.04 to -23.2 dB (P = 0.04). LSTP showed a generalized reduction in threshold 1.71 +/- 0.22 to 2.35 +/- 0.72 dB with a range of 0.12 to -2.17 dB (P = 0.25). The percentage of correct responses on the PASAT was not significantly different between CAP (76.9%) and LSTP (74.8%). False-positive and -negative catch trial responses were increased during CAP with PASAT testing (P = 0.009). A substantial increase of fixation losses occurred during CAP with PASAT (3.7-16.2, P = 0.002). LSTP with PASAT showed increases in localization error (P < 0.001) and reaction time (P = 0.004). CONCLUSIONS: Divided attention significantly affects performance on conventional automated perimetry with its fixed size stimuli and when the stimuli are scaled (LSTP). The deficits may simulate nerve-fiber-bundle-like defects.

Adult↗
PubMed1977

Automatic testing of the visual field using electro-oculographic potentials.

The central visual field is tested using static perimetry on a tangent screen located 1 m from the patient. During the test electro-oculographic (EOG) potentials, associated with eye movements, are recorded. For this purpose two pairs of electrodes are placed in such a way that one pair records the vertical and the other the horizontal component of the EOG potential. The EOG signals that are produced when the tested eye moves toward the light target on the screen are digitized and fed into a computer programmed to relate each pair of signals to the specific lamp on the tangent screen. The results of the test appear on a computer-printed chart that shows the distribution of the lamps on the testing board together with the information whether the lamp was seen by the subject. This method of visual field testing is both objective and automatic.

Automation↗