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PubMed1990

[Progression of early glaucomatous visual field defects].

We studied the mode of progression of visual field defects in glaucoma the using static computerized perimetry (OCTOPUS 201). As a result of analysis using Delta Program, the modes of progression of the visual field defects were divided into two groups, general depression and local depression. The cases of general depression were younger than those of local depression. In cases of local depression, we examined the direction of progression in isolated scotomas. Isolated scotomas located at the nasal visual field tended to progress toward the nasal and peripheral side.

Adult↗

PubMed2001

The visual field following acute primary angle closure.

PURPOSE: To determine the frequency and type of visual field loss six months after an episode of acute primary angle closure (APAC), and to identify risk factors for the development of such field loss. METHODS: This was a cross sectional observational study. All patients who suffered from an episode of APAC at two Singapore hospitals over a one-year period underwent static automated threshold perimetry six months after presentation. RESULTS: 38% of (29) patients with APAC have significant visual field defects six months after the acute episode. The majority of those with abnormal fields had hemifield defects, consistent with nerve fiber bundle pattern loss. Those with pre-existing chronic glaucoma or who develop a rise in intraocular pressure during follow-up are at risk of visual field loss. The risk of visual field loss is also significant if the duration of symptoms exceeds 7 days. CONCLUSIONS: The frequency of visual field loss at 6 months after APAC was low at only 38%. As the majority of eyes have no evidence of detectable functional damage developing as a consequence of the acute episode, APAC may not be blinding if treated promptly and adequately.

Acute Disease↗

PubMed1989

Visual field damage in normal-tension and high-tension glaucoma.

We studied the ocular characteristics of 40 pairs of normal-tension and high-tension glaucoma patients who matched closely for the extent of field damage, pupil size, and visual acuity. To determine if there were differences in visual field damage between patients with normal-tension and high-tension glaucoma, we studied characteristics of the areas of the patients' visual fields that were undisturbed. We computed the number of normal locations, the number of clustered normal locations, and the size of the largest cluster of normal locations. The results showed that for an equivalent extent of damage, the individuals in the normal-tension group had greater areas with normal sensitivity, hence more localized damage. A comparison of the patient data to control data showed that paired differences were larger when the normal-tension member of a pair had a larger value in any of the parameters. The results support the hypothesis that glaucoma patients with lower intraocular pressures have more localized damage and those with higher intraocular pressures have more diffuse damage.

Female↗

PubMed2002

Visual-field superiority as a function of stimulus type and content.

The objective of this study was to examine whether hemispheric superiority is determined more by stimulus type (facial, lexical) or content (neutral, emotional). A split, visual-field experiment was designed using a computer-based program with bilateral presentation (left visual-field, right visual-field) for four sets of stimuli: face (neutral, emotional) x word (neutral, emotional), N = 40. The dependent measures were the frequency of correct response and response latency of correct responses. The visual-field effect was nonsignificant for correct responses; however, the interaction of stimulus type x content was found significant. The interaction of visual-field x stimulus type was significant with response time as the dependent measure. Facial stimuli were processed faster in the left visual-field (a right hemispheric function) and lexical stimuli were processed faster in the right visual-field (a left hemispheric function). No hemispheric effect was observed for stimulus content.

Adult↗

PubMed2003

Associations between glaucomatous visual field loss and participation in activities of daily living.

PURPOSE: This study investigated the association between visual field loss and participation in daily activities in individuals with glaucoma. METHODS: Seventy-nine patients were recruited from the Royal Victorian Eye and Ear Hospital. Visual fields were assessed using the Esterman binocular visual field tests and participation in daily activities was assessed using the Impact of Vision Impairment (IVI) questionnaire. Visual acuity and contrast sensitivity were also measured. RESULTS: There was no independent relationship between visual field loss and IVI score (r = -0.20; P = 0.09), except for the mobility domain (r = 0.25; P = 0.03). Mobility was the most affected domain of the IVI (mean = 1.2). Over a quarter of the patients reported experiencing moderate to severe restriction with mobility activities despite relatively minor binocular field loss. CONCLUSION: Mobility is the area in which glaucoma patients encounter difficulties even when the visual field and visual acuity are relatively good. Questions related to mobility could be asked to identify those patients who need rehabilitation.

Activities of Daily Living↗

PubMed1987

Intraocular pressure and visual field defects after argon laser trabeculoplasty in chronic open-angle glaucoma.

Nineteen patients undergoing argon laser trabeculoplasty for open-angle glaucoma were studied prospectively. All patients had glaucomatous visual field defects with inadequate medical control of intraocular pressure (IOP) before laser treatment. All patients had two automated visual fields immediately before laser treatment. They also had follow-up automated perimetry at 1, 4, 8, and 12 months posttreatment. The serial visual fields were compared using a one-way analysis of variance and trend analysis. After the laser trabeculoplasty, six patients showed visual field improvement, eight showed no change, and five showed progressive visual field deterioration. Patients with little fluctuation of IOP measurements after laser treatment had a better prognosis for visual field retention. The mean IOP level, however, was a poor predictor of visual field progression. Patients with more extensive visual field damage before laser treatment did not do worse than patients with less extensive visual field loss.

Aged↗

PubMed1991

[Detection of retinal visual field defects by sectorial photic stimulation in scotopic luminance ERG].

We developed an electroretinographic procedure to assess visual field defects due to dysfunction of the outer retinal layers. For this objective we determined the amplitude/intensity function of the scotopic b-wave to full field (100 degrees of visual angle), quadrant and hemifield stimulation in 14 healthy volunteers and in patients with visual field disturbances. To prevent stray light effects, we confined the test light illuminance to 10(1.3) of the extrapolated normal ERG threshold (about 10(4.2) the sensory dark threshold). Whereas patients with dysfunction of the proximal retinal layers or the optic nerve did not show any change when the corresponding visual field was stimulated, those suffering from disturbances of the distal retinal layers (e.g., amotio, chorioretinal diseases) showed a reduction in the amplitude/intensity function, which was related to the extension and the degree of the field losses. The method reveals visual field defects caused by disturbances in the outer retinal layers where one-fourth or more of the corresponding retinal quadrant exhibits a sensitivity loss of more than 15 dB.

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↗

PubMed2006

Inter-eye comparison of patterns of visual field loss in patients with glaucomatous optic neuropathy.

PURPOSE: To compare inter-eye patterns of visual field (VF) loss on standard automated perimetry (SAP) in patients with glaucomatous optic neuropathy. DESIGN: Observational cross-sectional study. METHODS: Four-hundred-and-ninety eyes of 245 patients with glaucomatous optic neuropathy in at least one eye defined by masked stereophoto review were included. Patients had two reliable SAP visual fields within fifteen months for each eye. Patterns of visual field loss were classified independently by two graders masked to all other patient information. Patterns were described as altitudinal, arcuate, partial arcuate, paracentral, nasal step, temporal wedge, or normal based on the classification system of Keltner and associates. Superior and inferior hemifields were graded separately. RESULTS: Inter-grader agreement in visual field patterns before adjudication was 97% and 94% for the worse eye (superior and inferior hemifield) and 97% and 95% for the better eye (superior and inferior hemifield). The percentage of correspondence by hemifield location was: 53% (superior-superior), 62% (inferior-inferior), 45% (superior-inferior), and 55% (inferior-superior). The highest correspondence of individual glaucomatous VF pattern between eyes was for arcuate (superior-superior) and inferior partial arcuate (inferior-inferior) defects (24% and 26%, respectively). Smaller hemifield patterns showed lower correspondence between the eyes (nasal step, paracentral, temporal wedge, 0% to 13% correspondence). CONCLUSIONS: Patterns of visual field loss between eyes often corresponded within the same VF hemifield (superior-superior, inferior-inferior) as well as between opposite hemifields (inferior-superior), although opposite hemifield correspondence was less common. More advanced visual field defects (for example, partial arcuate) showed higher correspondence rates between the eyes than less advanced defects.

Aged↗

PubMed1991

Age-related maculopathy. II: The nature of the central visual field loss.

This is the second of three papers dealing with age-related maculopathy (ARM) and its effects on visual function (Swann, P.G. and Lovie-Kitchin, J.E. Age-related maculopathy. I: A review of its morphology and effects on visual function. Ophthal. Physiol. Opt. 10, 149-158 (1990)). We investigated the nature or character of the central visual field loss in ARM and pre-age related maculopathy (PARM) and compared them with age-matched normal subjects. Central visual fields were examined using the Friedmann Visual Field Analyser, Mark II, the Bausch and Lomb Autoplot Tangent Screen and Amsler charts. The central visual field defects in ARM were predominantly paracentral with a relative sparing of foveal sensitivity. PARM subjects did not show significant visual field defects. However, three PARM subjects did show slight distortions with the Amsler charts. The third paper in this series will compare the efficacy of the three methods of visual field investigation in the detection of these defects.

Age Factors↗

PubMed2004

The multifocal visual evoked potential: an objective measure of visual fields?

We examined the effects of inter-modal attention and mental arithmetic on Humphrey visual field sensitivity and multifocal visual evoked potential (mfVEP) amplitude. Four normally sighted subjects (ages ranging from 24 to 58 years) participated in this study. Monocular visual field sensitivity was measured under two conditions: (1) standard testing condition and (2) while the subject performed a Paced Auditory Serial Addition Task (PASAT). Monocular mfVEPs were recorded in response to a 60-sector stimulus. The checkerboard pattern in each sector was contrast reversed according to a binary m-sequence. mfVEPs were recorded under two conditions: (1) standard testing conditions and (2) while the subject performed a PASAT. We found that, when compared to the no-task condition, all subjects had locations of significantly reduced Humphrey visual field sensitivities when performing the PASAT. In contrast, there were no significant decreases in mfVEP amplitude in any sector for any of the subjects while performing the PASAT. Our findings indicate that divided attention and ongoing mental processes did not affect the mfVEP. Therefore, the mfVEP provides an objective measure of visual field function that may be useful for some patients with unreliable automated static perimetry results.

Adult↗

PubMedDate not supplied

A comparison between Humphrey and frequency doubling perimetry for chiasmal visual field defects.

PURPOSE: To evaluate and compare the diagnostic ability of frequency doubling technology perimetry (FDT) with standard automated perimetry (SAP) using Humphrey Field Analyser for the detection of visual field defects produced by chiasmal lesions. METHODS: Fifteen patients with documented chiasmal disease and previously diagnosed of bitemporal hemianopia with Humphrey perimetry were prospectively evaluated. All of them underwent a new SAP (SITA 24-2) followed by FDT tests (C-20 threshold). Diagnostic criteria for hemianopia were established according to the total deviation plot and the threshold values of FDT. A patient was diagnosed with hemianopia if one or both criteria were met. Based on these criteria, FDT sensitivity was calculated. Testing time and global indexes for both perimetric strategies were compared. RESULTS: The sensitivity of FDT was 75.0% (18 out of 24 eyes); the criterion based on threshold values was met more often (70.83%) than the criterion based on the total deviation plot (50.0%). Linear correlation was better for the external column than for the internal column of the visual field. Testing time with FDT was 122.16 seconds shorter than with SAP (p<0.001). The mean value for mean deviation (MD) was -13.62 dB (SD 6.88) for SAP and -8.83 dB (SD 5.94) for FDT (p<0.001). CONCLUSIONS: Compared with standard automatic perimetry, FDT has a low sensitivity for detecting temporal hemianopias and also has more difficulty in defining the vertical limits of the defects. Therefore, it does not appear to be an adequate method for the detection of chiasmal visual field defects.

Adult↗

PubMed2006

Visual field loss in young children and mentally handicapped adolescents receiving vigabatrin.

PURPOSE: In adult patients and in children of school age who have been treated with vigabatrin (VGB), persistent visual field defects have been reported as a side effect. To date, it is unknown to what extent VGB causes visual field loss in young children and mentally handicapped adolescents who cannot be tested with conventional perimetric METHODS: The purpose of the present study was to investigate VGB-induced visual field loss in these patients by using a noncommercial arc perimeter and a forced-choice, preferential-looking method. The visual field size was measured in 30 patients aged 1 to 15 years who had epilepsy and who were treated with VGB. The visual field of these patients was compared to the visual field of 70 control subjects. RESULTS: In eight (27%) patients who had been treated with VGB, the visual field was constricted compared with the visual field of the children belonging to the control group. CONCLUSIONS: Arc perimetry shows that mentally handicapped patients and children younger than 6 years treated with VGB have visual field loss compared with the loss reported in adult patients receiving VGB.

Adolescent↗

PubMed1995

Diffuse and localised visual field defects to automated perimetry in primary open angle glaucoma.

The occurrence of generalised or diffuse visual field depression in primary open angle glaucoma (POAG), in contrast to the presence of characteristic localised defects, is controversial. The frequency of diffuse visual field loss to automated static perimetry in the early stages of POAG was determined and compared with the frequency of localised defects. Twenty-five eyes of 25 consecutive POAG patients who met the selection criteria were tested on the Humphrey Visual Field Analyser with the Central 30-2 Threshold Test. Patients' mean age was 68 years. All eyes had visual acuity better than 6/9 with correction, refractive error of less than +/- 7 dioptres, no media opacities and normal pupils (3-6 mm). For all eyes, the frequency of abnormality on the STATPAC Total Deviation (TD) and Pattern Deviation (PD) plots were determined for all individual test points. Mean values and standard deviations were compared. The TD plots represent a composite of both diffuse and localised visual field depression, while PD plots are intended to reflect localised field defects. The frequency of involvement of the test points on the TD plots was higher than on the PD plots (mean +/- SD: 41.5 +/- 11.2% vs 27.5 +/- 10.9%) for all presenting defects. When only deep defects (STATPAC p < 1% and p < 0.5%) were evaluated, TD involvement was still more frequent than the PD (20.1 +/- 9.4% vs 13.2 +/- 7.2%). The topographical pointwise incidence of pure generalised sensitivity loss in the visual field was less frequent when only deep defects were taken into consideration (6.9 +/- 5.7%), and the incidence increased progressively with the inclusion of intermediate and shallow field defects (9.6 +/- 6.8% and 14.0 +/- 8.4% respectively). A component of diffuse sensitivity depression is present at all significant levels of visual field loss in glaucoma. This component of generalised loss decreases as the depth of the field defects increases. This finding suggests that early diffuse field loss converts into well-defined pattern defects at later stages.

Adult↗

PubMed2004

Retinal nerve fiber layer thickness measurements with scanning laser polarimetry predict glaucomatous visual field loss.

PURPOSE: To assess whether baseline retinal nerve fiber layer (RNFL) measurements obtained with a scanning laser polarimeter, the GDx Nerve Fiber Analyzer, (Laser Diagnostic Technologies Inc., San Diego, California) are predictive of development of repeatable glaucomatous visual field damage in glaucoma suspect eyes. DESIGN: Cohort study. METHODS: Participants were recruited from the UCSD longitudinal Diagnostic Innovations in Glaucoma Study (DIGS). One eye from each of 160 glaucoma suspects with normal standard automated perimetry (SAP) visual fields at baseline was studied. Study eyes were divided into convert and nonconvert groups based on the development of three consecutive glaucomatous visual fields during follow-up. SLP parameters, IOP, vertical cup disk ratio, stereophotograph assessment as glaucoma or normal, corneal thickness, and visual field indices were included in univariate and multivariate Cox proportional hazards models to determine which SLP RNFL and ocular parameters were predictive of visual field conversion. RESULTS: Sixteen (10%) eyes developed repeatable visual field damage (converts) and 144 (90%) did not (nonconverts). Mean (95%CI) follow-up time until visual field conversion for convert eyes was 2.7 (1.7, 3.6) years. Mean total follow-up of nonconvert eyes was 3.8 (3.5, 4.1) years. Four out of thirteen examined baseline SLP parameters and baseline SAP Mean Deviation (MD), SAP Pattern Standard Deviation (PSD), and glaucomatous stereophotograph assessment were significant univariate predictors of visual field conversion. In multivariate models adjusted for age, IOP and CCT, SLP parameters inferior ratio, ellipse modulation, and UCSD linear discriminant function (LDF) were significant predictors of visual field conversion. When SAP PSD and stereophotograph assessment were also included in the multivariate model inferior ratio and UCSD LDF remained independently predictive of visual field loss. CONCLUSIONS: Thinner baseline SLP RNFL measurements were independent predictors of visual field damage. In addition to thinner SLP RNFL measurements, higher baseline SAP PSD, and baseline glaucomatous stereophotograph assessment each contributed to an increased risk of the development of abnormal visual fields in glaucoma suspect patients. SLP RNFL measurements were independently predictive of future visual loss even when age, IOP, CCT, vertical cup disk ratio, and SAP PSD were included in the model.

Aged↗

PubMed2006

A lower visual field advantage for endpoint stability but no advantage for online movement precision.

It has been proposed that visually guided reaching movements performed in the lower visual field (LVF) of peripersonal space are more effective and efficient than their upper visual field (UVF) counterparts (Danckert and Goodale 2001). In the present investigation we sought to determine whether this purported visual field asymmetry reflects advantaged processing of online visual feedback. To accomplish that objective, participants performed discrete reaching movements to each of three target locations in the LVF and UVF. In addition, reaches were completed under conditions wherein target location remained constant throughout a reaching response (i.e., control trials) and a separate condition wherein target location unexpectedly perturbed at movement onset (i.e., experimental trials). We reasoned that the target perturbation paradigm would provide a novel means to assess a possible superior-inferior visual field asymmetry for online reaching control. In terms of the impact of a target perturbation, both visual fields demonstrated equal proficiency integrating visual feedback for online limb adjustments. Interestingly, however, the spatial distribution of movement endpoints in the LVF was less than UVF counterparts (cf. Binsted and Heath 2005). Taken together, the present findings suggest that although LVF and UVF reaches readily use visual feedback to accommodate an unexpected target perturbation, reaches in the LVF elicit advantaged spatial benefits influencing the effectiveness of online limb corrections.

Adolescent↗

PubMed1995

[The correlation between changes of static central visual fields and posterior polar lesions in high myopia].

The static central visual fields tested by an Octopus Field Analyzer and posterior polar lesions in 53 cases with high myopia were investigated. Cases with low and moderate degrees of myopia were the controls. The results demonstrate that the visual field defects are present in the high myopic eyes and they are related to the degree of high myopia, the age of the patient and the severity of the posterior polar lesion. The visual field defects present multiform and multilevel in character and they do not completely correspond to the fundus lesions. The appearance of central relative scotomata in high myopic eyes detected by a quantified automated perimeter is prior to the appearance of macular lesions seen under an ophthalmoscope. Therefore, the quantified automated central visual field examination is helpful to the early diagnosis of macular disease in high myopia.

Adolescent↗

PubMed1992

The development of the temporal and nasal visual fields during infancy.

We used static perimetry to measure the development of the monocular visual field during infancy. Infants from birth to 6 months of age, and adults, were shown a 3 or 6 degrees flashing light at various locations between 15 and 120 degrees in the temporal and nasal visual fields. We assumed that subjects could see a light if they moved their eyes toward it more often than they looked in the same direction on blank control trials. For both the 3 and 6 degrees lights, the visual field expanded with age from the center out, and development in the nasal visual field lagged behind development in the temporal visual field. Possible reasons for these findings are discussed.

Adult↗