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PubMed1982

Visual field changes in cone-rod degenerations.

The visual field test results from 20 patients with con-rod degeneration (CRD) from all inheritance patterns were reviewed. Typical fundus findings of CRD included optic disc pseudoedema, temporal disc atrophy, parapapillary and disc telangiectasis, and few to no retinal pigmentary deposits. Visual field changes were seen to be distinctive and, like electrophysiologic tests, were helpful in pointing to a retinal degenerative process rather than an optic neuropathy.

Adolescent↗

PubMed2006

Visual field defects and vision-specific health-related quality of life in African Americans and whites with glaucoma.

PURPOSE: To examine the relationship of visual field impairment to vision-specific health-related quality of life and symptoms in a large cohort (N=345) of African Americans and Whites of non-Hispanic origin diagnosed with glaucoma. MATERIALS AND METHODS: Participants consisted of persons > or =55 years of age recruited from university-affiliated ophthalmology and optometry practices in Birmingham, AL who had been diagnosed with glaucoma. Medical records were abstracted to collect information on demographics, visual acuity, and visual fields. A telephone survey was conducted to obtain information on vision-specific health-related quality of life [National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25)], glaucoma symptoms [Glaucoma Symptom Scale (GSS)], and cognitive status (Short Portable Mental Status Questionnaire). Visual fields were used to compute a visual field defect score for each eye based on the Advanced Glaucoma Intervention Study (AGIS) scoring system. RESULTS: Mean NEI VFQ-25 subscale scores ranged from the 50s to 80s. Scores for African Americans and Whites did not differ except for the general health and ocular pain subscales for which African Americans had slightly higher scores. For both African Americans and Whites, as the AGIS score became worse in the better and/or worse eye, there was a decrease in VFQ subscale score for most VFQ subscales including general vision, distance vision, near vision, social functioning, color vision, and peripheral vision (P<0.05). AGIS scores were unrelated to the GSS subscales in African Americans; for Whites, the visual but not the nonvisual subscale was related to AGIS score. CONCLUSIONS: Scores on most subscales of the NEI VFQ-25 and the 2 subscales of the GSS are highly similar in African Americans and Whites of non-Hispanic origin who have been diagnosed with glaucoma. In addition, for both African Americans and Whites, the VFQ subscales for the most part demonstrated good construct validity with respect to the extent of visual field impairment. Results imply that the NEI VFQ-25 and the GSS are appropriate instruments for studying the personal burden of glaucoma in studies whose samples involve both African American and White adults.

Black or African American↗

PubMed1985

Visual field and retinal nerve fiber layer comparisons in glaucoma.

Semiquantitative retinal nerve fiber layer (RNFL) scores given separately to diffuse and localized changes of the RNFL were correlated with the overall mean retinal sensitivity and visual field indexes calculated from 49 thresholds of the OCTOPUS program JO. The indexes have been developed to differentiate between generalized reduction and localized disturbances of the retinal sensitivity. The RNFL scores and visual field functions were highly correlated. Approximately 50% of the variation of the visual field functions could be accounted for by the RNFL loss scores. An adequate fit of visual field data on localized nerve fiber loss score was achieved by linear regression, whereas the diffuse nerve fiber loss score was improved by quadratic regression. This suggests that localized nerve fiber loss may be more directly associated with localized visual field disturbances than generalized fiber loss and that there may be a latency between the appearance of structural changes and generalized reduction of retinal sensitivity.

Glaucoma↗

PubMed1988

Modified grid laser photocoagulation for diabetic macular edema. The effect on the central visual field.

Modified grid laser photocoagulation has been shown to stabilize visual acuity in patients with diabetic macular edema, but the effect on extrafoveal visual function is uncertain. Automated static threshold perimetry was performed on 64 eyes of 36 patients before and after modified grid therapy with the argon green or krypton red laser. Twenty-eight eyes underwent two grid treatments for persistent macular edema. For all eyes tested, average threshold sensitivity in the central 5 degrees dropped 3.44 dB (standard deviation [SD], 3.79 dB) after the first treatment and 6.86 dB (SD, 5.02 dB) cumulatively after the second treatment. Qualitatively, the grayscale displays of the central visual field were darker after treatment, but the scotomata from laser photocoagulation could not be distinguished from those due to macular edema. The foveal threshold showed no significant change. In a subgroup of patients tested, color vision was not significantly improved and nearly all patients exhibited a tritan defect before and after treatment. No difference was detected between the argon and krypton groups. This suggests that with modified grid laser photocoagulation visual acuity and foveal threshold are preserved at the expense of generalized loss of threshold sensitivity across the central 10 degrees of the visual field.

Color Perception↗

PubMed1992

Progressive color visual field loss in glaucoma.

Twenty one eyes with primary open angle glaucoma were tested with standard (white stimulus-on-white background) and color (blue stimulus-on-yellow background) visual fields over a range of 6-26 mo. There was no significant increase in threshold between the initial and final standard fields overall or by quadrant (P less than 0.188, overall field). A significant increase in mean log thresholds for all areas of the color visual field (P less than 0.019, overall field) was found. Of the 21 patients, nine worsened by greater than 0.2 log units, two improved by greater than 0.2 log units, seven worsened by less than 0.2 log units, and three improved by less than 0.2 log units. When these same patients were matched to 21 normal eyes by age, lens density, and acuity they showed significantly reduced thresholds throughout their color visual fields (P less than 0.023). Whereas normal age-related increases in threshold for the short-wavelength system are only 0.10 log units per decade (n = 88), 10 glaucomatous eyes with increases of 0.14-0.75 log units were found within only 26 mo. The authors conclude that color visual fields may indicate significant change in visual function before it is apparent on standard visual fields.

Adult↗

PubMed2004

The Advanced Glaucoma Intervention Study (AGIS): 14. Distinguishing progression of glaucoma from visual field fluctuations.

PURPOSE: To determine the least worsening of a visual field (VF) and the least number of confirming tests needed to identify progression of glaucomatous VF defects. DESIGN: Cohort study of participants in a clinical trial. PARTICIPANTS: Seven hundred fifty-two eyes of 565 patients with advanced glaucoma. METHODS: Visual field tests were quantified with the Advanced Glaucoma Intervention Study (AGIS) VF defect score and the Humphrey Field Analyzer mean deviation (MD). Follow-up was 8 to 13 years. MAIN OUTCOME MEASURES: Two measures based on the AGIS VF defect score: (1) sustained decrease of VF (SDVF), a worsening from baseline by 2 (alternatively, 3 or 4) or more units and sustained for 2 (alternatively, 3) consecutive 6-month visits and (2) after the occurrence of SDVF, the average percent of eyes with worsening by 2 (alternatively, 3 or 4) or more units from baseline. Two similar measures based on MD. RESULTS: Based on the original AGIS criteria for SDVF (a worsening of 4 units in the AGIS score sustained during 3 consecutive 6-month visits), 31% of eyes had an SDVF. The percent of eyes with a sustained event increases by approximately 10% when either the minimum number of units of field loss or the minimum number of 6-month visits during which the loss is sustained decreases by 1. During 3 years of follow-up after a sustained event, a worsening of at least 2 units was found in 72% of eyes that had a 2-visit sustained event. The same worsening was found in 84% of eyes that had a 3-visit sustained event. Through the next 10 years after a sustained event, based on worsening of 2, 3, or 4 units at 2 or 3 consecutive tests, the loss reoccurred, on average, in >/=75% of study eyes. Results for MD are similar. CONCLUSIONS: In patients with advanced glaucoma, a single confirmatory test 6 months after a VF worsening indicates with at least 72% probability a persistent defect when the worsening is defined by at least 2 units of AGIS score or by at least 2 decibels of MD. When the number of confirmatory tests is increased from 1 to 2, the percentage of eyes that show a persistent defect increases from 72% to 84%.

Adult↗

PubMed1995

Central visual field changes associated with acquired pits of the optic nerve.

BACKGROUND: With the increased use of a hand-held indirect lens and slit-lamp biomicroscopy for stereoscopic viewing of the optic nerve, the authors believe that an acquired pit of the optic nerve is more common than was recognized previously. This increased recognition has led to the awareness that the central visual field was affected frequently in the presence of such an acquired pit. METHODS: The authors retrieved the charts of a series of 97 patients who had an acquired pit of the optic nerve during an 18-month period and retrospectively reviewed the automated visual fields associated with these pits using the Humphrey Visual Field Analyzer Programs 30-2 and 10-2 and looked for involvement of the central visual field. RESULTS: In 81.7% of the acquired pits of the optic nerves, one of the central-most test points (3 degrees from fixation) in the appropriate hemifield on the 30-2 format was depressed severely by Statpac II (P < 0.5). The authors therefore restudied as many patients as possible using the 10-2 format to determine the extent of central visual field involvement in the presence of an acquired optic nerve pit. Among these patients, the 10-2 format demonstrated that the approach of the defect to fixation varied, but was frequently inside 3 degrees, reaching between 1 degrees and 3 degrees from fixation in 96.7% of the eyes with depression of at least one central point on the 30-2 format. It was more likely that an acquired pit located at the inferior pole of the optic nerve would produce a visual field defect within 3 degrees of fixation than such a pit at the superior pole (P = 0.03). CONCLUSION: The authors showed that the presence of an acquired pit in an optic nerve damaged by glaucoma frequently is associated with a threat to fixation.

Adult↗

PubMed2001

Visual fields and foraging in procellariiform seabirds: sensory aspects of dietary segregation.

Retinal visual fields were determined using an ophthalmoscopic reflex technique in two seabird species of the family Procellariidae: white-chinned petrel Procellaria aequinoctialis and antarctic prion Pachyptila desolata. The binocular fields of both species show a similar shape but they differ in size and in the position of the bill within the field. In white-chinned petrels the binocular field extends vertically through approximately 140 degrees and has a maximum width of approximately 40 degrees. The bill is placed approximately central within the field. The binocular field of the prions is approximately half this width and vertical extent, and the bill is placed close to the ventral edge. These differences in binocular field topography can be correlated with the different foraging techniques that these birds employ when seeking a similar diet within the same environment. White-chinned petrels pursue individual items both at the surface and while diving to moderate depths. Antarctic prions feed primarily by filtering items from surface waters. These differences in visual field topography mirror those found in different terrestrial bird species that primarily employ visual or tactile cues in the pursuit of food items. White-chinned petrel eyes and visual fields show features of an amphibious optical design similar to those found in penguins and albatrosses.

Animals↗

PubMed1995

Visual field damage proximal to fixation in normal- and high-tension glaucoma eyes.

To compare in more detail the central visual field damage in normal-tension glaucoma (NTG) and high-tension glaucoma (HTG) eyes, a pointwise inner-group comparison of the data obtained with the Humphrey 10-2 was carried out in 68 NTG cases with maximum intraocular pressure (IOP) of < or = 21 mmHg and 62 HTG cases with maximum IOP of > or = 25 mmHg. All eyes had the usual field defects, with a mean deviation of > or = -15 dB (MD, STATPAC). Age, refraction and MD were matched between the two groups. Total deviation (TD, STATPAC), the difference between the measured threshold and the age-corrected normal reference at each test point of the 10-2 program, was used for pointwise inter-group comparisons. The data were analyzed with Wilcoxon rank-sum test and logistic discriminant analysis. The latter method was also applied to the data of the 30-2 program to confirm the results obtained with the 10-2 program. The comparisons using the different methods and programs gave consistent results. For a given amount of overall visual field damage in the two types of glaucoma, a superior arcuate area extending down to the horizontal meridian just nasal to the fixation point was significantly more depressed and an area inferior to the horizontal meridian and inferior temporal to the fixation point significantly less depressed in NTG eyes. HTG eyes were significantly more diffusely damaged in the central 10-degree visual field. NTG and HTG may have unique patterns of central visual field damage. These differences may implications in following NTG patients and studying the pathogenesis of this glaucoma.

Fixation, Ocular↗

PubMed1988

[Effects of learning experience to the visual field advantage on random form recognition].

In order to examine the effects of learning experience to the visual field advantage on random form recognition, two experiments were carried out with the successive matching task (Test). The learning task employed was to associate random forms with two letter nonsense words. In Exp. 1, 25 right-handed subjects participated in the five successive days to manipulate the levels of learning retention among them. In the first and third sessions, Tests (1, 2) followed the learning task. In the second and fourth sessions, only the learning task was carried out. In the fifth session, only Test 3 was conducted. In Exp. 2, the same subjects conducted only Test 4 at three months later, when their levels of retention were lowered. Results obtained were that shifts occurred from the left visual field advantage (LVF-A) for random form recognition in Test 1 to no visual field difference in Test 3 as the learning retention increased, and from no visual field difference to LVF-A again when the retention decreased in Test 4. The possibility as for the effects of learning experience in relation to hemispheric asymmetry was discussed.

Adult↗

PubMed2005

Whorf hypothesis is supported in the right visual field but not the left.

The question of whether language affects perception has been debated largely on the basis of cross-language data, without considering the functional organization of the brain. The nature of this neural organization predicts that, if language affects perception, it should do so more in the right visual field than in the left visual field, an idea unexamined in the debate. Here, we find support for this proposal in lateralized color discrimination tasks. Reaction times to targets in the right visual field were faster when the target and distractor colors had different names; in contrast, reaction times to targets in the left visual field were not affected by the names of the target and distractor colors. Moreover, this pattern was disrupted when participants performed a secondary task that engaged verbal working memory but not a task making comparable demands on spatial working memory. It appears that people view the right (but not the left) half of their visual world through the lens of their native language, providing an unexpected resolution to the language-and-thought debate.

Adult↗

PubMed2001

Overcoming the language barrier in visual field testing.

PURPOSE: To evaluate the effect of using recorded instructions in patients' native language compared with interpreter-assisted instructions on the reliability and duration of the visual field test. PATIENTS AND METHODS: Sixty patients referred for visual field testing were included in the study. Thirty-five had limited or no knowledge of the Hebrew language, and 25 control patients were fluent in Hebrew, the native language. None had previous experience with automated perimetry. Patients were randomized to receive recorded instructions on the visual field test in their native language or translator-assisted instructions by the technician before performing the test. For each patient, the time required for instructions and test performance and the reliability indices were documented. RESULTS: The method of instruction (recorded or interpreter-assisted) did not affect the time required for patient instructions (66 +/- 24 seconds and 57 +/- 30 seconds, respectively), the time for test performance (7.2 +/- 1.5 minutes and 7.8 +/- 1.8 minutes, respectively), and test reliability as measured by the rate of fixation losses. Regardless of the method of explanation, the time required for instructions and for performing the test were significantly shorter for Hebrew speakers than for non-Hebrew speakers. CONCLUSION: The use of a recorded explanation in the patient's native language before visual field testing is an applicable method for patient instruction. Clinics in areas with multilingual populations may use this method to save technicians time, without adversely affecting the time required for performing the test and its reliability.

Aged↗

PubMed1994

Advanced Glaucoma Intervention Study. 2. Visual field test scoring and reliability.

BACKGROUND: The Advanced Glaucoma Intervention Study (AGIS) is a multicenter, randomized clinical trial designed (1) to determine the better of two surgical management strategies for glaucoma when medical treatment alone no longer adequately controls the disease and (2) to clarify the clinical course and prognosis of open-angle glaucoma after surgical interventions have begun. The investigators of this study have developed quantitative methods to assess the test reliability and measure the severity of glaucomatous visual field defects with the 24-2 threshold program of the Humphrey Visual Field Analyzer. This report details these methods and presents information about long-term fluctuation during a time interval short enough to render change due to disease unlikely. METHODS: In AGIS, reliability assessment of automated visual field tests is based on the number of questions asked; percent of fixation losses, false-positive responses, and false-negative responses; and amount of short-term fluctuation. The AGIS visual field defect score is based on the number and depth of clusters of adjacent depressed test sites in the upper and lower hemifields and in the nasal area of the total deviation printout of the threshold program single-field test STATPAC-2 analysis. The score ranges from 0 (no defect) to 20 (all test sites deeply depressed). The fluctuation in score between two tests obtained during an interval preceding AGIS surgical interventions, ranging from 1 day to 6 weeks on 756 eyes of 562 patients, is analyzed. RESULTS: The scores of the first visual field tests, which determined eligibility for the study, range from 1 to 17. Large positive or negative interest fluctuations (absolute changes of 4 or more) occurred in the second tests for 16% of eyes; more scores improved (11%) than worsened (5%). The frequency of large fluctuations tended to increase as the time interval between tests increased. Absolute interest fluctuations were independent of age. CONCLUSION: For visual field tests obtained with the automated perimeter, AGIS investigators have developed objective, quantitative methods of scoring test reliability and severity of glaucomatous field loss. For 16% of eyes, long-term fluctuations were large enough (> or = 4 points) to suggest improvement or worsening of the glaucomatous defect even though the interval in which the fluctuations occurred was short enough (median time, approximately 1 week) to render changes in disease status unlikely.

Adult↗

PubMed1985

Oculokinetic perimetry: a simple visual field test for use in the community.

A method of visual field examination is described which enables an unsupervised person to carry out self-assessment using only a paper test chart, a record sheet, and a pencil. It is entitled 'oculokinetic perimetry' because it is the subject's eye that moves and not the test target. By providing non-ophthalmic health care workers with a simple means of performing perimetry in the community, and by allowing susceptible people to carry out self-assessment of the visual fields at home, this test should facilitate the detection and management of glaucoma, especially in underdeveloped countries.

Choroiditis↗

PubMed1996

Visual field defects in Alzheimer's disease patients may reflect differential pathology in the primary visual cortex.

The aim of this study was to test the hypothesis that differences in density of senile plaques (SP) and neurofibrillary tangles (NFT) in the cuneal and lingual gyri of area V1 of the visual cortex could explain the predominantly inferior visual field defects seen in patients with Alzheimer's disease (AD). The density of SP and NFT was measured in the cuneal and lingual gyri of 18 AD patients. In 7/18 (39%) patients, the density of SP and/or NFT was significantly greater in the cuneal compared with the lingual gyri. In 3/18 (17%) patients, densities were greater in the lingual than the cuneal gyri and in 8/18 (44%) patients there were no significant differences among gyri. The data suggest that pathological differences between cuneal and lingual gyri could contribute to the reported visual field defects in some AD patients.

Aged↗

PubMedDate not supplied

Clinical use of a new method for visual field damage classification in glaucoma.

This new method, based on the use of MD and CPSD (or CLV) visual field indices, can instantly classify not only the stage of glaucomatous visual field damage, but also the type of defect (localized, generalized or mixed). This system was used to study glaucomatous visual field defects in 500 automated tests, performed with either Humphrey 30-2 or Octopus G1 threshold tests. The most common defects found were mixed, and purely local defects were very unusual, especially in advanced glaucoma.

Chronic Disease↗

PubMed2006

[Reading performance in patients with central visual field disturbance due to glaucoma].

PURPOSE: To evaluate the relationship between central visual field disturbance due to glaucoma and reading performance. SUBJECTS AND METHODS: We evaluated the reading performance of 11 patients (14 eyes) with visual acuities of 1.0 and higher who had absolute scotoma within 3 degrees of the central visual field. The ages of the patients ranged from 37 to 77, with a median of 62 years. Maximum reading speed of texts printed horizontally and vertically was measured using MNREAD-J. Subjective reading difficulties were investigated orally. The relationship between the maximum reading speed of both horizontal and vertical texts, the subjective reading difficulties, the number of quadrants, and the position and continuity of absolute scotoma were evaluated. RESULTS: The mean maximum reading speed for vertical and horizontal texts by the 11 patients was 323 and 335 characters/minute(c/m), respectively, and was not significantly slower than that of normal eyes. In 2 of 14 eyes, a significant (p < 0.05) difference between maximum vertical and horizontal reading speeds was observed. In 3 of 14 eyes, absolute scotoma was distributed continuously in more than 2 adjacent quadrants, and these patients also had subjective reading difficulties. CONCLUSION: Reading difficulty is present in patients having absolute scotoma within 3 degrees of the central visual field when the scotoma involves more than 2 adjacent quadrants.

Adult↗

PubMed1992

[The effect of the intraocular pressure reduction on glaucomatous disc changes and visual field defects].

The authors prospectively studied changes in the optic disc and visual field associated with intraocular pressure (IOP) reduction for one year after surgery in 12 primary open-angle glaucoma eyes of 7 patients who underwent trabeculectomy because of elevated IOP despite maximum tolerable medical therapy and whose cup volume was demonstrated to be decreased at 3 or 6 months after surgery. Topographic parameters including C/D ratio, rim area and cup volume were determined by the Optic Nerve Head Analyzer plus (Rodenstock). The 30-2 central threshold field was obtained with a Humphrey Field Analyzer at the same time. Mean deviation (MD), corrected pattern standard deviation (CPSD) and total deviation (TD) were used to evaluate visual field changes. Significant improvement of C/D ratio, rim area and cup volume and significant IOP reduction were noted at 1 year after surgery as compared with preoperative baseline value (p less than 0.01). Also the MD was significantly decreased at 1 year after surgery, compared with the preoperative baseline value (p less than 0.05). There was a significant negative correlation between the preoperative MD and the percent change of the MD at 1 year after surgery (r = -0.80, p less than 0.01). Our results suggest that the decrease of optic disc cupping can persist over one year after surgery and that the early visual field defects in glaucoma eyes can gradually improve in association with the decrease of cupping.

Adult↗