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PubMedDate not supplied

Prognostic factors for progression of visual field damage in patients with normal-tension glaucoma.

PURPOSE: To evaluate the rate of progression and the prognostic factors of visual field damage in patients with normal-tension glaucoma (NTG). METHODS: Ninety-two NTG patients (92 eyes) were followed up for more than 2 years with topical antiglaucoma medications. All subjects were classified as having early damaged eyes with an initial mean deviation (MD) of -6 dB or better, moderately damaged eyes with MD between -6 dB and -12 dB, and severely damaged eyes with MD of -12 dB or worse, and survival data were analyzed using regression analysis based on the Cox proportional hazards model. RESULTS: The probability of visual field stability was significantly higher in patients with moderate damage than in those with severe damage (P = 0.035). The patients with early damage showed no difference in the probability of visual field stability compared with patients with moderate or severe damage. The progression of visual field damage was significantly associated with mean intraocular pressure (IOP) (P = 0.000) or IOP fluctuation (P = 0.002) during follow-up regardless of the severity of the initial visual field damage. CONCLUSIONS: The rate of progression of visual field damage differed according to the severity of the initial visual field damage. IOP reductive medication may be effective in preventing glaucomatous visual field progression in patients with NTG.

Adult↗

PubMed2004

Attentional cueing improves vision restoration therapy in patients with visual field defects.

BACKGROUND: In patients with postgenicular lesions of the visual system, areas of residual vision (ARVs) are the main predictor of recovery induced by vision restoration therapy (VRT). In these partially defective regions, the elevated perceptual thresholds can be acutely reduced by attentional cueing. OBJECTIVE: To examine whether directing attention to ARVs using a visuospatial cue also increases long-term neural plasticity and thus enhances permanent training outcome. METHODS: In a prospective, randomized clinical trial, treatment outcome was compared in patients with postgenicular visual system lesions who received either standard VRT (control group [CG]; n = 10) or VRT with attentional cueing (experimental group [EG]; n = 9). Visual field size was determined before and after a 6-month treatment period using Tubingen Automated Perimetry and computer-based high-resolution perimetry (HRP) and in regular intervals throughout this period by HRP and detection performance in VRT. RESULTS: In the area of the cue, restoration of vision was significantly greater than during VRT without cueing: cued patients showed a much more pronounced shift of the visual field border toward the blind area than that observed in the CG or in uncued regions of the EG. Focusing attention at ARVs during treatment changed topographic and temporal patterns of recovery as compared with uncued regions of the visual field. CONCLUSIONS: Use of a visuospatial cue to focus attention at areas of residual vision amplifies long-term neuronal plasticity. The authors propose that top-down signals preactivate partially damaged areas of V1, thus linking visual and attentional neuronal networks, with the effect of permanently increasing conscious visual perception.

Adult↗

PubMed2001

Influence of refractive correction on peripheral visual field in static perimetry.

PURPOSE: To determine the influence of refractive errors on peripheral visual field thresholds in automated static perimetry. METHODS: In 47 subjects (age 16-49 years), the difference of perimetric thresholds was tested in the peripheral visual field without and with contact lens correction, using a custom-made program (Goldmann stimulus size III) with the automated perimeter Octopus 2000 R. Refractive errors ranged from -16.75 to +12.5 diopters. Sixty-four test locations on three concentric rings between 30 degrees and 50 degrees in 19 hyperopic and 28 myopic eyes were tested. RESULTS: All rings in myopic eyes revealed a significant influence of refraction on the differential light sensitivity in the peripheral visual field. In hyperopic eyes only the inner ring showed a significant influence of refraction. The decrease in sensitivity, measured in dB/diopter, for the myopic inner ring was 0.75; for the myopic middle ring it was 0.46; for the myopic outer ring it was 0.22; and for the hyperopic inner ring it was 0.40. CONCLUSIONS: A significant association between refractive errors and differential light sensitivity exists in the peripheral visual field of myopic eyes. Therefore, contact lens wear is recommended when performing automated perimetry of the peripheral visual field of myopic patients with higher refractive errors.

Adolescent↗

PubMed1992

Role of the temporal cilioretinal artery in retaining central visual field in open-angle glaucoma.

The authors reviewed the optic disc photographs of 34 eyes with high-pressure open-angle glaucoma with advanced visual field loss. Thirteen eyes (38%) had one or two temporal cilioretinal arteries, and 21 eyes (62%) had no temporal cilioretinal artery. All 13 eyes with a temporal cilioretinal artery retained central visual field and had visual acuity of 20/40 or better. In the 21 eyes without a temporal cilioretinal artery, 8 eyes lost central visual field and 12 eyes had a visual acuity of less than 20/40, while 13 eyes retained central visual field and 9 eyes had a visual acuity of 20/40 or better. Significant differences were obtained when eyes with and without cilioretinal arteries were compared for retention of visual field (P less than 0.02) and visual acuity (P less than 0.01). The presence of a temporal cilioretinal artery may provide more circulation to the temporal rim of the optic disc and aid in retaining central field and visual acuity in advanced open-angle glaucoma.

Aged↗

PubMed2001

Visual field loss associated with vigabatrin: quantification and relation to dosage.

PURPOSE: To describe the correlation between visual field loss and the duration, dosage, and total amount of vigabatrin (VGB) medication in a group of patients with epilepsy. Co-medication of antiepileptic drugs (AEDs) and compliance were also studied. METHODS: Ninety-two patients (53 male and 39 female) taking VGB medication in the past or the present, attending the Outpatient Epilepsy Clinic in Utrecht, were examined with the Goldmann perimeter. The amount of visual field loss was calculated by the Esterman grid method and by a new method, with which the percentage surface loss of the visual field is measured. A complete drug history was compiled, specifying the amount and duration of VGB medication. Concomitant AED medication was noted. Serum levels of AEDs were determined. RESULTS: Linear regression showed the total amount of VGB as the most significant parameter to predict visual field loss (p < 0.001). Further, men were more affected than women (p = 0.026). Compliance was good, and other AEDs did not influence the results. CONCLUSIONS: Because prolonged use of VGB medication is correlated with the amount of visual field loss, VGB should be prescribed only when there are no alternatives. In such cases, we recommend an examination of the peripheral visual field before starting therapy and a repeated examination every 6 months.

Adult↗

PubMed2004

[Changes in the static visual field of patients with low and medium myopia].

UNLABELLED: Myopia is associated with many diverse changes in the structure and function of the eye. Determination of the visual field belongs to the diagnostic arsenal used for detection and monitoring of such alterations. It is well established that myopia is accompanied by changes in the kinetic visual field. Recently, static visual field examinations are gaining wider acceptance as they represent the most sensitive and reliable approach to early changes in myopia. However, only a few papers on static perimetry in myopia have been published and the results are conflicting. No publications have appeared in Polish medical press. Therefore, we decided to investigate which alterations occur in the static visual field of patients with myopia. We enrolled 32 men and 58 women (180 eyes) aged 19 to 34 (mean 23 years) and formed three groups (I-III) of 30 subjects each: (I) control (without any refractive anomaly); (II) low myopia (average refractive error -2.0 D sph. +/- SD of 1.0); and (III) medium myopia (average refractive error -5.6 Dsph +/- SD of 1.2). Myopia was defined as a refractive error of value < or = -0.5 D, with low myopia not exceeding 4.0 D, and medium myopia between -4 and -8 D. Inclusion criteria were: full visual acuity with/without correction, astigmatism < 0.75 D cyl., intraocular pressure < 21 mm Hg, and no eye pathology other than myopia. A full panel of ophthalmologic tests was carried out, including repeat static perimetry (central 30 degrees) with Medmont M600 perimeter. Appropriate lenses were used during the tests. Average Defect (AD), Pattern Defect (PD), Mean Sensitivity (MS), and Fluctuation (F) values were recorded. Static visual field was assessed with the repeat examination only. Spearman's rank correlation coefficient, Kendall's tau, Gamma and linear correlations were analyzed. P values of less than 0.05 were considered statistically significant. A reduction in AD among subjects with low (P < 0.03) and medium (P < 0.03) myopia was found. There were no significant alterations in PD (Tab. 1). Elevation of myopia leads to reduction in AD (P < 0.0003) (Fig. 1), reduction in MS (P < 0.004) (Fig. 2), as well as increase in F (P < 0.04) (Fig. 3). CONCLUSION: Low and medium myopia may produce significant alterations in the visual field.

Adult↗

PubMed2003

[Frequency doubling perimetry in terminal visual field defects].

PURPOSE: To evaluate the Frequency Doubling Technology (FDT) in end-stage glaucomatous visual field defects. METHODS: FDT (C-20 threshold test) was performed in 22 consecutive patients presenting an end-stage visual field defect with 24-2 SITA (0 dB in more than 75% and less than 100% of the visual field). Comparisons of the percentage of non-abolished points, topographic correlation, test duration and global indexes were performed between C-20 and 24-2 SITA test. RESULTS: FDT sensitivity was 100%. C-20 test showed 13.7% more points with sensitivity greater than 0 dB compared to 24-2 test (P = 0.002). Two and a half less minutes were required for C-20 test performing (P<0.001). The mean value of Mean Defect was 11.48 dB better in FDT (P = 0,000). The mean value of the Pattern Standard Deviation was 5.37 dB (SD: 1.92) and 6.35 dB (SD: 3.61) for 24-2 and C-20 test respectively (P = 0.258). The inferotemporal quadrant was the best conserved in both perimetric strategies (Kappa agreement test value = 0.911; P<0.001). CONCLUSIONS: FDT showed greater ability than 24-2 test for end-stage visual field defects evaluation, with the advantage of being less time-consuming. Very good topographic correlation between both strategies was found. Further studies evaluating FDT reproducibility in severe glaucomatous visual field damage are necessary.

Adult↗

PubMed1994

[Sectorization of the central 10 degrees visual field in open-angle glaucoma].

In an attempt to determine an optimal sector pattern of the central 10 degrees visual field in glaucoma, we applied the VARCLUS procedure, a new clustering algorithm provided by SAS Institute, to 379 glaucoma visual fields of the central 10-2 program of the Humphrey visual field analyzer. The subjects were 211 normal-tension glaucoma (NTG) and 168 primary open angle glaucoma (POAG) eyes with early to moderately advanced stages of visual field defects. The 68 2-degree grid test points in the central 10 degrees visual field were divided into 10 sectors. The sector pattern was compatible with the projection of nerve fiber layers and no sectors extended over the horizontal meridian. Comparison of the mean of total deviation in the sector of 76 eyes of 76 POAG patients with the maximum intraocular pressure: (IOP) > or = 25 mmHg (high-tension group) and 85 eyes of 85 NTG patients with the maximum IOP < or = 18 mmHg (low-tension group) revealed that four sectors nasal superior to the fixation were significantly more damaged in the low-tension group. We suggest that the sector pattern obtained here is useful in studying the visual field of glaucoma and that the damaging processes in the optic nervehead are not the same in the high-tension and low-tension groups.

Aged↗

PubMed1985

Lesions of the optic radiations mimicking lateral geniculate nucleus visual field defects.

Three patients were found to have visual field defects which involved homonymous horizontal sectors of the visual fields, thus mimicking field defects associated with lesions of the lateral geniculate nucleus. Computed tomography provided anatomical evidence that the responsible lesion involved the optic radiations rather than the lateral geniculate nucleus.

Adult↗

PubMed2002

Structure and function evaluation (SAFE): I. criteria for glaucomatous visual field loss using standard automated perimetry (SAP) and short wavelength automated perimetry (SWAP).

PURPOSE: To develop criteria for detecting glaucomatous visual field loss for standard automated perimetry (SAP) and short wavelength automated perimetry (SWAP). DESIGN: Longitudinal observational study. METHODS: Three populations were evaluated: (1) 348 normal subjects (348 eyes) were tested to develop normative databases and statistical analysis packages for SAP and SWAP. (2) An independent group of 47 normal subjects (94 eyes) with 4 years of longitudinal follow-up was evaluated to determine specificity of different criteria. (3) A group of 298 patients (479 eyes) with elevated intraocular pressure and normal baseline SAP visual fields were evaluated to determine the sensitivity of different criteria for detecting early glaucomatous visual field loss. RESULTS: Six criteria demonstrated high specificity for correctly identifying eyes with normal visual fields (98%-100%) for both SAP and SWAP: (1) a pattern standard deviation (PSD) worse than the normal 1% level, (2) a glaucoma hemifield test (GHT) "outside normal limits," (3) one hemifield cluster worse than the normal 1% level, (4) two hemifield clusters worse than the normal 5% level, (5) four abnormal (P <.05) locations, (6) five abnormal locations (P <.05) on the pattern deviation probability plot. For all criteria, confirmation on a second visual field was required for high specificity. The GHT "outside normal limits," two hemifield clusters worse than the normal 5% level and four abnormal (P <.05) test locations on the pattern deviation probability plot provided the highest percentages of conversion from a normal to a glaucomatous visual field. CONCLUSIONS: Criteria based on the GHT, GHT hemifield clusters, and the pattern deviation probability plot provide high sensitivity and specificity for detecting early glaucomatous visual field changes.

Adolescent↗

PubMed2005

The relation between intraocular pressure peak in the water drinking test and visual field progression in glaucoma.

AIM: To compare the results of the water drinking test between glaucomatous eyes with and without visual field progression. METHODS: Retrospective analysis of 76 eyes of 76 open angle glaucoma patients followed for a mean period of 26.0 (SD 13.8) months. Patients were submitted to the water drinking test at the beginning of the follow up period. Reliable achromatic automated perimetry tests performed during the studied period were used to characterise visual field progression. All subjects were under clinical therapy and had an intraocular pressure (IOP) lower than 17 mm Hg monitored by isolated measurements during the follow up period. The results of the water drinking test were compared between glaucomatous eyes with and without visual field progression. RESULTS: Twenty eight eyes reached definite visual field progression. There were no significant differences in the mean age, sex, race, basal IOP, number of antiglaucomatous drugs, initial mean deviation (MD), and corrected pattern standard deviation (CPSD) between eyes that showed visual field progression and the ones who did not progress. A significant difference of 1.9 (SD 0.6) mm Hg (p = 0.001, analysis of covariance; 95% CI 0.8 to 3.0) was observed between glaucomatous eyes that showed visual field deterioration and glaucomatous eyes that did not progress. A significant difference of 16.8% (SD 4.6%) in the mean percentage of IOP variation was also observed between the two groups (p<0.001, analysis of covariance; 95% CI 7.7 to 26.0). CONCLUSIONS: Mean IOP peak and percentage of IOP variation during water drinking test were significantly higher in patients with visual field progression compared with patients who did not progress.

Adult↗

PubMed1992

Visual field defects in patients with normal-tension glaucoma and patients with high-tension glaucoma.

We compared the automated visual field test results of 24 patients with normal-tension glaucoma and 24 patients with high-tension glaucoma who were closely matched for the amount of visual field loss to determine any differences in the characteristics of visual field defects between the two groups. Patients were matched with a maximum allowable difference in mean deviation of 0.3 dB. Although the normal-tension group had a greater amount of focal visual field loss (pattern standard deviation), the difference was not statistically significant (P = .628). Additionally, there was no statistically significant difference in the amount of diffuse or focal visual field damage in the superior hemifields between the two groups; however, the patients with normal-tension glaucoma had a significantly greater amount of localized visual field loss in the inferior hemifield than the patients with high-tension glaucoma (P = .015). Our data support the hypothesis that a vascular mechanism may have a greater role in the pathogenesis of optic nerve damage and visual field loss in patients with normal-tension glaucoma than in patients with high-tension glaucoma.

Aged↗

PubMed1985

Long-term prognosis of visual field in glaucoma simplex and glaucoma capsular.

The fate of visual fields in 42 eyes with capsular glaucoma followed for 5 to 14 years (mean 9.1 years) and 46 eyes with simple glaucoma followed for 5 to 14 years (mean 10.2 years) was studied retrospectively. In the treatment the IOP levels were around 19.5 mmHg. In both groups the visual field deteriorated in 70-80% of eyes, and 11% of patients became blind. In most cases the progression appeared during the first 4-6 years of follow-up, but in individual cases it did not occur until 8-10 years after the diagnosis. In 26 eyes disc cupping preceded the visual field loss. Five out of 42 eyes with capsular glaucoma developed retinal vein occlusion whereas this occurred in 2 out of 46 eyes with simple glaucoma. Two patients with IOP level of 9 mmHg maintained unchanged visual fields for 6 and 11 years, respectively.

Aged↗

PubMed1989

[Visual perception in normal children and adults II. Correlation between dominance of visual field and dominance of the eye].

To clarify more precisely about the correlation between the dominance of visual field and dominance of the eye, tachistoscopic examination was performed on 48 normal adults; 24 males and 24 females, and 24 right-handed and 24 left-handed subjects. The mean of the time of exposure was less than 4.5 msec. The time of exposure was independent of handedness, dominance of the eye, sex, or the type of stimulus. Four right-handed and four left-handed subjects showed dominance of the left visual field for the A value, suggesting no correlation between handedness and dominance of the visual field. However, six of those eight subjects were found to have dominance of the left eye for the A value, and all seven subjects with dominance of the left visual field for the D value showed dominance of the left eye (chi 2 = 16.39, p less than 0.001). It was concluded that dominance of the eye was significantly correlated with visual field. It is therefore important to examine dominance of the eye as well as dominance of the visual field for evaluation of cerebral dominance with regard to visual perception.

Adult↗

PubMed2004

Acute effects of sildenafil on Humphrey visual field and intraocular pressure.

PURPOSE: To evaluate the effects of sildenafil on visual field and intraocular pressure in a group of healthy subjects. METHODS: Twenty-eight healthy male volunteers with normal eyes were included in the study. Visual field examinations were performed using FASTPAC 30-2 program (white-on-white and blue-on-yellow) with the Humphrey field analyzer before and one hour after receiving oral 50 and 100 mg sildenafil citrate. RESULTS: The mean age was 51.1 +/- 8.9 years. Mean deviation, pattern standard deviation, short-term fluctuation and corrected pattern standard deviation did not differ significantly among tests both in white-on-white and blue-on-yellow visual field examinations. Changes in intraocular pressure were not statistically significant. CONCLUSIONS: No significant effect of sildenafil was seen on visual field and intraocular pressure in healthy subjects.

3',5'-Cyclic-GMP Phosphodiesterases↗

PubMed1998

Blue-on-yellow visual field and retinal nerve fiber layer in ocular hypertension and glaucoma.

BACKGROUND AND OBJECTIVE: It has been suggested that the clinically detectable changes of the blue-on-yellow (B/Y) visual field and retinal nerve fiber layer (RNFL) may precede standard white-on-white (W/W) visual field defects in the progression of glaucoma. The aim of this study was to test the relationship between the results of B/Y visual fields and semiquantitative RNFL evaluation in corresponding areas and to determine how the B/Y visual fields and RNFL scores label the normal W/W perimetry hemifields in patients with glaucoma and ocular hypertension. DESIGN: A cohort study. PARTICIPANTS AND METHODS: Monochromatic RNFL photographs of 32 normal subjects and 29 patients with ocular hypertension and different stages of glaucoma were assessed in a masked fashion. The B/Y and W/W visual fields (program 30-2) were examined with a Humphrey perimeter. The results of both visual fields were adjusted for the patients' age and lens transmission index measured with a lens fluorometer. MAIN OUTCOME MEASURE: Mean deviation (MD) of visual field and semiquantitative score of RNFL loss were measured. RESULTS: The total and hemifield MD values of B/Y and W/W visual field showed a statistically significant correlation with diffuse and overall score of RNFL loss in corresponding areas. The hemifield MD values of B/Y perimetry obtained from "normal" W/W hemifields of patients with early glaucoma were well correlated (r = -0.56) with respective RNFL loss scores found to be abnormal in 84% of hemispheres. The difference between the hemifield MD values of B/Y perimetry obtained from normal W/WAN hemifields of patients with ocular hypertension and patients with early glaucoma was not statistically significant (analysis of variance). The respective B/Y hemifield data of normal subjects were statistically significantly different from the data of patients with ocular hypertension and early glaucoma. CONCLUSIONS: The hemifield MD values of B/Y perimetry correlate well with semiquantitative scores of RNFL loss obtained from the corresponding hemisphere. The B/Y perimetry as well as RNFL assessment may show glaucomatous defects in a hemifield found to be normal on W/W perimetry. In subjects with ocular hypertension, the functional damage detected by B/Y perimetry may, in some cases, precede RNFL defects on conversion to glaucoma.

Adult↗

PubMed1981

Visual field area on the Goldmann hemispheric perimeter surface. Correction of cartographic errors inherent in perimetry.

An isopter of visual field charted using the Goldmann perimeter represents a conical area of visual space whose apex is at the eye of the subject and whose base intersects the hemispherical surface of the perimeter bowl. Conventional isopter plotting conceals cartographic distortion and leads to serious underestimates of visual field area when measured by planimetry. Mathematical methods are presented which allow estimation of the true visual field area represented by different isopters on the surface of the Goldmann hemispheric perimeter. A correction can be applied to planimetric measurements to reduce the error inherent in the transposition of the curved surface of the perimeter onto flat, polar azimuthal visual field charts. This study may form the basis for quantitative evaluation of pathological changes in the area of the visual field.

Humans↗

PubMed2002

Circulating platelet aggregates and progression of visual field loss in glaucoma.

The aim of the study was to assess a relationship between circulating platelet aggregates (CPA) and progression of visual field loss in primary open-angle glaucoma patients. CPA was determined in 27 patients with open-angle glaucoma with nonprogressive visual field loss and 15 patients with open-angle glaucoma and progression of visual field loss. Intraocular pressure (IOP) under topical therapy was < 18 mmHg in all patients. CPA in glaucoma patients with progression of visual field loss was not significantly higher than those without visual field progression (p = 0.59). In conclusion, our study shows that increased platelet aggregability is not solely responsible for progression of visual field loss in glaucoma patients, and indicates the role of IOP in the pathogenesis of visual field loss.

Case-Control Studies↗