June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Reclaiming the Periphery - Frequency of Seeing for Static Automatic Perimetry on Peripheral Isopters for Patients with Glaucoma and Healthy Controls
Author Affiliations & Notes
  • Vera Mönter
    Optometry and Visual Science, City University London, London, United Kingdom
    Ophthalmology and Visual Sciences, Dalhousie University, Halifax, NS, Canada
  • David Crabb
    Ophthalmology and Visual Sciences, Dalhousie University, Halifax, NS, Canada
  • Paul Artes
    Optometry and Visual Science, City University London, London, United Kingdom
  • Footnotes
    Commercial Relationships Vera Mönter, None; David Crabb, Allergan Inc. (R), Moorfields MDT (P); Paul Artes, Heidelberg Engineering, Germany (C), Haag-Streit AG, Switzerland (C), Carl Zeiss Meditec, Germany (C), Optovue Inc, CA, USA (C), Peridata GmbH, Germany (F)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 3916. doi:
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      Vera Mönter, David Crabb, Paul Artes; Reclaiming the Periphery - Frequency of Seeing for Static Automatic Perimetry on Peripheral Isopters for Patients with Glaucoma and Healthy Controls. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3916.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

Clinical visual field (VF) tests often focus on the central 30°; an area that neglects more than 80% of a person’s overall VF. However, vision in the far periphery is important for mobility, balance and guidance of attention. Our goal is to establish an automatic kinetic test for the peripheral VF (PVF), complementing standard automated perimetry of the central 30°. We test the hypothesis that there is a consistent relation between responses to static and kinetic stimuli in glaucoma patients and healthy controls allowing us to link both approaches.

 
Methods
 

PVFs of 15 patients (Mean age: 60 years, MD: -7.2 dB) with glaucoma and 15 controls (Mean age: 39 years) were examined with a fully automated kinetic test on the Octopus 900 (HAAG-STREIT). Stimuli with intensity of 15 dB (III1e) were presented moving at 5°/sec along 16 meridians (Fig1). The median response of three presentations was chosen to define the isopter. As a global measure for PVF defects we defined the mean isopter radius deviation (MIR dev) - the difference of the MIR and the MIR of the age matched normative isopter (Vonthein et al., 2007). For a subgroup of 7 patients and 11 controls frequency of seeing (FOS) curves to size III static stimuli (200ms) were measured at five locations on the isopter (Fig1). Psychometric functions were fitted to determine the sensitivity (50% seeing).

 
Results
 

The FOS showed a lower sensitivity for static [median (m): 11.8 dB, 95% CI: 11.3, 12.2] than expected from the kinetic stimuli (15 dB). The difference in sensitivity was similar for controls [m: 12.1 dB, 95% CI: 11.4, 12.7] and glaucoma patients [m:11.3 dB, 95% CI 10.8, 11.9] (Fig2) and was independent of location, age and eccentricity. MIR dev and MD of the central VF were not closely related [r2 = 0.35].

 
Conclusions
 

FOS data reveals a consistent difference between static and kinetic sensitivity in glaucoma patients and controls at isopter locations. Despite the different measurement acquisition, both approaches can therefore be combined to measure the peripheral and central VF. A difference in the extent of VF loss in central and peripheral areas may explain the low association between MIR dev and MD in glaucoma patients.

 
 
Fig1: Case example: PVF, CVF and FOS.
 
Fig1: Case example: PVF, CVF and FOS.
   
Keywords: 642 perimetry  
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