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At least 271 records · Page 15Linked to original sources
PubMed1997

Factors associated with intraocular pressure-induced acute visual field depression.

OBJECTIVE: To determine the factors associated with visual field depression produced by artificial elevation of intraocular pressure (IOP). METHODS: The visual threshold was determined at 26 locations in the central visual field at a spontaneous IOP, at 30 mm Hg, at 40 mm Hg, and at the IOP immediately following release of the suction cup used to elevate the IOP artificially in 33 subjects with and without glaucoma. The net decrease in threshold sensitivity at each IOP level relative to sensitivity obtained at the spontaneous IOP was calculated (acute visual field depression). RESULTS: Factors potentially influencing the acute visual field depression between subjects were determined with stepwise regression. The reciprocal of ocular perfusion pressure, a clinical measure, was strongly correlated with acute visual field depression (dependent variable), particularly at 40 mm Hg (at 30 mm Hg, r=0.412, P=.02, n=32; and at 40 mm Hg, r=0.813, P<.001, n=33). When a second variable, the diagnosis of glaucoma, was included in the regression at 40 mm Hg, it contributed significantly (partial r=0.650, P<.001, n=26). The degree of glaucomatous damage (vertical cup-disc ratio or baseline Humphrey 24-2 visual field mean deviation) failed to correlate with acute field depression, with or without correction for ocular perfusion pressure. CONCLUSIONS: The elevation of IOP produces acute, reversible visual field depression. This depression is largely dependent on the subject's ocular perfusion pressure. The degree of depression is greater in those with glaucoma but is not strictly related to the degree of glaucomatous damage.

Acute Disease↗
PubMed1996

Rate of progression in open-angle glaucoma estimated from cross-sectional prevalence of visual field damage.

PURPOSE: To estimate the rate of visual field loss in persons with open-angle glaucoma. METHODS: The visual field data obtained by Goldmann perimetry from 151 persons with open-angle glaucoma from the Baltimore Eye Survey were graded on a nine-level severity scale. Approximately one half of these persons had previously diagnosed glaucoma and were being treated. Using regression analysis, their scores were compared to other features, including age, vertical cup/disk ratio, treatment status, gender, race, and intraocular pressure. These data were used to estimate the average rate of progressive field loss and blindness in glaucoma. RESULTS: Among 112 black subjects, the severity of visual field damage was significantly associated with age (P < .02), history of glaucoma treatment (P < .04), and intraocular pressure (P < .0001). Using the relationship between age and damage, we estimated that the rate of deterioration of black glaucoma subjects was two grading levels per decade, which is consistent with previous reports. For 39 white subjects, the inclusion of age improved the model relationship between damage score and other variables. The best estimate of individual damage rate for whites was similar to that in blacks. However, the statistical association of age and damage in whites was less strong than in blacks, possibly because of fewer white subjects in the sample. CONCLUSIONS: While glaucoma is a frequent cause of visual disability, rate of progressive visual field loss is not sufficient to lead to bilateral blindness in the majority of those affected. Aggressiveness of glaucoma therapy should be related to the rate of visual field loss stressing confirmation of field progression.

Adult↗
PubMedDate not supplied

Visual field defects in children with congenital glaucoma.

PURPOSE: To determine visual field defects in a cohort of children with congenital glaucoma. METHODS: Monocular visual fields were measured in 24 meridians for targets V4e, I4e, I2e, and I1e, using a Goldmann perimeter in a group of 13 children between the ages of 4 and 14 years with congenital glaucoma and 10 age-matched healthy children. Localized visual field defects (eg, paracentral scotoma, nasal step, and arcuate scotoma) were determined by abnormal findings or shape of the eye in at least one of each of the targets presented. RESULTS: Visual field extent for target 12e was significantly constricted for unilateral and bilateral cases of congenital glaucoma when compared with control eyes. A post-hoc procedure (Tukey Test) showed significant differences between unilateral cases and normal control eyes, and between bilateral cases (best outcome eye) and normal control eyes. Stimuli V4e and 14e results were comparable for patients and normals. Stimulus I1e showed significantly different total extent visual field for bilateral and normal controls. Specific visual field defects were found only in bilateral cases. Paracentral scotoma was found in 1 of 12 eyes with bilateral congenital glaucoma. Nasal steps were found in 6 of 12 eyes with bilateral congenital glaucoma. Arcuate scotoma were found in 4 of 12 eyes with bilateral congenital glaucoma. CONCLUSION: Localized visual fields were found in 37.5% of eyes with congenital glaucoma. Early treatment for congenital glaucoma provided better visual field outcome.

Adolescent↗
PubMed2001

Mathematical and optimal clustering of test points of the central 30-degree visual field of glaucoma.

PURPOSE: To determine a mathematically optimal sector pattern of the central 30 degree visual field for the follow-up of glaucomatous visual field change based on a large number of actual visual field test data of patients with glaucoma. METHODS: Visual field test data obtained from 1,039 eyes of 1,039 patients with open-angle glaucoma (OAG) using the 30-2 program of the Humphrey Field Analyzer were used for sectorization of the central 30 degree visual field. Of the 1,039 visual field data, 698 (modeling data) were used for determining the sector pattern and 341 (testing data) for checking the sector pattern. The modeling data were further divided into three groups according to the mean deviation (MD) (MD > or = -10 dB, -20 < or = MD < -10 dB, and MD < -20 dB), and the sector pattern was constructed from visual field data of each group using a clustering procedure called VARCLUS. The testing data were used for determining the optimal sector pattern. In a separate set of repeated visual field data of 303 patients with OAG, the fluctuation of MD, sector values of each sector determined, and total deviation of each test point were calculated and compared. RESULTS: The sector pattern constructed from visual field data of MD > or = -10 dB summarized the visual field performance most effectively. The fluctuation of the sector value of each sector was roughly 1.5 times smaller than the total deviation of each test point. CONCLUSION: The sector pattern determined may be useful in analyses of the visual field data of patients with glaucoma.

Glaucoma, Open-Angle↗
PubMed2002

Rate and pattern of visual field decline in primary open-angle glaucoma.

PURPOSE: To study the rate and pattern of visual field decline in primary open-angle glaucoma. DESIGN: Retrospective observational case series. PARTICIPANTS: Forty eyes of 40 patients with primary open-angle glaucoma that were followed longitudinally with serial Goldmann visual fields for a minimum period of 8 years in an academic institution. Eyes with any other ocular disease except for mild cataract were excluded. METHODS: Visual fields obtained with worse than 20/50 Snellen visual acuity from cataract were excluded from analysis. In the remainder (671 Goldmann visual fields), the I4e isopter was quantified manually using a grid template previously described by Esterman. The visual field was divided into central and peripheral, superior and inferior, and nasal and temporal regions, all centered at the blind spot. The rate of visual field decline was estimated for each visual field region (including the four quadrants: superonasal [SN], superotemporal [ST], inferotemporal [IT], and inferonasal [IN]) using linear regression. Asymmetry of visual field progression was determined by comparing the rates of progression among the four quadrants. Pertinent clinical factors were evaluated for association with the asymmetry of visual field progression. MAIN OUTCOME MEASURES: Rates of visual field decline for the entire visual field and each region. Long-term clinical outcome measures, including visual acuity, cataract and cup-to-disc ratio progression, intraocular pressures, and medical and surgical interventions were also studied. RESULTS: The rate of visual field change was -1.3% per year for the entire visual field. The rates of visual field section change (in % per year) were -1.3 (central), -1.4 (peripheral), -1.5 (superior), -1.2 (inferior), -1.4 (nasal), -1.2 (temporal), -1.8 (SN), -1.3 (IT), -1.2 (IN), and -1.1 (ST). About half the patients showed symmetric visual field decline, whereas others showed a more asymmetric pattern. Asymmetric visual field progression was associated with the presence of disc hemorrhage, overall rate of visual field progression, and surgical intervention for glaucoma. CONCLUSIONS: In this group of selected patients with primary open-angle glaucoma with a long-term follow-up, all sections of the visual field declined over time. Disc hemorrhage was associated with more asymmetric visual field progression, implicating focal damage to the optic disc.

Adult↗
PubMed2002

Sensitivity and specificity of the Swedish interactive threshold algorithm for glaucomatous visual field defects.

PURPOSE: To determine the sensitivity and specificity of two new visual field algorithms in detecting glaucomatous visual field defects: (1) Swedish interactive threshold algorithm (SITA) standard and (2) SITA fast. DESIGN: Prospective observational case series. PARTICIPANTS: Ninety normal subjects and 82 glaucoma patients. TESTING: Central 30 degrees fields were performed with the Humphrey visual field analyzer 30-2 program (Humphrey Systems, Dublin, CA) using full threshold, SITA standard, and SITA fast algorithms on the same day for two or more sessions within a 1-month period. MAIN OUTCOME MEASURES: Sensitivity and specificity in detecting glaucomatous visual field defects with SITA standard and SITA fast using full threshold testing as the reference standard. RESULTS: The sensitivity of SITA standard and SITA fast in detecting glaucomatous defects overall was 98% and 95%, respectively. In the subset of mild glaucomatous field defects (26 patients), sensitivity of SITA standard was 92% versus 85% with SITA fast. Sensitivity was 100% for both algorithms in moderate to severe glaucomatous defects. Specificity for glaucoma defects using SITA standard and SITA fast was 96% for both algorithms. SITA standard reduced test-taking time from full threshold by 52% in normal subjects and 47% in glaucoma patients (P < 0.001). SITA fast reduced test-taking time by 72% in normal subjects and 65% in glaucoma patients (P < 0.001). Mean deviation values were 0.4 dB and 0.8 dB better in SITA standard and SITA fast fields, respectively, in normal subjects (P < 0.001), and 0.7 dB and 1.2 dB in SITA standard and SITA fast fields, respectively, in glaucoma patients (P < 0.001) compared with full threshold values. CONCLUSIONS: The new algorithms for measuring visual fields, SITA standard and SITA fast, have excellent sensitivity and specificity for glaucomatous visual field loss with considerable savings in time.

Adult↗
PubMed2002

Spatial and temporal processing of threshold data for detection of progressive glaucomatous visual field loss.

OBJECTIVE: To evaluate the effect of spatial and temporal filtering of threshold visual field data on the ability of pointwise linear regression (PLR) to detect progressive glaucomatous visual field loss. METHODS: Longitudinal visual field data (Full-Threshold Program 30-2 test point pattern) were simulated using a computer model of glaucomatous visual field progression. This approach permitted construction of a "gold standard" because matching visual field data without variability could be generated and analyzed. Four clustered progressive defects were produced, consisting of 2, 3, 9, and 18 locations, respectively, each with progression rates of -1 and -2.5 dB/y. Pointwise linear regression was used to identify progressive test locations (criterion for progression of statistically significant slope of < or =-1 dB/y, P<.05). Each visual field series was analyzed after the following 3 procedures: (1) no filtering (unprocessed data), (2) Gaussian spatial possessing (3 x 3 grid), and (3) temporal processing (2 field moving average). The effect of spatial and temporal processing on PLR discriminatory power for progression detection was quantified by comparison with the gold standard. RESULTS: Spatial processing reduced PLR sensitivity to levels below that achieved for analysis of unprocessed data for small progressive defects (< or =9 locations) or at the low true progression rate (-1 dB/y). Under these conditions, spatial processing caused small PLR specificity improvement. Spatial processing only improved PLR sensitivity above unprocessed levels when progressive defects were large and changing rapidly (progression rate of -2.5 dB/y). Temporal processing gave consistent PLR improvement in sensitivity for all defect sizes and true progression rates. Pointwise linear regression sensitivity gain provided by temporal processing allowed progression to be detected 2 to 3 visual fields earlier than for analysis of raw data. Specificity dropped slightly as a result of temporal processing but remained at 89% or above for all conditions studied. CONCLUSIONS: Gaussian spatial processing reduces PLR discriminatory power with low true progression rates or small progressive defect sizes and, therefore, is of limited use for detection of progressive visual field loss. Temporal processing improves the sensitivity of PLR and reduces the number of tests required to detect progressive loss with minimal loss of specificity. CLINICAL RELEVANCE: Image processing techniques can be applied to threshold visual field data to enhance sensitivity or specificity of PLR for the determination of progressive change. This investigation demonstrates that temporal processing may assist with the detection of significant progressive visual field loss with fewer test results than unprocessed data.

Computer Simulation↗
PubMed1979

Mapping the representation of the visual field by electrical stimulation of human visual cortex.

Electrical stimulation of human visual cortex produces punctuate phosphenes in the visual field. This phenomenon, which is being explored as the basis for a visual prosthesis for the blind, also provides the first electrophysiological information about the retinocortical map in man. Stimulation of points clustered on the surface of the visual cortex produces phosphenes clustered in visual space. However, adjacent surface electrodes located on opposite sides of a sulcus can produce widely separated phosphenes, because the intervening cortex is buried and inaccessible to stimulation. Such electrodes can also produce multiple phosphenes by simultaneously stimulating both banks of the sulcus. Electrodes which are widely spaced on the brain can produce phosphenes close together in visual space providing they stimulate cortex corresponding to overlapping maps in areas 17 and 18. Analysis of the phosphene map indicates that successive stimulation of points further from the tip of the occipital pole produces phosphenes progressively more distant from the fixation point. Successive stimulation of points along the orthogonal dorsoventral dimension produces a progressive change in phosphene bearing. These results confirm the general view of cortical organization derived from field defect studies in man, and from anatomical and electrophysiological studies in monkeys, and provide a new tool for more detailed study of retinotopic projections in man.

Adult↗
PubMed1988

[Behavior of visual acuity, visual fields and contrast sensitivity in simulated cataract].

Visual acuity, contrast sensitivity, and visual fields were examined with and without occluders both in a group of healthy subjects and in a group of patients with field defects (mostly caused by glaucoma). The various results were compared with one another as well as with the results obtained from a group of cataract patients examined before and after surgery. The results confirm clinical experience: visual acuity enables some conclusions to be drawn on the degree and progression of opacity of a lens. The changes in contrast sensitivity and in the visual field, however, represent rather the quality of the visual degradation. Contrast sensitivity and diffuse alterations in the visual field have similar progression patterns. The alterations in contrast sensitivity are more pronounced at higher frequency levels. The contrast sensitivity test can be recommended as a simple and complementary functional test, particularly on cataract patients with severe complaints and relatively good visual acuity. The results of occlusive experiments afford some practical conclusions which enhance knowledge and differentiation of visual field changes induced by cataract and glaucoma. These conclusions can provide a basis for further and more detailed investigations.

Adult↗
PubMed2006

Visual field recovery after vision restoration therapy (VRT) is independent of eye movements: an eye tracker study.

AIM: It has been argued that patients with visual field defects compensate for their deficit by making more frequent eye movements toward the hemianopic field and that visual field enlargements found after vision restoration therapy (VRT) may be an artefact of such eye movements. In order to determine if this was correct, we recorded eye movements in hemianopic subjects before and after VRT. METHODS: Visual fields were measured in subjects with homonymous visual field defects (n=15) caused by trauma, cerebral ischemia or haemorrhage (lesion age >6 months). Visual field charts were plotted using both high-resolution perimetry (HRP) and conventional perimetry before and after a 3-month period of VRT, with eye movements being recorded with a 2D-eye tracker. This permitted quantification of eye positions and measurements of deviation from fixation. RESULTS: VRT lead to significant visual field enlargements as indicated by an increase of stimulus detection of 3.8% when tested using HRP and about 2.2% (OD) and 3.5% (OS) fewer misses with conventional perimetry. Eye movements were expressed as the standard deviations (S.D.) of the eye position recordings from fixation. Before VRT, the S.D. was +/-0.82 degrees horizontally and +/-1.16 degrees vertically; after VRT, it was +/-0.68 degrees and +/-1.39 degrees , respectively. A cluster analysis of the horizontal eye movements before VRT showed three types of subjects with (i) small (n=7), (ii) medium (n=7) or (iii) large fixation instability (n=1). Saccades were directed equally to the right or the left side; i.e., with no preference toward the blind hemifield. After VRT, many subjects showed a smaller variability of horizontal eye movements. Before VRT, 81.6% of the recorded eye positions were found within a range of 1 degrees horizontally from fixation, whereas after VRT, 88.3% were within that range. In the 2 degrees range, we found 94.8% before and 98.9% after VRT. Subjects moved their eyes 5 degrees or more 0.3% of the time before VRT versus 0.1% after VRT. Thus, in this study, subjects with homonymous visual field defects who were attempting to fixate a central target while their fields were being plotted, typically showed brief horizontal shifts with no preference toward or away from the blind hemifield. These eye movements were usually less than 1 degrees from fixation. Large saccades toward the blind field after VRT were very rare. CONCLUSION: VRT has no effect on either the direction or the amplitude of horizontal eye movements during visual field testing. These results argue against the theory that the visual field enlargements are artefacts induced by eye movements.

Adult↗
PubMed1987

[Fluctuations and stable elements in the visual field in glaucoma].

In glaucomatous visual fields there are more fluctuations than stable elements. High-amplitude fluctuations of stimulus threshold values are characteristic of glaucoma. The correlation between sensitivity and the mean loss can be demonstrated by the ABC test. The structure of scotomas is explained. There is a stable, relatively small nucleus (a) of individual defects which stay in the same location for three years and mainly have the most severe loss (greater than or equal to 2.0 logE). However, accompanying and border fluctuations (b and c) predominate. They are detected by recording individual defects. The results of a study lasting several years are communicated, in which 1124 visual field examinations were performed in 146 patients using the Peritest computer-controlled perimeter.

Age Factors↗
PubMed1992

Visually perceived eye level: changes induced by a pitched-from-vertical 2-line visual field.

The physical elevation corresponding to visually perceived eye level (VPEL) changes linearly with the pitch of a visual field. Deviations from true eye level average more than 0.5 times the angle of pitch over a 65 degrees pitch range. A visual field consisting of 2 dim, isolated vertical lines in darkness is more than 4/5 as effective as that of a complexly structured visual field; 2 horizontal lines have a small and inconsistent effect. Differences in influence on VPEL between pitched-from-vertical and horizontal lines were predicted from an analysis that extracted differences in retinal perspective resulting from changes in pitch. The Great Circle Model (GCM), based on a spherical approximation to the erect, stationary eye, predicts the present results and results of 8 other sets of experiments. The model treats the influence of a single line on VPEL as systematically related to the elevation of the intersection between the great circle containing the image of the line and the central vertical retinal meridian; generalized GCM combines visual inputs with inputs from the body-referenced mechanism and maps onto the central nervous system.

Darkness↗
PubMed1999

Comparison of central and peripheral visual field properties in the optic neuritis treatment trial.

PURPOSE: To compare the results of peripheral kinetic visual field testing and central static perimetry for patients enrolled in the Optic Neuritis Treatment Trial to determine (1) whether loss and recovery of visual field sensitivity in the far periphery was different from that observed in the central visual field and (2) whether the far peripheral visual field provided additional useful information that was not available in the central visual field results. METHODS: Both affected and fellow eyes of 448 patients with optic neuritis in the Optic Neuritis Treatment Trial were evaluated according to the trial protocol during the patients' first 3 years in the study. Central static visual field tests were performed with program 30-2 on the Humphrey Field Analyzer, and peripheral kinetic testing consisted of plotting the I3e and II4e isopters on the Goldmann perimeter. Both test procedures were conducted according to the trial protocols, and quality control assessments and clinical evaluations were performed on all the visual fields. RESULTS: For both affected and fellow eyes at all 11 visits, there was a greater number of abnormal visual fields in the central static perimetry results than in the peripheral kinetic data. Only 2.9% of affected eyes had an abnormal peripheral visual field with a normal Humphrey mean deviation during year 1. At baseline, 97.1% of affected eyes had an abnormal Humphrey mean deviation on central static testing, whereas only 69.9% had abnormal peripheral kinetic visual fields. Approximately 80% of the I3e and II4e isopters for affected eyes that were abnormal at baseline were within normal limits at 30 days, but it took until week 19 for even 70% of the Humphrey mean deviations to return to normal. In addition, the II4e isopters (more peripheral than the I3e isopters) that were abnormal at baseline showed a somewhat greater percentage of improvement from baseline through day 30 than the abnormal I3e isopters. Although this difference is statistically significant, it is probably not clinically significant. For visits after week 19, approximately 25% to 30% of affected eyes had an abnormal Humphrey mean deviation, whereas only 10% to 15% of peripheral kinetic fields were abnormal. CONCLUSIONS: For the affected eye in optic neuritis, the central visual field shows greater abnormalities than the far peripheral visual field. When the results obtained through Humphrey automated central static visual fields and Goldmann peripheral kinetic isopters are compared, the far periphery appears to recover more rapidly and more completely than the central field, at least in more severe cases of optic neuritis. In most cases, recovery in optic neuritis can probably be monitored effectively with automated perimetry of the central visual field alone. However, in cases of severe loss of the central visual field, a peripheral kinetic visual field obtained with a Goldmann perimeter may provide additional information about the patient's vision in the far periphery.

Adolescent↗
PubMed1989

[Relationship between central visual field and pattern VECP in optic neuritis].

We compared the visual field within 10 degrees with the latency and amplitude of the P100 component of pattern visually evoked cortical potentials (PVECPs) in optic neuritis. Twenty five eyes of 17 cases with optic neuritis suffered from multiple sclerosis (MS) and in 21 eyes of 17 cases optic neuritis was caused by unknown etiology. The visual field was tested by program 31 of the automated perimeter Octopus. PVECPs were recorded with a television system. The visual field was considered to be abnormal for when at least one abnormal point was found within a 10-degree field. P100 peak latency of PVECPs with above normal mean latency plus 2SD was defined as abnormally prolonged. The abnormalities found by 10-degree visual field and PVECPs latency correlated significantly both in cases of MS and unknown cause. The eyes with mean loss of over 4dB within a 10-degree visual field invariably had a delayed latency. Those with an abnormal central point or abnormal points in the lower part within 10-degree visual field had a delayed latency. The latency was estimated in relation to causes, age, visual acuity and visual field. The cases with worse vision or worse field showed a tendency to have a prolonged latency. In unilateral cases the ratio of PVECPs amplitude between affected eyes and healthy fellow eyes was studied. The eyes which had abnormal visual field within 10 degrees and a delayed latency showed reduced amplitude of at most 61% compared with that of the healthy fellow eyes(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1999

The full-field flicker test in glaucomas: influence of intraocular pressure and pattern of visual field losses.

BACKGROUND: The purpose of this study was to evaluate how temporal contrast sensitivity (TCS) determined with full-field flicker stimuli is influenced by intraocular pressure and whether TCS is reduced in glaucoma patients with diffuse perimetric losses as well as in patients with localized visual field deficits. METHODS: TCS was determined with sinusoidally flickering light (37.1 Hz) in a full-field bowl. Perimetric mean defect (MD) and cumulative defect curves (Octopus G1) were used to distinguish between patients with localized and diffuse field deficits. Normal subjects (296), low-tension glaucoma patients (98) and open-angle glaucoma patients with previously elevated intraocular pressure (541) were classified into five subgroups taking into account the depth of their visual field losses. RESULTS: No significant correlation between full-field flicker sensitivity and prevailing intraocular pressure was found in normals (Y=1.36+0.006 X) or in patients (Y=0.95-0.0002 X). Analyses of validity at a predefined specificity of 90% reveal a reduction of TCS in patients with early (MD<5 dB) diffuse perimetric losses (sensitivity 69%) as well as in those showing localized visual field defects (sensitivity 65%). Sensitivity was 87% in patients with diffuse perimetric defects (MD 5-10 dB), 93% in a group of patients with both types of losses, and 100% in advanced glaucomas (MD>20 dB). The lack of TCS is similar in open-angle glaucomas and in field-loss-matched normal-tension glaucoma patients. CONCLUSIONS: Significantly reduced TCS in patients with early diffuse perimetric losses as well as in those showing localized visual field defects indicates that localized damages can be associated with general deterioration of the ability to perceive flickering stimuli. Thus, this flicker test can be performed in a full-field bowl with no need for fixation. Considering its other clinical qualities (photopic conditions, low influence of prevailing intraocular pressure and media opacity) the test may be a useful, convenient supplementary procedure in glaucoma screening.

Chronic Disease↗
PubMed1997

Correlation of blue-on-yellow visual fields with scanning confocal laser optic disc measurements.

PURPOSE: Visual field defects and changes in the optic nerve head are signs of glaucoma. It has been shown that blue-on-yellow (B-Y) perimetry can reveal visual field defects earlier and shows them larger than does white-on-white (W-W) perimetry. The Heidelberg retina tomograph (HRT) can produce three-dimensional images of the optic disc. The aim of this study was to find out how B-Y perimetry results correlate with optic disc parameters in comparison with W-W perimetry results. METHODS: One randomly chosen eye was evaluated in each of 40 normal subjects and 37 patients with ocular hypertension and different stages of glaucoma. B-Y and W-W visual fields (program 30-2) were obtained with a Humphrey perimeter. B-Y perimetry results were adjusted for the patient's age and lens transmission index measured with a lens fluorometer. The B-Y visual field adjusted mean deviation (MD) was calculated as the difference between the measured and expected mean sensitivity values, predicted by the regression model fitted in normal subjects. The HRT with software version 1.11 was used to acquire and evaluate topographic measurements of the optic disc. RESULTS: The cup shape measure showed strongest correlation with the MD of both the B-Y and W-W visual fields. The multiple correlation coefficients from quadratic regression were 0.65 for both visual fields. Except for peripapillary retinal nerve fiber layer measurements, the statistically significant correlations of the B-Y visual field indexes with other HRT parameters were equal to or better than those of W-W perimetry. CONCLUSIONS: B-Y perimetry MDs are well correlated with optic nerve head parameters measured with the HRT. In early stages of glaucoma, most HRT variables were better correlated with the B-Y MD than with the W-W MD.

Adult↗
PubMed2005

Visual field progression in glaucoma: total versus pattern deviation analyses.

PURPOSE: To compare visual field progression with total and pattern deviation analyses in a prospective longitudinal study of patients with glaucoma and healthy control subjects. METHODS: A group of 101 patients with glaucoma (168 eyes) with early to moderately advanced visual field loss at baseline (average mean deviation [MD], -3.9 dB) and no clinical evidence of media opacity were selected from a prospective longitudinal study on visual field progression in glaucoma. Patients were examined with static automated perimetry at 6-month intervals for a median follow-up of 9 years. At each test location, change was established with event and trend analyses of total and pattern deviation. The event analyses compared each follow-up test to a baseline obtained from averaging the first two tests, and visual field progression was defined as deterioration beyond the 5th percentile of test-retest variability at three test locations, observed on three consecutive tests. The trend analyses were based on point-wise linear regression, and visual field progression was defined as statistically significant deterioration (P < 5%) worse than -1 dB/year at three locations, confirmed by independently omitting the last and the penultimate observation. The incidence and the time-to-progression were compared between total and pattern deviation analyses. To estimate the specificity of the progression analyses, identical criteria were applied to visual fields obtained in 102 healthy control subjects, and the rate of visual field improvement was established in the patients with glaucoma and the healthy control subjects. RESULTS: With both event and trend methods, pattern deviation analyses classified approximately 15% fewer eyes as having progressed than did the total deviation analyses. In eyes classified as progressing by both the total and pattern deviation methods, total deviation analyses tended to detect progression earlier than the pattern deviation analyses. A comparison of the changes observed in MD and the visual fields' general height (estimated by the 85th percentile of the total deviation values) confirmed that change in the glaucomatous eyes almost always comprised a diffuse component. Pattern deviation analyses of progression may therefore underestimate the true amount of glaucomatous visual field progression. CONCLUSIONS: Pattern deviation analyses of visual field progression may underestimate visual field progression in glaucoma, particularly when there is no clinical evidence of increasing media opacity. Clinicians should have access to both total and pattern deviation analyses to make informed decisions on visual field progression in glaucoma.

Adult↗