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C. A. Castelberg, M. Zulauf, J. M. Wild; The Effect of Defocus on the Pulsar Perimetry in Normal Individuals and in Patients With Open Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5293.
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To determine the effect of defocus on Pulsar perimetry in normal individuals naive to any form of perimetry and in individuals with open angle glaucoma (OAG) experienced in Standard Automated Perimetry (SAP).
Thirty-one individuals (17 normal individuals [mean age 63.8 yrs, SD 8.2] and 14 with OAG [mean age 62.4 yrs, SD 8.2]) attended for perimetry on 5 occasions, each separated by one week. Those with OAG had previously undergone a mean of 10.9 (SD 5.5) examinations with SAP. At each of the 5 visits, each individual was examined in one designated eye with the SITA Standard algorithm and Program 24-2 of the Humphrey Field Analyzer 745i (Carl Zeiss Meditec, Dublin, CA) and with the TOP algorithm and Program CP-T30W of the Pulsar perimeter at one of each of 4 different levels of defocus (plano, +2.00 DS, + 4.00 DS and +6.00 DS). The order of the program within the visit and the order of defocus for the Pulsar perimeter were randomized within individuals and were varied over each of the five visits. The effect of defocus on the Group mean Mean Sensitivity (MS), Mean Defect (MD) and the square root of the Loss Variance (sLV) derived by the Pulsar was investigated using separated repeated measures ANOVAs. Age, designated eye, previous experience, pupil size, diagnostic group, order of perimetry and order of defocus were considered as between-subject factors; and defocus and visit as within-subject factors.
The Pulsar group mean MS (p<0.001), MD (p<0.001) and sLV (p<0.001) each deteriorated with increasing defocus. The slopes of the degradation in the group mean MS of the normal individuals and of the individuals with OAG were 1.5 dB and 3.0 dB per dioptre of defocus, respectively. The corresponding slopes for the group mean sLV were 0.27dB and 0.1 dB per diopter of defocus, respectively.
Refractive correction optimized for the viewing distance of the Pulsar perimeter is essential.
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