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PubMed1997

Motion perception thresholds in areas of glaucomatous visual field loss.

This study examined whether one can differentiate between areas of known visual field loss and areas of known relative field sparing in eyes with primary open angle glaucoma using motion coherence thresholds. Two visual field locations from patients with primary open angle glaucoma (n = 14), which differed significantly in sensitivity, were selected for presentation of a motion stimulus. In the area of visual field loss mean threshold was 17.4 +/- 4.1 dB (1.74 +/- 0.41 log units relative to the brightest stimulus). In the area of relative field sparing mean threshold was 27.0 +/- 3.6 dB (2.70 +/- 0.36 log units). Motion coherence thresholds were significantly poorer for the area of visual field loss compared to the area of relative field sparing (P < 0.0032, two-tailed paired t-test). This result suggests that a perimetric type motion test should be evaluated for early detection of glaucoma.

Glaucoma, Open-Angle↗

PubMed1999

Visual field improvement after treatment of optic disk pit maculopathy with the macular buckling procedure.

PURPOSE: To evaluate visual field changes in 18 of 21 patients with unilateral optic disk pit maculopathy who were successfully treated with the macular buckling procedure. METHODS: In this prospective study, visual field examination with the Humphrey analyzer (programs 30-2 and 10-2) was recorded before treatment, repeated 1 month after the operation, and repeated every 6 months thereafter. All 18 patients were treated with the macular buckling procedure. The operation consisted of fixation of a silastic sponge explant at the posterior pole corresponding to the macula. RESULTS: In 18 eyes included in the study and successfully treated, an improvement in visual field indices was recorded. The mean deviation improved from -7.75+/-3.15 (program 30-2) and -10.19+/-3.66 (program 10-2) decibels before surgery to -6.25+/-2.61 (P<0.0001) and -8.56+/-3.13 (P<0.0001) decibels at the last examination, respectively. No additional visual field defect was induced in any of the 18 eyes after treatment. Also, the majority of the eyes (16/18) gained from 1 to 7 Snellen lines of visual acuity (P<0.0001). CONCLUSION: Improvement of central and peripheral visual field (within 30 degrees of fixation) was recorded after the treatment of optic disk pit maculopathy with the macular buckling procedure. This technique seems to be effective for treatment of the disease with good anatomic and functional results.

Adolescent↗

PubMed1995

Points of a normal visual field are not statistically independent.

The aim of the present study was to determine whether the sensitivity values at individual test locations in a normal visual field are statistically independent. A total of 144 eyes of 144 normal subjects were tested with the Humphrey Field Analyzer, program 30-2. For each point in the visual field the pairwise correlation of sensitivity values to all other points was calculated together with the angular distance between points. The overall 2775 correlation coefficients were plotted as a function of angular distance. With increasing distance the correlation coefficients decrease continually from 0.63 (distance 6 degrees) to approx. 0.5 (distance 30 degrees and above). The strong relationship between adjacent points that is present at up to 30 degrees is destroyed by intraindividual randomisation of the visual field data. Interindividual randomisation abolishes any correlation. Adjacent locations in a normal visual field are strongly statistically related to each other. Two patterns may be separated; part of the correlation is an intrinsic neighbourhood effect present up to 30 degrees and part is due to the observation that the sensitivity values of a specific visual field are obtained from the same subject and are thus not independent. Therefore, for the calculation of normal values, procedures have to be developed that take the relationship between neighbouring points into consideration.

Adolescent↗

PubMed2006

[Comparison of early and late rehabilitation of stroke and cerebral trauma patients with visual field defects].

BACKGROUND: Most rehabilitation studies on visual field deficits after stroke or trauma are conducted after completion of the spontaneous recovery phase. However, the question arises whether more extensive visual field improvements can be reached when the training starts very soon after the lesion. METHODS: In this study, the results of 26 patients who began visual restoration therapy within the first 12 months after the lesion were compared with an age-related group whose lesions were more than 1 year old. RESULTS: The early-onset group showed an improvement of 8% in computer campimetry and 10-15% in conventional automated perimetry. The late-onset group had 13.5% improvement in campimetry and 20% in perimetry. CONCLUSION: In contrast to our assumptions, there was no significant difference between the groups. Furthermore, the late-onset group showed considerably greater improvement than the early-onset group. It is proposed that pronounced attention deficits soon after brain damage may complicate the training.

Brain Injuries↗

PubMed2004

[Visual fields changes in chronic angle closure glaucoma patients after their intraocular pressures were well controlled].

OBJECTIVE: To investigate the progression of visual field loss and to explore the prognosis of glaucomatous optic neuropathy in patients with chronic angle-closure glaucoma (CACG) after their intraocular pressures were well controlled under 21 mmHg. METHODS: Forty-seven eyes of 29 patients in the Department of Ophthalmology in PUMC Hospital were included. All the patients had at least two separate tests of visual fields using the 24-2 program of the Humphery Visual Field Analyzer after their intraocular pressure were well controlled under 21 mmHg after sugery. The visual fields of patients were followed routinely for at least 1 year. In addition, all patients were divided into 2 groups according to follow-up period: 1-2 years group and over 2 years group. Visual field scores were calculated with the Advanced Glaucoma Intervention Study (AGIS) method. The visual fields were divided 5 sections and the sensitivity and defect depth of each section were calculated. RESULT: No statistically significant differences were found in terms of AGIS scores, localized sensitivities and localized defects within the time interval of the observation. CONCLUSION: Glaucomatous optic neuropathy is not likely to progressively deteriorate in CACG cases once their intraocular pressure are well controlled under 21 mmHg.

Aged↗

PubMed2006

No apparent association between ocular perfusion pressure and visual field damage in normal-tension glaucoma patients.

PURPOSE: To investigate the correlation of ocular perfusion pressure (OPP) with general and localized visual field damage in normal-tension glaucoma (NTG) patients. METHODS: Correlations between OPP, blood pressure, age, intraocular pressure, refractive error, and extent of visual field damage in the eye with the worst mean deviation (MD) were investigated retrospectively in 94 eyes of 94 NTG patients. Visual fields were analyzed statistically with respect to 15 sectors between two age-matched groups of subjects with high or low OPP. RESULTS: Significant positive correlations were found between OPP and age (P < 0.001), blood pressure and age (P < 0.05), and MD and refractive error (P < 0.01). OPP had no significant correlation with MD or mean sensitivity in the visual field in any of the visual field sectors. CONCLUSION: OPP and systemic blood pressure have no evident effect on the extent or pattern of visual field damage in NTG.

Adolescent↗

PubMed2002

Visual field loss in patients with glaucoma who have asymmetric peripapillary focal arteriolar narrowing.

OBJECTIVE: To evaluate the relationship between peripapillary focal arteriolar narrowing and visual field defects. METHODS: From our institutional practice, we identified 31 patients with glaucoma who had peripapillary focal arteriolar narrowing in only one eye and compared visual field data between the two eyes. Mean deviation (MD) and corrected pattern standard deviation (CPSD) were recorded using Humphrey visual field testing at the time proximal narrowing was apparent on the fundus photograph. Visual field data from subsets of patients with mild and severe narrowing were also compared. RESULTS: The MD and CPSD were significantly worse in eyes with peripapillary focal arteriolar narrowing. The eyes with narrowing exhibited a mean MD of -8.77 +/- 8.27 dB and a mean CPSD of 5.01 +/- 3.42 dB. Eyes without narrowing displayed a mean MD of -4.52 +/- 6.64 dB and a mean CPSD of 3.01 +/- 2.68 dB (P =.003 for both). There was no significant difference in severity of the visual field defect between eyes with mild and severe arteriolar narrowing. CONCLUSION: To our knowledge, this is the first study to show that the presence of peripapillary focal arteriolar narrowing is related to the severity of visual field loss in patients with glaucoma.

Aged↗

PubMed1983

Three-dimensional topography of the central visual field. Sparing of foveal sensitivity in macular disease.

Threshold static perimetry was performed using test object patterns that covered contiguous areas of the central visual field. Computer imaging methods were used to display a three-dimensional surface that was interpolated between the sensitivity values at each of the test object locations. The examinations covered the area out to and including 10 degrees of eccentricity from the point of fixation, corresponding to the same area of the visual field covered by the Amsler grid. The normal visual field surface appears as a high plateau with a smoothly rising level of sensitivity forming a peak at the point of fixation. It was found that in a variety of macular diseases, including those caused by vascular, as well as primary degenerative disorders, central scotomas were characterized by relative sparing of visual sensitivity at the point of fixation. The pattern thus produced was one of a ring-shaped depression within the central 10 degrees of the visual field. This phenomenon was present in 20% of cases with central scotomas resulting from macular disease, but was not found in any eye of 64 patients suffering from central scotomas as a result of optic nerve disease. This pattern of visual field loss may be common, though not frequently recognized. It is proposed that the phenomenon of preservation of foveal sensitivity may be a marker for macular disease, as distinct from central visual field defects arising from optic nerve disease.

Adult↗

PubMed2003

Interobserver agreement on visual field progression in glaucoma: a comparison of methods.

AIM: To examine the level of agreement between clinicians in assessing progressive deterioration in visual field series using two different methods of analysis. METHODS: Each visual field series satisfied the following criteria: more than 19 reliable fields, patient age over 40 years, macular threshold at least 30 dB. The first three fields in each series were excluded to minimise learning effects: the following 16 were studied. Five expert clinicians assessed the progression status of each series using both standard Humphrey printouts and pointwise linear regression (PROGRESSOR). The level of agreement between the clinicians was evaluated using a weighted kappa statistic. RESULTS: A total of 432 tests comprising 27 visual field series of 16 tests each were assessed by the clinicians. The level of agreement on progression status between the clinicians was always higher when they used PROGRESSOR (median kappa = 0.59) than when they used Humphrey printouts (median kappa = 0.32). This was statistically significant (p = 0.006, Wilcoxon matched pairs signed rank sum test). CONCLUSIONS: Agreement between expert clinicians about visual field progression status is poor when standard Humphrey printouts are used, even when the field series studied are long and consist solely of reliable fields. Under these ideal conditions, clinicians agree more closely about patients' visual field progression status when using PROGRESSOR than when inspecting series of Humphrey printouts.

Adult↗

PubMed2005

The impact of visual field loss on driving performance: evidence from on-road driving assessments.

PURPOSE: The purpose of this study was to investigate the relationship between visual field loss and driving performance as determined by on-road driving assessments. METHODS: We reviewed the files of 1350 patients enrolled in a rehabilitation program at the Bloorview MacMillan Rehabilitation Centre, Toronto, Canada. We identified 131 patients with visual field loss who had undergone an on-road driving assessment. These patients had a primary diagnosis of visual impairment or a primary diagnosis of cerebral vascular accident (CVA) with a secondary diagnosis of visual impairment. None of these patients had documentation of neglect, substantial motor or cognitive deficits. We report the data obtained from 13 hemianopics, 7 quadrantanopics, 25 patients with monocular vision, 10 patients with moderate peripheral losses (<135 degrees of horizontal visual field measured at the midline), and 76 patients with mild peripheral losses (between 135 degrees and 186 degrees of horizontal visual field). The on-road assessment consisted of driving in the area surrounding the rehabilitation center, and the outcome was based on performance on a number of tasks commonly encountered in daily driving. For the purposes of this study, the assessment outcomes were classified as safe, unknown, or unsafe. RESULTS: Overall, the extent of visual field loss did not have a significant impact on driving performance (chi2 = 4.37, p = 0.358). However, hemianopia tended to have a worse impact on driving performance than quadrantanopia with a marginally significant result (chi2 = 3.33, p = 0.068). Overall, the location of the visual loss was not significantly related to driving fitness (chi2 = 1.05, p = 0.30). However, localized defects in the left hemifield (chi2 = 9.561, p = 0.002) and diffuse visual loss in the right hemifield (chi2 = 10.395, p = 0.001) seemed to be associated with driving impairments. A large proportion of monocular drivers were safe drivers and the location of their deficit had no significant impact. CONCLUSIONS: Although the extent of visual field defects appears to be related to driving performance as determined by an on-road driving assessment, large individual differences were observed. This highlights the need for individualized on-road assessments for patients with visual field defects.

Automobile Driving↗

PubMedDate not supplied

Changes in the visual field after photocoagulation or cryotherapy in children with retinopathy of prematurity.

We examined the visual field in 13 children (26 eyes) who had had retinopathy of prematurity for which photocoagulation or cryotherapy was administered more than 10 years previously. Defects of the visual field observed in the periphery of the temporal side corresponded to the sites of photocoagulation scar formation and to areas severely affected by retinopathy of prematurity. In addition, sensitivity in some patients was reduced over the entire visual field. It has been established that treatment with photocoagulation and cryotherapy is effective in preventing the progression of retinopathy of prematurity. However, on the basis of our results, we recommend that the use of photocoagulation and cryotherapy be minimized to prevent the progression of visual field defects.

Adolescent↗

PubMed1995

[Intra-ocular pressure dynamics and visual field index in normal tension glaucoma].

A variety of visual field indices were studied with Octopus peridata with the use of Octopus 201 and its examination program No. 31 in 31 eyes of 31 normal tension glaucoma (NTG) cases that showed mild to moderate degree of glaucomatous visual field defects. Twelve eyes of 12 normal volunteers served as the controls. On the basis of the results of clinical tests for intra-ocular pressure (IOP) dynamics including C-value, diurnal variation of IOP and IOP rise after the water drinking test, 31 NTG eyes were divided into 17 positive response eyes and 14 negative response eyes by the clinical tests. Though significant difference (p < .0001) of the value in visual field indices was found between NTG eyes and control eyes, no significant difference was observed between positive and negative response eyes of NTG. The value of global short-term fluctuation in positive response eyes (2.1 +/- 0.9 dB), however, appeared to be significantly (p < .004) greater than that in negative response eyes (1.3 +/- 0.4 dB) and control eyes (1.3 +/- 0.4 dB).

Adult↗

PubMed2007

Two spatially separated attention systems in the visual field: evidence from inhibition of return.

It has been demonstrated that the human visual field shows some functional inhomogeneities, in particular when the central and perifoveal regions are compared to the more peripheral regions. The present study examined this inhomogeneity by examining the effect of stimulus eccentricity on inhibition of return (IOR), a phenomenon that biases our attention towards novel locations against returning it back to previously attended locations. Eighteen subjects were examined in a visual detection task, in which a target appeared randomly following a nonpredictive spatial cue in the visual field. The eccentricities of the cues and targets were systematically manipulated from 5 degrees to 30 degrees with 5 degrees increments. Results showed that response times to targets that appeared at cued locations were significantly slower than those at uncued locations for all stimulus eccentricities, demonstrating the IOR effects. However, response times at cued locations increased significantly when stimulus eccentricity shifted from 15 degrees to 20 degrees, leading to a much stronger IOR effect at more peripheral regions compared to central and perifoveal regions, indicating a functional dissociation between these two regions of the visual field. Possible neural mechanisms underlying this dissociation are discussed, and two attention systems modulating the two functional regions of the visual field are put forward to best account the present finding implicating in particular midbrain mechanism.

Attention↗

PubMed1995

Size of the visual field in collegiate fast-pitch softball players and nonathletes.

The purpose of this study was to examine whether visual-field size differed between female Division I collegiate fast-pitch softball players and female college students who were nonathletes. The relationship between visual-field size and batting performance among the softball players was also examined. 24 female undergraduate students (12 varsity fast-pitch softball players and 12 nonathletes) participated. The size of the visual field was measured via manual kinetic perimetry, and batting performance was assessed using a batting-skill test as well as batting averages for an entire competitive season. Analyses indicated that the mean visual-field size of softball players was significantly larger than that of nonathletes. However, there was no relationship between visual-field size and batting performance among the softball players. Results are discussed with respect to the origin of the superiority of visual-field size of softball players.

Adult↗

PubMed1991

[A comparative study on visual field defect in low tension glaucoma].

The mode of visual field defect and the change of intraocular pressure (IOP) were analyzed between progressive low tension glaucoma (LTG) and non-progressive LTG. Maximum IOP and phasic fluctuation in IOP during the follow-up period in progressive cases were significantly higher than those in non-progressive cases (p less than 0.01). This greater range in phasic fluctuation may lead to the development of glaucomatous damage. Analysis of the pattern of visual field defect revealed significantly greater frequency of dense defects within 10 degrees of the fixation area in progressive cases. Another analysis on the mode of visual field damage between progressive LTG and POAG demonstrated higher frequency of focal progression of the damage. These results suggest that there are some different etiological factors among progressive LTG, non-progressive LTG and POAG, while focal anatomical weakness at the optic nerve head also influences the development of damage in some case of progressive LTG.

Glaucoma↗

PubMed1993

Quantification of congruence between the right and left visual fields.

In the past, congruence between the right and left visual fields could only be evaluated subjectively. This study presents a congruence index to assess the similarity of the two visual fields objectively and quantitatively based on probability calculations. In 18 patients with suprachiasmal lesions of the visual pathways (cerebrovascular accident or tumor), the index found a homonymous congruence in all cases (100%). Of 26 persons with pituitary adenoma, in 22 cases (85%) the index found heteronymous congruence. The validity of the method may be even higher, because all cases with atypical indices also had atypical congruence by subjective evaluation. Using this new method in 41 patients with primary open-angle glaucoma, heteronymous congruence was detected in 73% and homonymous congruence was found in 17%. This new index may be useful for the development of computerized parametric methods of differential diagnosis.

Adult↗

PubMed2006

[Objective evaluation of the visual field defects in a patient with cerebral infarction using multifocal VEPs].

PURPOSE: We investigated whether visual field defects can be objectively evaluated using multifocal visual evoked potentials (mVEP) in a patient with cerebral infarction in whom it is difficult to measure the visual field. METHODS: To determine normal waves in mVEP recording was performed using a VERIS Junior Science (Mayo, Aichi, Japan) in 20 healthy subjects (20 eyes), peak latency and amplitude were used for assessment. In a patient with cerebral infarction, mVEP were recorded, and compared with the lesion observed by computed tomography. RESULTS: In 20 healthy subjects, the waveforms in the nasal and temporal quadrants were very similar but the waveforms in the superior and inferior quadrants were mirror images. The mVEP in patient with cerebral infarction showed abnormal waves, corresponding to the visual field defects in the lesion observed by computed tomography. CONCLUSIONS: Objective evaluation of visual field defects using mVEP may be useful in patients with cerebral infarction in whom kinetic/static perimetry as a subjective examination is difficult.

Aged↗

PubMed2005

Relationship between visual field loss and contrast threshold elevation in glaucoma.

BACKGROUND: There is a considerable body of literature which indicates that contrast thresholds for the detection of sinusoidal grating patterns are abnormally high in glaucoma, though just how these elevations are related to the location of visual field loss remains unknown. Our aim, therefore, has been to determine the relationship between contrast threshold elevation and visual field loss in corresponding regions of the peripheral visual field in glaucoma patients. METHODS: Contrast thresholds were measured in arcuate regions of the superior, inferior, nasal and temporal visual field in response to laser interference fringes presented in the Maxwellian view. The display consisted of vertical green stationary laser interference fringes of spatial frequency 1.0 c deg(-1) which appeared in a rotatable viewing area in the form of a truncated quadrant extending from 10 to 20 degrees from fixation which was marked with a central fixation light. Results were obtained from 36 normal control subjects in order to provide a normal reference for 21 glaucoma patients and 5 OHT (ocular hypertensive) patients for whom full clinical data, including Friedmann visual fields, had been obtained. RESULTS: Abnormally high contrast thresholds were identified in 20 out of 21 glaucoma patients and in 2 out of 5 OHT patients when compared with the 95% upper prediction limit for normal values from one eye of the 36 normal age-matched control subjects. Additionally, inter-ocular differences in contrast threshold were also abnormally high in 18 out of 20 glaucoma patients who had vision in both eyes compared with the 95% upper prediction limit. Correspondence between abnormally high contrast thresholds and visual field loss in the truncated quadrants was significant in 5 patients, borderline in 4 patients and absent in 9 patients. CONCLUSION: While the glaucoma patients tested in our study invariably had abnormally high contrast thresholds in one or more of the truncated quadrants in at least one eye, reasonable correspondence with the location of the visual field loss only occurred in half the patients studied. Hence, while contrast threshold elevations are indicative of glaucomatous damage to vision, they are providing a different assessment of visual function from conventional visual field tests.

Adult↗