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At least 91 records · Page 5Linked to original sources

SITA visual field testing in children.

PURPOSE: The Swedish Interactive Thresholding Algorithm (SITA) is a new testing strategy for the Humphrey perimeter. The standard SITA algorithm shortens test time in adults without increasing variability, but its usefulness for detecting field defects in children has not been investigated. METHODS: We evaluated 92 standard SITA 24-2 visual fields of children, most of whom had various types of optic neuropathies (pediatric idiopathic intracranial hypertension, homonymous defects, bitemporal defects, papilledema from brain tumors), and compared them with 49 full threshold 24-2 fields obtained in similar patients. We evaluated outcome measures of foveal threshold, mean defect, pattern standard deviation, false-negative and false-positive rates, and test time. Five children (9 eyes) had both SITA and full threshold testing (FTT). RESULTS: The SITA decreased test time by over 50% compared with FTT (12.6 +/- 3.0 minutes vs 6.6 +/- 1.6 minutes [P <.00001]). When patients with field defects were eliminated, the pattern standard deviation was lower with SITA than FTT (P <.002), indicating lower intratest variability of SITA in subjects with normal fields. No detectable difference was observed in the other outcome measures. Subjective analysis of gray-scale fields in patients who underwent testing with the use of both strategies showed marked similarities. CONCLUSIONS: SITA shortens test time significantly compared with FTT and does so without jeopardizing interpretability. SITA has less intratest variability than FTT and therefore should be better for detecting and following defects. Caution is advised when following a visual field defect unless the same strategy is used for each evaluation. Switching strategies in the absence of a stable field defect is not recommended.

Adolescent↗

A new apparatus for visual field testing with binocular fixation.

A new instrument for visual field examination with binocular fixation is described. The binocular vision was dissociated with polarizing plates. Only the point of fixation was visible to both eyes while the testing chart (Amsler chart) was visible to one eye in the use of this apparatus. The examination was done with both the patient's eyes open. With the use of this apparatus, not only was the visual line fixed steadily in order to detect various changes of the central visual field due to maculopathy or optic neuropathy and these changes were detected accurately and quickly, but also suppression scotoma associated with amblyopia or squint could be detected quantitatively.

Adolescent↗

Serial follow-up in traumatic optic neuropathy using scanning laser polarimetry and visual field testing.

A 40-year-old male patient suffered from traumatic optic neuropathy in his right eye. Scanning laser polarimetry was arranged at 2 weeks, 9 weeks, 13 weeks, 24 weeks, and 34 weeks after the trauma. Manual or automated visual field testing was also arranged at 1 week, 5 weeks, 16 weeks, and 28 weeks correspondingly. The data revealed using scanning laser polarimetry (program GDx, version 1.0.05; Laser Diagnostic Technologies, San Diego, Calif, USA) were nearly normal at 2 weeks after trauma, but lower visual field loss was revealed using visual field testing within 2 weeks after the trauma. The superior hump of the GDx deviated from normal at about 9 weeks and some GDx parameters (the Number, Superior/Nasal, Ellipse Modulation (Ellipse Mod.), Maximal Modulation (Max. Mod.), Symmetry, Superior Ratio (Super. Ratio)) became worse later in the series. We propose that visual field defects might be present before retinal nerve fiber layer loss. In this case, scanning laser polarimetry for evaluating the severity of traumatic optic neuropathy was limited especially within 2 weeks after the trauma.

Adult↗

Laser treatment of diabetic macular edema: comparison of ETDRS-level treatment with threshold-level treatment by using high-contrast discriminant central visual field testing.

Grid laser is recognized as an extremely effective treatment of diabetic macular edema, although it causes significant chorioretinal damage when applied and scars that expand with time. The purpose of this study is to compare the effects of two methods of grid laser photocoagulation for diabetic macular edema on high-contrast target discrimination in the central visual field. Grid laser photocoagulation with the Early Treatment Diabetic Retinopathy Study intensity burns has previously been shown to cause full retinal thickness burns. In this study, it produced severe destruction of paraxial vision, most marked at 2 degrees to 10 degrees from fixation. Grid laser using threshold-level burns, in contrast, appeared to produce some improvement in thresholded high-contrast vision at eccentricities from 2 degrees to 3 degrees outward, but failed to normalize visual parameters at these intercepts or at intercepts closer to fixation. Therefore, the recommendations are made (1) to use screening modalities other than biomicroscopic perception of retinal swelling to define earlier opportunities for intervention in the diabetic maculopathic process and (2) to use threshold or sub-threshold methods of laser grid photocoagulation for treating leakage and/or edema.

Adult↗

Screening for glaucoma: the time taken by primary examiners to conduct visual field tests in practice.

A panel of 101 primary examiners (optometrists or their ancillary staff) in England and Wales prospectively recorded the time taken to examine the central visual fields of each of 10 (or more) of their patients. The results indicate that the time depended not only on the test procedure but on how frequently the examiner conducted such a test. A basic test with semi-automated field screening equipment, applied routinely by 30 examiners on 547 patients, took an average 3.7 min per patient; (lower quartile 2.8 min). For such examiners, a standard extended test took 4.9 min. Similar times applied whether tests were conducted by an optometrist or an assistant. It was concluded that visual field screening in a normal population could reasonably be assumed to take an average 4 min per patient.

Adult↗

Use of visual field tests in glaucoma detection by optometrists in England and Wales.

This paper is based on a survey of 241 optometrists (5% of the national total) in England and Wales, which covered many aspects of glaucoma detection. There were 45 optometrists (19%) who did not use a field screener. Of the 196 who did, 173 reported their criteria for deciding which patients to test: 17 (estimated at 8% of the original sample) used a field screener routinely in patients over 40 years; 40 (19%) selectively tested all patients with intraocular pressure > 20 mmHg, together with most others in whom any glaucoma risk factor was present, (this required a visual field test in only one in five patients aged over 40 years and may be relatively cost-effective); the remaining 116 (55%) on average tested less than one in ten of their patients with a field screener, practice which is shown to contribute little to the number of glaucomas detected. Routine field testers had the highest glaucoma detection rates, and those of the selective testers were not significantly lower.

Age Factors↗

Programmed visual field testing.

The use of programmed static spot-checking is remarkably accurate in detecting the presence of visual field defects, even the earliest abnormality, provided the correct stimulus (or stimuli) is chosen to check an appropriate number of spots, and the location of each missed response is retested. Automatic quantitation of visual field defects (so it can later be determined if the defects are worsening) can be accomplished automatically with some of the more expensive new instruments. The less elaborate instruments require repetitive testing or manual interaction, achieving accurate results, but typically with a cumbersome record of the results that is difficult to interpret. An efficient plan for the usual office at present is to use an automated spot-checking instrument for screening and diagnosis, but to depend upon the tangent screen or Goldmann perimeter for quantitation unless the most expensive automated instruments can be afforded.

Automation↗

Defective visual field tests in chronic heavy smokers.

PURPOSE: To evaluate the visual field changes in smokers. METHODS: In 24 healthy, chronic, heavy cigarette smokers and 16 age and sex-matched healthy non-smokers, central 30-2 threshold tests were evaluated. The quantitative perimetric indices as objective retinal sensitivity measures were recorded in both eyes, but only those from the second eye were chosen for analysis. The visual field defects were also assessed. RESULTS: All subjects had normal visual acuity. The central visual fields in smokers showed relative to absolute scotomas in 20 degrees to 30 degrees. Quantitative perimetric indices including total threshold dB with red and white target, MD, PSD, and CPSD values were significantly different (p<0.05) between the groups. Smokers showed both diffuse and localised retinal sensitivity decrease. SF showed no significant difference (p>0.05) between the groups. CONCLUSION: In healthy, chronic, heavy cigarette smokers, retinal sensitivity was found to be decreased although central vision was not affected. This is possibly due to a cumulative effect of chronic smoking onto the retinal and/or optic nerve functions without clinically evident optic neuropathy.

Adult↗

[The effectiveness of glaucomatous visual field test using a size I stimulus].

PURPOSE: Perimetry using size I and III targets was conducted on glaucoma patients. The detectability of the visual field defects using a size I target and abnormal spatial summation was investigated. SUBJECTS & METHODS: Subjects were 14 eyes of 11 glaucoma patients with mild to moderate visual field defects and 11 eyes of 11 normal persons. Program 24-2 of the Humphrey Field Analyzer was applied to each subject. Based on the mean sensitivity and standard deviation at each coordinate in normal persons, the Z-score was calculated in the visual fields of glaucoma patients (absolute scotomas were excluded). RESULTS: The mean Z-score of retinal sensitivity, was less for size III than for size I in abnormal lesions, and less for size I than for size III in normal lesions (paired t-test, p < 0.01). Pathological spatial summation was found more frequently in normal lesions than in abnormal lesions. CONCLUSIONS: In mild visual field defects, size I detects abnormalities with greater sensitivity than size III. Perimetry using the size I target can be effective as a supplementary diagnostic method to detect and follow the early glaucomatous visual field.

Glaucoma↗

A clinical comparison of visual field testing between Goldmann-type manual perimetry and the Marco MT-336 automated perimeter.

A randomized, prospective clinical trial was performed to compare the Marco MT-336 automated perimeter with Goldmann-type manual kinetic perimetry. The number of true and false, positive and negative scotomas were counted, as determined by the findings on the Marco perimeter, assuming that the Goldmann perimeter was the "gold standard." For eight of the available programs, the accuracy specificity, sensitivity, positive predictive value and negative predictive value were determined. Chi-squared testing across and within programs was performed to determine the degree of agreement between the tests as to the presence or absence of scotomas. Additionally, McNemar's test was used to determine the amount of random disagreement between the two methods of testing. Although there are inherent difficulties in the analysis, the authors conclude that the Marco MT-336 perimeter is an accurate instrument for both detecting and ruling out the presence of visual field defects.

Adolescent↗

Structure-function relationships in the human visual system using DTI, fMRI and visual field testing: pre- and post-operative assessments in patients with anterior visual pathway compression.

The focus of this project is to improve our understanding of the relationships between brain structure and function in patients presenting with anterior visual pathway compression using functional MRI (fMRI), visual field(VF) maps and diffusion tensor imaging (DTI). Significant visual loss can occur when large pituitary lesions compress the optic chiasm. Surgical resection of these lesions decompresses the chiasm and can lead to visual recovery. In this preliminary study, we selected patients presenting with slowly progressive visual loss secondary to a compressive pituitary region mass. Using preoperative DTI data, we reconstructed white matter projections of the optic radiations and demonstrated a structural correlation with functional vision as quantified by formal visual field mapping and fMRI. The structural data generated through a fiber tracking algorithm may represent a potentially powerful tool to better understand functional visual deficits in patients with anterior visual pathway compression. Furthermore, we believe that specific patterns in preoperative DTI data may predict the likelihood of postoperative visual recovery in a select group of patients.

Brain↗

Monocular visual-field testing under binocular conditions.

Spectacles with plastic polarizers in front of each eye, with the polarizing axis at right angles to each other, permit monocular visual-field tangent screen testing under binocular conditions, provided a rotatable polarizer is attached in front of the standard ophthalmic slide projector which generates the test light.

Eyeglasses↗