Eccentricity-specific dissociation of visual functions in patients with lesions of the central visual pathways.
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50 eyes of 50 patients with different types of glaucoma (27 eyes with POAG, 14 eyes with glaucoma due to pseudoexfoliation, 8 eyes with chronic narrow-angle glaucoma, 1 eye with normal-tension glaucoma) were examined with light-sense perimetry (Humphrey-Field-Analyzer, program 30-2) and resolution perimetry according to Frisén [2-7]. As the field area tested by Frisén's ring perimeter is smaller than that of the HFA, the comparison was restricted to the area of the ring perimeter, so that 50 out of 77 test locations of the HFA were included. In addition to a quantitative comparison with statistical criteria based on age-corrected normal values, a subjective qualitative assessment was established. The quantitative comparison of all hemifields showed good agreement in 61% of eyes, the ring perimeter indicating moderately and markedly increased numbers of defects in 13% and 4% of eyes and the HFA in 18% and 4% of eyes, respectively. Qualitative comparison of the entire fields revealed good agreement in 46% of eyes, with moderately and markedly more defects in 18% and 10% for the ring perimeter and 12% and 14% for the HFA, respectively. The average time needed for examination was 6.0 +/- 1.1 min for the ring perimeter and 17.2 +/- 2.7 min for the HFA. The Global Deviation of the ring perimeter correlates linearly with the Mean Deviation of the HFA (r = 0.4824, P < 0.001).
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75 eyes of 75 patients with different types of glaucoma (21 eyes with normal-tension glaucoma, 49 eyes with primary open-angle glaucoma and 5 eyes with pigmentary glaucoma) were examined by automated light-sense, flicker and resolution perimetry. All fields were classified as being "normal" (N) or having "diffuse loss" (D), "localized loss" (L) and "diffuse plus localized loss" (DL) in masked fashion. The frequency distributions for the various field loss categories against the highest intraocular pressure ever reported in the patients' records were plotted. The frequency distributions for the purely localized defects show a peak at 20 mmHg and are markedly skewed to low pressure values, while the diffuse plus localized damage and the purely diffuse loss, however, show a peak at about 30 mmHg. The data support the hypothesis that diffuse field loss may be an indicator of pressure-induced damage.
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