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PubMed1981

Multivariate analysis in glaucoma. Use of discriminant analysis in predicting glaucomatous visual field damage.

A discriminant function obtained in 1978 to separate patients with glaucomatous visual field loss from those without visual field loss was shown to have a predictive value in ocular hypertensive persons as to the subsequent development of visual field loss in five years. A prospective discriminant analysis also was carried out to identify those factors that best separate those in whom visual field defects developed from those in whom they did not.

Factor Analysis, Statistical↗
PubMed1992

Visual field loss after attacks of migraine with aura.

Visual fields were mapped with kinetic are perimetry in 23 migraine with aura subjects and, for comparison, in 20 migraine without aura subjects and in 21 non-headache controls. Central vision on the Amsler eye chart and visual perception threshold on a computer task were also investigated. Measures were obtained at least seven days after an episode of migraine. In addition, 10 of the migraine with aura subjects and 10 migraine without aura subjects were studied the day after an attack. The day after migraine with aura, visual sensitivity in the periphery of the visual fields was depressed, central vision was blurred, and visual perception threshold was elevated. These visual disturbances had resolved 7 to 10 days later. With the exception of a minor increase in visual perception threshold, vision was normal after attacks of migraine without aura. Residual effects of the migraine aura could mediate the subclinical visual disturbances which persist for at least one day after attacks of migraine with aura.

Adolescent↗
PubMed1986

Interocular differences of the visual field in normal subjects.

One way of judging if a visual field is abnormal, particularly when a patient has unilateral or asymmetric disease, is to compare the suspicious visual field to that of the normal eye. This assumes that in normal individuals the two visual fields are symmetrical. To determine the extent of normal symmetry, the authors examined the central visual fields of both eyes of 20 normal subjects with program 30-2 of the Humphrey perimeter. The inter-ocular sensitivity difference at single pairs of locations ranged from 0 to 9 decibels with large differences occurring most frequently in the upper field. Confidence intervals constructed from this set of normal data predict that asymmetry exceeding 6 decibels should occur in fewer than 1% of test locations and that asymmetry of overall mean sensitivity exceeding 1.4 decibels should occur in fewer than 1% of normal subjects.

Adult↗
PubMed1994

Visual field loss while wearing full-face respiratory protection.

The loss of visual field was quantified for 21 test subjects while they wore three full-face respirators. Changes in visual field were quantified for each type of respirator using a modified Goldmann projection perimeter. The loss of visual field was determined by calculating the area under the curve while wearing a respirator to that while wearing no respirator. Distinct patterns of visual field loss were apparent for the different style respirators. Analysis of the patterns could lead to the design of full-face respirators with improved visual qualities, which could improve worker safety for certain occupations. This technique also could be of help when selecting models of respiratory protection when certain visual fields must be maintained.

Adolescent↗
PubMed1990

The visual field in chronic open angle glaucoma: the rate of change in different regions of the field.

Using automated perimetry the distribution of visual field loss in 40 chronic open angle glaucoma eyes (40 patients) was found to be predominantly in the nasal, supranasal, and superotemporal regions. The rate of change of visual field threshold values in seven regions of the field was measured by trend analysis over 44.9 +/- 17.9 months. Seventeen eyes had a significant rate of field loss in one or more regions of the field with the remaining eyes either showing improvement or stability. Seven of the 17 eyes with significant regional field loss had stable overall fields. The greatest rate of field loss occurred in the temporal and superotemporal regions. The correlation between the mean threshold value of the initial field test and the rate of change of field over time was significant in the temporal region and of borderline significance in the superotemporal region. The relationship was such that the greater the initial threshold value, the greater the subsequent rate of field loss.

Eye↗
PubMed1996

Visual field loss after macular hole surgery.

BACKGROUND: Vitrectomy has been successfully used for treating idiopathic macular holes. Although macular hole surgery has been successful and is generally regarded as a safe procedure, various complications have been reported. The authors report eight patients with symptomatic peripheral visual field loss occurring after vitrectomy for macular holes. METHODS: Over a 3-year period, vitrectomy with removal of the posterior cortical vitreous and fluid-gas exchange was performed on 50 eyes of 47 patients with idiopathic macular holes. Eight patients reported visual field loss postoperatively, and Goldmann visual fields were obtained. The clinical characteristics and outcomes of the group of patients with visual field loss were compared with the group of patients without visual field loss. RESULTS: Postoperatively, significant peripheral visual field loss was documented in eight patients. The macular holes were anatomically closed in seven eyes (87.5%) of these patients compared with 37 (88.1%) of 42 eyes in the group of patients with no symptomatic visual field loss. The visual field loss was not associated with age, sex, macular hole stage, postoperative intraocular pressure, or history of hypertension or coronary artery disease. The etiology of visual field loss was unclear in six patients. CONCLUSION: Vitrectomy for idiopathic macular holes can result in significant peripheral visual field loss. The etiology of this complication usually is unknown.

Aged↗
PubMed1985

The development of young infants' ability to detect stimuli in the nasal visual field.

We compared infants' ability to detect single lines of varying width in the temporal and nasal visual fields. The smallest lines detected by 1-month-olds at 20 degrees in the nasal visual field were more than eight times wider than those detected at 30 degrees in the temporal visual field. In contrast, 2-month-olds detected smaller lines at 20 degrees in the nasal visual field than at 30 degrees in the temporal visual field. Converging evidence suggests that the observed improvement between 1 and 2 months in detection in the nasal visual field reflects the maturation of a projection from the retina through the visual cortex to the superior colliculus.

Eye Movements↗
PubMed1994

The influence of patient reliability on visual field outcome.

The reliability of subjects to perform to perimetry correctly should be carefully evaluated to interpret visual field examinations adequately. Clinicians generally agree that numerous false-positive responses to catch trials cause measured thresholds to be falsely high and numerous false-negative responses cause measured thresholds to be falsely low. We studied the effect of false-positive and false-negative responses on the outcome of visual field measurements. Of 47 eyes, the results of 106 stable glaucomatous visual field tests (Program G1, Octopus 201, Interzeag, Schlieren, Switzerland) with false-positive responses and no more than one false-negative response to catch trials were compared to the results of reliable visual field tests (no false-positive and no more than one false-negative response) performed on the same eye. Similarly, 60 stable visual fields with false-negative responses and no more than one false-positive response were used to study the effect of false-negative responses on visual field sensitivities. Linear regression analysis disclosed a mean sensitivity increase of 1.5 dB for every 10% of false-positive responses (r = .34, P = .000) and a mean sensitivity decrease of 1.2 dB for every 10% of false-negative responses (r = .26, P = .04). These results may be used to help reduce the magnitude of unexplained long-term fluctuation in visual field interpretation.

Adult↗
PubMed1983

Visual field testing with red targets.

Ten patients with partial temporal visual field defects were examined with a modified tangent screen projection perimeter (Auto-Plot). Defects demonstrated with an isopter for chromatic recognition of a 3-mm red stimulus could always be reproduced with an isopter for achromatic recognition of a dim, 3-mm white stimulus. The red-white intensity ratio producing equivalent fields remained constant for a given patient but varied from subject to subject (range, 3.0 to 7.5; mean, 5.7; SD, 1.8). Thus, red functioned as dim white, but no single fixed ratio of intensities was applicable to all subjects. Visual field testing with 1 foot-candle of tangent screen illumination permitted subjects to adapt to dark. As retinal sensitivities increased, the corresponding visual field steadily enlarged for 30 minutes. This effect was greater in the pathologic temporal fields, which increased relatively more than intact nasal fields. The result was poor visual field reproducibility with time.

Color↗
PubMed1998

Simulating binocular visual field status in glaucoma.

AIMS: To simulate the central binocular visual field using results from merged left and right monocular Humphrey fields. To assess the agreement between the simulation and the binocular Humphrey Esterman visual field test (EVFT). METHOD: 59 consecutive patients with bilateral glaucoma each recorded Humphrey 24-2 fields for both eyes and binocular EVFT on the same visit. EVFT results were used to identify patients exhibiting at least one defect (< 10 dB) within the central 20 degrees of the binocular field. This criterion is relevant to a patient's legal fitness to drive in the UK. Individual sensitivity values from monocular fields are merged to generate a simulated central binocular field. Results are displayed as a grey scale and as symbols representing defects at the < 10 dB level. Agreement between patients failing the criterion using the simulation and the EVFT was evaluated. RESULTS: Substantial agreement was observed between the methods in classifying patients with at least one defect (< 10 dB) within the central binocular field (kappa 0.81; SE 0.09). Patients failing this criterion using the EVFT results were identified by the binocular simulation with high levels of sensitivity (100%) and specificity (86%). CONCLUSIONS: Excellent agreement exists between the simulated binocular results and EVFT in classifying glaucomatous patients with central binocular defects. A rapid estimate of a patient's central binocular field and visual functional capacity can be ascertained without extra perimetric examination.

Adult↗
PubMed1985

Repeated automatic visual field screening in a cohort study.

During 1977 and 1978 automatic visual field screening was performed in 1511 persons born 1907-1921 and taking part in a population study. Three years later automatic visual field screening was repeated in 2565 eyes of 1293 persons. "Irrelevant" defects were common and had a limited repeatability. "Relevant" defects were easily detected at the first and reproduced at the second survey. From a clinical point of view, the yield of the visual field screening at the second survey was restricted. We concluded that repeated visual field screening by automatic perimetry is quite feasible but has little reward.

Diagnostic Errors↗
PubMed1981

Visual field topography and binocular responses in frog's nucleus isthmi.

Visual responses of 125 units have been extracellularly recorded with glass micropipettes from the left nucleus isthmi in the frog Rana nigromaculata, and 101 electrode tip positions marked with cobalt staining to reconstruct a visual field map in the nucleus. 80% of the units recorded show ON-OFF responses to a stationary spot of light and many are directionally selective in response to black or white targets moving through their receptive fields. All the cobalt-marked spots are within the nucleus, indicating that the nucleus isthmus proper is a restricted part of the frog visual system. There is a visual field map in the nucleus. The entire contralateral hemifield and the nasal 40 degrees of the ipsilateral hemifield project on the nucleus topographically. A cell-free band inside the nucleus is a boundary line separating the contralateral hemifield from the ipsilateral one. Dorsal to it is the contralateral field representation. The upper visual field projects on the rostral half of the nucleus and the central and medio-ventral portion of its caudal half. The lower field is represented on the dorsal and lateral part of the caudal half. Fifteen binocular units have been found from the nucleus, 13 of which are dominantly activated by the contralateral eye, the other two are almost equally excited by either eye. These binocular units are mainly situated in the medulla of the rostral half of the nucleus isthmus.

Animals↗
PubMed1997

Correlation between mean visual field loss and morphometric optic disk variables in the open-angle glaucomas.

PURPOSE: To correlate morphologic changes of the optic disk with mean visual field defect in glaucoma. METHODS: Color optic disk photographs of 302 patients with primary open-angle glaucoma, 53 patients with pseudoexfoliative glaucoma, and 55 patients with normal-pressure glaucoma were morphometrically evaluated. The data were correlated with mean visual field defect. RESULTS: The correlation between mean visual field defect and neuroretinal rim area was similar to a logarithmic function. The visual field deteriorated slightly in the early stage and markedly in the advanced stages of glaucoma. A discrepancy between normal visual field and abnormal optic disk occurred more often in young than in old patients. Neuroretinal rim shape, total rim area, and rim area in the temporal inferior and temporal superior disk sectors correlated best with mean visual field loss. Alpha and beta zones of peripapillary atrophy and diameter of retinal arterioles were less clearly correlated. Calculated rim variables that were corrected for optic disk area did not markedly improve the correlation coefficients. In eyes with normal visual fields, rim shape was the most important disk variable for detecting glaucomatous optic nerve damage. There were no patients with glaucomatous visual field loss and an unremarkable optic disk. CONCLUSIONS: In early glaucoma, changes are more marked in optic disk appearance than in the visual field, suggesting that at least for some patients, for early glaucoma diagnosis, optic disk appearance is more important than perimetry, whereas for follow-up examination, perimetry may be more useful than optic disk morphometry. The most useful planimetric optic disk parameters are neuroretinal rim shape and rim area.

Adult↗
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↗
PubMed1997

Deterioration of visual fields in patients with glaucoma with and without optic disc hemorrhages.

OBJECTIVE: To evaluate visual field deterioration in patients with glaucoma with and without optic disc hemorrhages (DHs). DESIGN: A prospective study at quarterly base involving annual perimetry; mean follow-up of 9 years. SETTING: Outpatient department, nonreferral basis. PATIENTS: Sixty-eight patients with primary open-angle glaucoma, 34 with normal pressure glaucoma (NPG), and 125 with ocular hypertension. RESULTS: Visual field deterioration occurred in 32%, 32%, and 6% of the patients without DHs who had NPG, primary open-angle glaucoma, or ocular hypertension, respectively, while visual field deterioration occurred in 80%, 89%, and 14% of patients with DH, respectively. Cox proportional hazards ratio(CHR) for deterioration in patients with vs patients without DHs was 5.4 for NPG (P<.01) and 3.6 for primary open-angle glaucoma (P<.01). In patients with NPG and DHs, ipsilateral eyes with DHs deteriorated in 58%, while contralateral eyes without DHs deteriorated in 11% (CHR, 8.9; P<.04). For primary open-angle glaucoma and ocular hypertension, progression did not differ between eyes with DHs and contralateral eyes without DHs. Mean (+/-SD) interval between DHs and ipsilateral visual field deterioration was 3.1+/-1.7 years. No difference in the proportion of eyes progressing after single or recurrent DHs was noted. The position of DHs was related to the site of the visual field loss in 44% of the eyes. CONCLUSIONS: The presence of DHs increased the risk of visual field deterioration. Disc hemorrhages were indicative only of deterioration in ipsilateral eyes in patients with NPG.

Disease Progression↗
PubMed1996

[Objective visual field measurement using "pupil perimetry"].

In an attempt to measure the visual field objectively, we developed a system of "Pupil Perimetry". An infrared pupillometry machine was linked to a Goldmann perimeter to record the visual field by mapping the change in the pupil area (mm2) at each target location within the field. We decreased the background intensity to 10Asb to get maximum pupil response. The target was exposed for 0.25 seconds with an intensity of 1,000 Asb. Pupil response was observed up to 90 degrees laterally and 60 degrees nasally across a meridian in normal subjects. Visual fields obtained from patients with homonymous hemianopsia, glaucoma and Leber's optic neuropathy were compatible with a field obtained by a Humphrey field analyzer (FHA) 30-2 program. Pupil perimetry is a useful tool for measuring the visual field objectively.

Adult↗
PubMed1992

Grating acuity and visual field development of infants with bronchopulmonary dysplasia.

The grating acuity and visual fields were assessed of 48 infants with bronchopulmonary dysplasia (BPD) who had no periventricular leukomalacia or grade III or IV intraventricular hemorrhage, and no stage 3 or greater retinopathy of prematurity. Infants were tested at four, eight, 11, 17 and 24 months corrected age, and their results were compared with those of 81 healthy preterm infants and 54 with hyaline membrane disease (HMD) that did not result in BPD. The BPD group showed no significant difference in acuity development compared with the healthy preterm and HMD groups. Infants with BPD had significantly smaller visual fields than either control group at 11 months; visual field development was similar for all groups at all other test ages. The authors conclude that infants with BPD who have no significant ocular or neurological complications show normal grating acuity and visual field development during the first two years of life.

Bronchopulmonary Dysplasia↗