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Y. Hashimoto, F. Maeda, K. Tanzawa, G. Takizawa, Y. Kiyokawa, K. Kani, A. Tabuchi; Detection of Glaucomatous Visual Field Defects Using the Goggle-Type Pupil Perimeter. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5523.
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We devised a new type of pupil perimeter using a head mount display system.The display has an individual stimuli and recording system for each eyes, and it is possible to record the pupil light reflexes for each eyes simultaneously. Relative afferent pupillary defects can be analyzed. In this study, the detection of glaucomatous visual field defects was investic gated using the pupillary light reflexes caused by various pattern stimuli given to glaucoma patients.
The pupillary light reflexes of 18 subjects with glaucoma with different degrees of defects in the Humphrey visual field of the right and left eyes or the upper and lower regions of the same eye were measured using the goggle-type pupil perimeter.Two kinds of pattern stimuli were used for glaucoma to the Bjerrum scotoma and the nasal step defect which Chen et al (2005) described. The stimuli were given to the right and left eyes or the upper and lower regions of the same eye at an interval of 0.5 seconds following a one-second break. We averaged the numbers of the responses obtained from the detection and then calculated the ratio of RAPD (a direct light reflex pupillary contraction ratio / an indirect light reflex pupillary contraction ratio in terms of the pupil diameter of pre-stimuli-pupil diameter of post-stimuli/pupil diameter of pre-stimuli ×100(%)).
We compared our findings with the normal adult reference values found before, glaucomatous visual field defects could be detected in 86.6% with criteria at the 68.0% confidence interval by right and left eyes measurement respectively. Defects were also in 83.3% with criteria at the 95.0% confidence interval by measurement of the upper and lower regions of the same eye.
The goggle-type pupil perimeter can detect glaucomatous visual field defects in an objective manner, is available for one of the screenings of glaucoma.
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