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K. Rohrschneider, A. F. Scheuerle; Static Versus Kinetic Perimetry in Glaucomatous Visual Field Defects. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5495.
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Computerized static perimetry is the technique of choice in follow-up of glaucoma patients. Goldmann perimetry offers the option to more clearly delineate the remaining visual field in advanced deterioration. We compared both techniques, the latter performed by an experienced technician, regarding sensitivity to detect early changes and the option to determine function loss caused by bundle defects in comparison to results of laser scanning tomography (HRT 2, Heidelberg Engineering).
375 eyes of 205 patients aged 64 ± 14 years (14 to 93) with glaucoma as well as glaucoma suspects were included. In all eyes computerized static perimetry (Octopus 500 or 900, Haag-Streit), Goldmann perimetry and laser scanning tomography was performed. Results of all examinations were analyzed independent from other exams. Perimetric results were evaluated semi-quantitatively according to Aulhorn glaucoma stages, MD values from automated perimetry were additionally used. We compared perimetric findings with glaucoma parameters of the HRT as well as evaluation of complete HRT measurements by two experienced observers.
Goldmann and static perimetry showed glaucoma stage 0 and 1 in 255 and 227 eyes, while MD in static perimetry was 7.3 ± 7.1 dB (Median 5.1 dB). There was high correlation between kinetic and static perimetry findings. However beginning field defects in computerized perimetry (MD 17dB global Moorfields classification was normal, while RB and FSM were negative in 49 of these eyes.
Although computerized static perimetry allows for reliable visual field technique with high sensitivity especially for beginning glaucomatous visual field defects, Goldmann perimetry performed by an experienced operator also gives valuable results and the number of fields with glaucoma stage 0 and 1 is only 15% higher in static perimetry. Field defects caused by complete nerve fiber bundle defects will be delineated with both techniques, while kinetic perimetry often gives better delineation of the arcuate border. Comparison of visual fields with HRT measurements mostly demonstrated more serious morphological damage, as expected. Besides FSM and RB classification, even the global Moorfields classification might even miss some advanced optic disc changes, although sectorial changes were often present.
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