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At least 253 records · Page 14Linked to original sources
PubMed2006

Contrasting blue-on-yellow with white-on-white visual fields: Roles of visual adaptation for healthy peri- or postmenopausal women younger than 70 years of age.

PURPOSE: To test the hypothesis that differences between short-wavelength automated perimetry (SWAP) and white-on-white visual field sensitivities are related to between-individual variation in the visual adaptation properties of SWS cone pathways. METHODS: Twenty-six healthy amenorrheic (peri- or postmenopausal) women not using hormonal medication were tested. Subjects ranged in age from 48 to 68 years. They were tested by using foveal increment-threshold techniques and also with two types of 24-2 visual field tests: a full-threshold SWAP blue-on-yellow (B/Y) test and a white-on-white (W/W) test obtained using a Swedish Interactive Threshold Algorithm (SITA Standard). The age-corrected sensitivity differences between the two types of visual fields were compared against foveal measures of visual sensitivity and adaptation, which were obtained psychophysically using dim and bright yellow backgrounds. All measurements for each subject were made at a single testing session. The comparisons were made for the entire visual field and for separate portions of the visual field. The analyses also included pupil size data obtained during visual field testing. RESULTS: The B/Y minus W/W (B/Y - W/W) mean deviation difference was described (R = 0.80) by a multilinear model with three significant factors: (1) an adaptation factor and (2) a baseline sensitivity factor, each derived from the foveal psychophysical data for short-wavelength test stimuli, and (3) a pupil size factor, as recorded for SWAP. The total deviation differences in the periphery of the visual field (approximately 22 degrees from fixation) were described (R = 0.87) by a model with four significant factors, the fourth being an "eccentricity factor" describing the rate of change of the B/Y - W/W total deviation difference measured as a function of increasing retinal eccentricity approximately 9 degrees -17 degrees from fixation. More than 40% of the variance in the B/Y - W/W mean deviation differences was accounted for either directly or indirectly (via effects of pupil size) by variations in adaptation to the yellow background used for SWAP. CONCLUSIONS: Much of the extra variability in SWAP sensitivities for a select group of healthy women can be accounted for by differences in the degree of desensitization induced by the yellow background used for SWAP. For clinical practice, pupil status (dilated or undilated) should be altered only with caution from one SWAP testing session to another.

Adaptation, Ocular↗
PubMed1994

Comparison between Fastpac and conventional Humphrey perimetry.

As part of the Melbourne Visual Impairment Project, a substudy was performed to determine the efficacy of the newly released Fastpac program for the Humphrey Field Analyser. A comparison was performed of the Fastpac and conventional full threshold 24-2 fields obtained in 39 eyes of 36 participants. Also a comparison study was performed of the standard and non-standard 80-point screening tests to the standard 24-2 full threshold test in 23 eyes of 23 participants. In the full threshold comparison there was 100% agreement between the two with Fastpac being 32% to 39% faster than standard. In the 80-point screening test comparison, non-standard was no faster than standard. Sensitivities were 17/17 (1.0) for non-standard and 15/18 (0.83) for standard, as compared with the standard 24-2 full threshold test. Fastpac software offers accurate screening and threshold testing in less time than the standard algorithm.

Algorithms↗
PubMed2002

Using machine learning classifiers to identify glaucomatous change earlier in standard visual fields.

PURPOSE: To compare the ability of several machine learning classifiers to predict development of abnormal fields at follow-up in ocular hypertensive (OHT) eyes that had normal visual fields in baseline examination. METHODS: The visual fields of 114 eyes of 114 patients with OHT with four or more visual field tests with standard automated perimetry over three or more years and for whom stereophotographs were available were assessed. The mean (+/-SD) number of visual field tests was 7.89 +/- 3.04. The mean number of years covered (+/-SD) was 5.92 +/- 2.34 (range, 2.81-11.77). Fields were classified as normal or abnormal based on Statpac-like methods (Humphrey Instruments, Dublin, CA) and by several machine learning classifiers. The machine learning classifiers were two types of support vector machine (SVM), a mixture of Gaussian (MoG) classifier, a constrained MoG, and a mixture of generalized Gaussian (MGG). Specificity was set to 96% for all classifiers, using data from 94 normal eyes evaluated longitudinally. Specificity cutoffs required confirmation of abnormality. RESULTS: Thirty-two percent (36/114) of the eyes converted to abnormal fields during follow-up based on the Statpac-like methods. All 36 were identified by at least one machine classifier. In nearly all cases, the machine learning classifiers predicted the confirmed abnormality, on average, 3.92 +/- 0.55 years earlier than traditional Statpac-like methods. CONCLUSIONS: Machine learning classifiers can learn complex patterns and trends in data and adapt to create a decision surface without the constraints imposed by statistical classifiers. This adaptation allowed the machine learning classifiers to identify abnormality in visual field converts much earlier than the traditional methods.

Algorithms↗
PubMed1993

Evaluation of baseline-related suprathreshold testing for quick determination of visual field nonprogression.

OBJECTIVE: To evaluate a commercially available means of baseline-related suprathreshold examination designed to detect visual field worsening. DESIGN: Patients for whom results of a baseline series of static-threshold visual field examinations were available underwent both a second static-threshold examination (full-threshold strategy; average time, 15 minutes) and a baseline-related suprathreshold examination ("fast-threshold" strategy; average time, 5 minutes). RESULTS: Most of the 1702 points examined were apparently unchanged from baseline, showing with either method only the degree of variation expected from the measurement inconsistency (short-term fluctuation). For points that did show a change, the changes shown by the two methods were correlated. Change in the field as a whole, represented by a cluster of locations showing deterioration, was evident more frequently with the standard testing strategy: 11 of 37 field examinations showed deterioration by both methods and an additional 11 examinations showed deterioration by the full-threshold method only. CONCLUSIONS: Each examination method identified pointwise changes not detected by the other, the combined effect of false-positive errors (imperfect specificity) and false-negative errors (imperfect sensitivity) with each of the two methods. The findings relating to clusters could represent a better sensitivity of the full-threshold method in detecting visual field deterioration, a better specificity of the suprathreshold method, or both.

Evaluation Studies as Topic↗
PubMed1992

Evaluation of methods for automated Hemifield analysis in perimetry.

A new aid to perimetric analysis, the Glaucoma Hemifield Test, primarily evaluates up-down differences in automated static visual field tests. We analyzed the visual fields of 163 eyes of 163 normal subjects and 77 eyes of 77 patients with glaucoma diagnosed on bases other than perimetry using the Glaucoma Hemifield Test and a similar, previously developed, hemifield analysis method. The performance of the Glaucoma Hemifield Test was compared with that of the earlier method and the differences in test design were evaluated individually. The Glaucoma Hemifield Test allowed significantly improved separation between the normal group and the group with glaucoma than did the earlier method. This improvement was due to an increase in sensitivity, and was associated with the use of test point significances instead of threshold values, and a large normal database alone in the determination of normal limits.

Adult↗
PubMed1992

Increasing short-term fluctuation by increasing the intensity of the fixation aid during perimetry.

An increase in short-term fluctuation is a clinically useful clue in the diagnosis of acquired disorders of the visual pathways. However, short-term fluctuation can also be increased in normal subjects by several factors. We found an increase in short-term fluctuation occurred in normal subjects when the visual field was tested using a bright fixation aid. Eight normal subjects underwent automated perimetry with the Octopus 2000R, in which the dimmest (12.5 candelas/m2) and brightest (435 cd/m2) available fixation aids were used. Mean short-term fluctuation values were 1.63 +/- 0.27 dB with the dimmest aid, and were 2.65 +/- 1.26 dB with the brightest aid. The difference was significant using the paired t-test (P = .037). Moreover, mean sensitivity was reduced from 35.67 +/- 2.26 dB to 33.66 +/- 1.71 dB when the brightest fixation aid was used (P = .004). In six of eight subjects, the relative changes in short-term fluctuation after an increase in brightness of the fixation aid were more pronounced than those in mean sensitivity. An increase in intensity of the fixation aid may cause visual changes in normal subjects that resemble those induced by disorders in the visual pathways. Whenever possible, minimal intensity of the fixation aid should be used to allow for an adequate interpretation of short-term fluctuation values.

Adult↗
PubMed2001

The paracentral visual field in multiple sclerosis: evidence for a deficit in interneuronal spatial summation?

A visual complaint such as blurred or "washed-out vision" can be one of the early signs of multiple sclerosis (MS). Although visual deficits are commonly attributed to optic nerve demyelination even with preserved visual acuity, the results of a considerable number of visual studies are inconsistent with this interpretation [Camisa, Mylin, & Bodis-Wollner, Annals of Neurology 10 (1981) 532-539; Regan & Neima, British Journal of Ophthalmology 68 (1984) 310-315]. However, a retinal axonal (nerve fiber layer) defect can be detected in some eyes, this is not the rule. Routine visual field (VF) tests, with a low sampling rate may also be non-informative in MS and optic neuritis, possibly because the VF abnormalities may be small and spotty or they can be found between tested points. The present study combined the advantages of VF and contrast sensitivity (CS) testing by applying contrast perimetry (CP), to the central 16 degrees of the VF. Four paracentral VF quadrants were tested in clinically affected and unaffected eyes of 31 MS patients and 26 controls. The stimuli were vertical Gaussian apertured sinusoidal gratings (Gabors) of 1 cpd. CS was obtained as a function of the diameter of the Gábor ranging from 1 to 7.4 degrees. The CP data of controls and definite and probable MS groups were significantly different for each pattern size, but the largest difference was found at diameters 2.5-3.7 degrees. Our study adds to previous evidence showing that optic nerve pathology does not explain "subclinical" and manifest visual dysfunction in MS. Given previous studies revealing orientation dependent monocular visual deficits and our study results, parsimony suggests that MS affects a network relying on myelinated lateral axonal branches of the visual cortex, binding monocular columns of neurons with like-with-like specificity.

Adult↗
PubMed2004

Detecting early to mild glaucomatous damage: a comparison of the multifocal VEP and automated perimetry.

PURPOSE: To gain better understanding of the relationship between abnormalities detected by the multifocal VEP (mfVEP) compared with those detected by static achromatic, automated perimetry in patients with glaucoma. METHODS: Fifty patients were studied who had open-angle glaucoma that met the following criteria: (1) a mean deviation (MD) of better than -8 dB in both eyes on the 24-2 Humphrey visual field (HVF) test (Carl Zeiss Meditec, Dublin, CA); and (2) glaucomatous damage in at least one eye, as defined by a glaucomatous optic disc and an abnormal 24-2 HVF test result (pattern standard deviation [PSD] <5% and/or glaucoma hemifield test [GHT] results outside normal limits). Monocular mfVEPs were obtained from each eye by using a pattern-reversal dartboard array, 44.5 degrees in diameter, which contained 60 sectors. Recording electrodes were placed at the inion (I) and I+4 cm, and also at two lateral locations up 1 cm and over 4 cm from I. Monocular and interocular mfVEP probability plots were derived by comparing the results with those of normal control subjects. For both the HVF and mfVEP probability plots, a hemifield was classified as abnormal if three or more contiguous points were significant at less than 5%, with at least one at less than 1%. RESULTS: Of the 200 hemifields tested (50 patients x two eyes x two hemifields), 75 showed significant clusters on the HVF, and 74 (monocular probability plot) and 93 (monocular or interocular plot) showed significant clusters on the mfVEP. Overall, the HVF and mfVEP results agreed on 74% of the hemifields, and 90 hemifields were normal and 58 were abnormal on both the mfVEP (interocular and/or monocular abnormal) and HVF cluster tests. Of the 52 disagreements, 35 hemifields had a significant cluster on the mfVEP, but not on the HVF, whereas the reverse was true of 17 hemifields. A case-by-case analysis indicated that misses and false-positive results occurred on both the HVF and mfVEP tests. CONCLUSIONS: As predicted from a theoretical analysis, under these conditions (i.e., the signal-to-noise level) the HVF and monocular mfVEP tests showed a comparable number of defects, and, with the addition of the interocular test, the mfVEP showed more abnormalities than the HVF. However, although there were abnormalities detected by the mfVEP that were missed by the HVF, the reverse was true as well.

Adult↗
PubMed2000

Mapping the visual field to the optic disc in normal tension glaucoma eyes.

PURPOSE: To establish the anatomical relationship between visual field test points in the Humphrey 24-2 test pattern and regions of the optic nerve head (ONH) DESIGN: Cross-sectional study. PARTICIPANTS: Glaucoma patients and suspects from the Normal Tension Glaucoma Clinic at Moorfields Eye Hospital. METHODS: Sixty-nine retinal nerve fiber layer (RNFL) photographs with well-defined RNFL defects and/or prominent bundles were digitized. An appropriately scaled Humphrey 24-2 visual field grid and an ONH reference circle, divided into 30 degrees sectors, were generated digitally. These were superimposed onto the RNFL images. The relationship of visual field test points to the circumference of the ONH was estimated by noting the proximity of test points to RNFL defects and/or prominent bundles. The position of the ONH in relation to the fovea was also noted. MAIN OUTCOME MEASURES: The sector at the ONH corresponding to each visual field test point, the position of the ONH in relation to the fovea, and the effect of the latter on the former. RESULTS: A median 22 (range, 4-58), of a possible 69, ONH positions were assigned to each visual field test point. The standard deviation of estimations was 7.2 degrees. The position of the ONH was 15.5 degrees (standard deviation 0.9 degrees ) nasal and 1.9 degrees (standard deviation 1.0 degrees ) above the fovea. The location of the ONH had a significant effect on the corresponding position at the ONH for 28 of 52 visual field test points. CONCLUSIONS: A clinically useful map that relates visual field test points to regions of the ONH has been produced. The map will aid clinical evaluation of glaucoma patients and suspects, as well as form the basis for investigations of the relationship between retinal light sensitivity and ONH structure.

Cross-Sectional Studies↗
PubMed1979

Refsum's disease. Eye manifestations in a patient treated with low phytol low phytanic acid diet.

The cardinal eye symptoms of Refsum's disease are night blindness, retinal pigmentary degeneration and constriction of the visual fields. Similarities with or differences from retinitis pigmentosa are discussed. A 39-year-old male has had manifestations of Refsum's disease from the age of 7 years and has been on a low phytol low phytanic acid diet for the last 13 years. Peripheral ring scotomas were present. Some reduction of the visual fields has been recorded, but only in the far periphery. The central field has not been significantly constricted during a 7-year period. Very good visual functions were found within this area. All cone mechanisms were functioning at a normal level. A moderately reduced sensitivity level of the rod mechanism could be explained in a great measure by poor pupillary dilation in the dark. In this patient minimal or no progression of the visual findings was apparent. Probably an effect of treatment, there is little resemblance with ordinary retinitis pigmentosa. ERG showed moderate abnormality. Normal conducting time was found by VER. With fluorescein angiography a central area of normal appearance was sharply outlined in contrast to marked degenerations in paracentral regions.

Adult↗
PubMed2004

The prevalence of primary open-angle glaucoma in Japanese: the Tajimi Study.

PURPOSE: To assess the prevalence of primary open-angle glaucoma (POAG) and its association with intraocular pressure (IOP) in Tajimi City in central Japan. DESIGN: A cross-sectional epidemiologic study in a defined population. PARTICIPANTS: Subjects randomly selected from the population older than 40 years in Tajimi City. INTERVENTION: Each subject underwent a screening examination comprised of an interview and ophthalmic examinations, including measurement of IOP by a Goldmann applanation tonometer, central corneal thickness (CCT), slit-lamp examination, fundus photography, and a screening visual field test using frequency doubling technology. When ocular diseases were suspected, the subjects were referred for definitive examination. During the definitive examination, slit-lamp examination, IOP measurement, a visual field test using Humphrey Field Analyzer 30-2 SITA Standard program (Humphrey Instruments, San Leandro, CA), optic disc and fundus examination, and gonioscopy were performed and stereoscopic disc photographs were obtained. A diagnosis of glaucoma was made based on optic disc appearance, perimetric results, and other ocular findings. MAIN OUTCOME MEASURES: Prevalence of POAG, mean IOP, and mean CCT. RESULTS: Of 3870 eligible people, 3021 (78.1%) participated in the study. The estimated prevalence of POAG in the population older than 40 years was 3.9% (95% confidence interval [CI]), 3.2%-4.6%). The prevalence of cases of POAG with IOP levels of 21 mmHg or less was 3.6% (95% CI, 2.9%-4.3%), whereas the prevalence for those with IOP levels of more than 21 mmHg was 0.3% (95% CI, 0.1%-0.5%). The average IOP for eyes with POAG was 15.4+/-2.8 (standard deviation) in the right eye (n = 115) and 15.2+/-2.8 mmHg in the left eye (n = 115), which was significantly higher than that of nonglaucoma subjects (14.5+/-2.5 in the right eye; n = 2759; P = 0.0004; and 14.4+/-2.6 mmHg in the left eye; n = 2757; P = 0.0026). The mean CCT of POAG eyes with IOP levels of 21 mmHg or less was 518+/-29 (n = 109) in the right eye and 519+/-29 microm (n = 110) in the left eye, levels that were not significantly different from that of nonglaucoma eyes (520+/-32 microm [n = 2690]; and 522+/-32 microm [n = 2692]; P>0.05). CONCLUSIONS: The prevalence of POAG in this population was 3.9%. In 92% patients with POAG, the IOP was 21 mmHg or less.

Adult↗
PubMed2005

Optical coherence tomography longitudinal evaluation of retinal nerve fiber layer thickness in glaucoma.

OBJECTIVES: To longitudinally evaluate optical coherence tomography (OCT) peripapillary retinal nerve fiber layer thickness measurements and to compare these measurements across time with clinical status and automated perimetry. METHODS: Retrospective evaluation of 64 eyes (37 patients) of glaucoma suspects or patients with glaucoma participating in a prospective longitudinal study. All participants underwent comprehensive clinical assessment, visual field (VF) testing, and OCT every 6 months. Field progression was defined as a reproducible decline of at least 2 dB in VF mean deviation from baseline. Progression of OCT was defined as reproducible mean retinal nerve fiber layer thinning of at least 20 mum. RESULTS: Each patient had a median of 5 usable OCT scans at median follow-up of 4.7 years. The difference in the linear regression slopes of retinal nerve fiber layer thickness between glaucoma suspects and patients with glaucoma was nonsignificant for all variables; however, Kaplan-Meier survival curve analysis demonstrated a higher progression rate by OCT vs VF. Sixty-six percent of eyes were stable throughout follow-up, whereas 22% progressed by OCT alone, 9% by VF mean deviation alone, and 3% by VF and OCT. CONCLUSIONS: A greater likelihood of glaucomatous progression was identified by OCT vs automated perimetry. This might reflect OCT hypersensitivity or true damage identified by OCT before detection by conventional methods.

Aged↗
PubMedDate not supplied

Abnormal multifocal electroretinogram (mfERG) in ethambutol toxicity.

OBJECTIVE: To report the abnormal multifocal electroretinogram (mfERG) findings in two cases of presumed ethambutol toxicity. DESIGN: Retrospective observational case series. PARTICIPANTS: Two patients with ethambutol toxicity and visual loss. TESTING: Multifocal electroretinography. MAIN OUTCOME MEASURE: Waveform measurements on multifocal electroretinography. RESULTS: Two patients with bilateral visual loss due to ethambutol toxicity underwent mfERG testing that disclosed both diffuse and central field loss compatible with retinal dysfunction as a contributing mechanism to the visual field loss. CONCLUSION: Ethambutol toxicity affects not only the optic nerve but probably other retinal elements based upon abnormal mfERG findings.

Aged, 80 and over↗
PubMed2000

A comparison of manual kinetic and automated static perimetry in obtaining ptosis fields.

OBJECTIVE: To compare examination time and visual field loss for ptosis fields obtained with manual kinetic (Goldmann) perimetry and automated static (Humphrey) perimetry. METHODS: Both eyes of 12 patients with bilateral aponeurogenic ptosis were prospectively examined using Goldmann and Humphrey (ptosis protocol) perimetry with the eyelids ptotic and taped into a normal position. RESULTS: Bilateral examination time for Goldmann fields was 10 +/- 2 minutes and for Humphrey fields was 50 +/- 10 minutes (P<.001, n = 12). Superior fields at the 12:00 meridian were 46 degrees +/- 6 degrees taped, and 28 degrees +/- 12 degrees untaped for Goldmann perimetry (P<.001), and 38 degrees +/- 8 degrees taped, and 24 degrees +/- 12 degrees untaped for Humphrey perimetry P<.001). Goldmann field loss was 18 degrees +/- 9 degrees (taped minus untaped). Humphrey field loss was 14 degrees +/- 13 degrees (P<.04, n = 24). Mean Goldmann radial fields were 56 degrees +/- 6 degrees taped and 39 degrees +/- 13 degrees untaped (P<.001). Goldmann superior hemifield areas were 5,167 +/- 964 degrees2 taped and 2,830 +/- 1,466 degrees2 untaped (P<.001). Humphrey mean vertical superior hemifield was 37 degrees +/- 9 degrees taped and 21 degrees +/- 11 degrees untaped (P<.001). Mean sensitivity of Humphrey fields was 15 +/- 3 dB taped and 9 +/- 5 dB untaped (P<.001). Mean vertical center of gravity was 23 degrees +/- 3 degrees taped and 16 degrees +/- 5 degrees untaped (P <.001). CONCLUSION: Goldmann manual kinetic and Humphrey automated static visual field testing are both effective in documenting ptosis associated visual field loss. Humphrey automated ptosis fields, as performed in this study, require longer examination times than Goldmann manual fields and may be a less sensitive indicator of field loss.

Adult↗
PubMed1988

A comparison of experienced clinical observers and statistical tests in detection of progressive visual field loss in glaucoma using automated perimetry.

The visual fields of 30 patients (subjects) with glaucoma were sent to six experienced clinicians (observers). Each subject had at least four visual field examinations on the OCTOPUS 201 automated perimeter spanning at least one year. Each observer was asked to review the visual field data of each subject and determine whether the visual fields were stable, improved, or worse over time. The visual field data were then analyzed using six different statistical models. In only 15 of the 30 subjects did at least five of the six human observers agree on the behavior of the visual field. Agreement among the statistical models was better, with at least five of the six models agreeing on 22 of the 30 subjects. It was concluded that there is, at present, no validated technique for detecting progressive visual field loss in glaucoma using automated perimetry when relatively few visual fields are available for analysis.

Analysis of Variance↗
PubMed1988

The effect of regression towards the mean on visual disability rating scales.

The effects of regression towards the mean on visual disability rating scales are analyzed. Some current strategies underestimate true visual disability by approximately 20% because they selectively retest missed points. This error does not occur if single pass or global retesting is utilized. Global retesting is a cost effective method of minimizing this problem and decreasing test variance.

Aged↗